Most poorer countries have seen major drops in maternal mortality since 2000. While wealthy countries are generally seeing a flatlining or slight increasing trend, the rate has nearly doubled in the US. Acutely, (ie the medical issue not social causes) what is causing this to happen? What illnesses are pregnant women now getting more frequently? Why were we able to avoid these in a time (2000) where information sharing and technological capabilities were much worse? Don’t we have a good grasp on the general process of pregnancy and childbirth and the usual issues that emerge?
It seems as if the rise of technology in medicine, increasing volume of research on the matter, and the general treatment level of US hospitals would decrease or at the very least keep the rate the same. How is it that the medical knowledge and treatment regimens have deteriorated to such an extent? Are the complications linked to obesity?
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At least a partial explanation is the increase in obesity among adult women.
In 1995 some 25% of the population in the US were obese or extremely obese. Today that’s approximately 50% of the population, and it’s especially prevalent among low-income women…ie, the people with the worst health insurance.
Obesity and pregnancy is in general a risky combination with a whole slew of issues that makes pregnancy high risk (both directly and indirectly, with comorbidities like diabetes). It also increases the risk for a pre-term delivery and increases both the chance that a cesarean delivery will have to be performed and makes it more difficult to perform.
Also note that the problem with maternal mortality is extremely different between the states. If you just look at the US as a whole the problem is bad, but not looking at it on a state-by-state basis obscures exactly how bad it is. In California maternal mortality is equivalent to some of the best European countries (ie, really good). In Mississippi it’s worse than Mauritius and almost as bad as Guatemala (ie, *much* worse than it should be).
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