Maternal deaths keep rising in US, raising scrutiny

Health experts think they know how to tackle the issue of rising pregnancy-related deaths in the U.S. The challenge is getting Congress to listen.

While rates of maternal mortality have declined in other industrialized countries, they have dramatically increased in the U.S. since 2000. About 700 to 900 women die in the U.S. every year from mostly preventable complications related to pregnancy, such as blood loss and high blood pressure. 

The scope of the problem isn’t widely known, even among some members of Congress, who have been focused on other public health issues like the opioid crisis.

{mosads}“The opioid epidemic is in the news cycle literally every day,” said Dr. Neel Shah, vice president of March for Moms, a march being held in Washington, D.C., in May that aims to raise awareness about maternal mortality and other issues.

“We think this is an issue that touches enough American families that it ought to get the same attention.” 

For every 100,000 live births in America, 26.4 women experience pregnancy-related deaths, according to a study published in The Lancet, a general medical journal. 

There is also a racial disparity, with black women four times as likely to die from pregnancy than white women. 

On average, among developed countries, there are 12 deaths per 100,000 live births, according to the World Health Organization. 

Why the U.S. struggles with pregnancy-related health problems is hard to answer, experts say, especially since the country isn’t very good at tracking and investigating deaths.

But a perfect storm of factors could be helping to push U.S. rates higher than any other industrialized nation’s.

First, an increasing number of women have health conditions that can complicate a pregnancy, including cardiovascular diseases. 

And while women are most vulnerable to health programs after a pregnancy, the U.S. is the only industrialized country that doesn’t guarantee paid leave for childbirth. American women are also less likely to have contact with their physician until six weeks after birth, even though most complications take place prior to that. 

Women in America are also waiting longer to have children than their mothers and grandmothers did, which is relevant because studies have shown that pregnancy is riskier for those who are 40 or older. 

Finally, the U.S. relies more heavily on C-sections than many other countries. The major surgical procedure comes with risks like infection and hemorrhaging. 

“There are really big differences when you look across the world at other developed nations,” Shah said. 

“A part of it is after women have the babies, they tend to be much more supported and tend to get everything they need in other developed nations.” 

In the U.S., bills that would address these issues, like paid parental leave, face an uphill battle in Congress. 

But two bipartisan bills that have been stuck in committee for about a year could make a difference in helping the U.S. understand, and eventually solve, its maternal mortality crisis.

The bills, sponsored by Rep. Jaime Herrera Beutler (R-Wash.) in the House and Sen. Heidi Heitkamp (D-N.D.) in the Senate, would support state-level efforts to form review committees that specifically track and investigate pregnancy-related deaths, and then look for ways to prevent future deaths from occurring. 

These deaths still aren’t widely tracked across the U.S.; the legislation would standardize current state efforts to do so and help states that don’t have committees create them. 

Despite having no organized opposition from members of Congress or outside groups, the bill hasn’t had a hearing, moved out of committee or been scheduled for a vote. It has 107 co-sponsors in the House, including 23 Republicans.

But having a better idea of where moms are dying and why can help shape policies to make sure it doesn’t happen to other women in the future, experts say.

“In terms of maternal mortality, you really do need the foundation of the data collection in order to really address the issue,” said Kathryn Schubert, chief advocacy officer for the Society for Maternal-Fetal Medicine. 

“We’ve been pushing really hard, and from my perspective, it seems like a no-brainer. It’s just a small thing that I think will help a lot of people.” 

Supporters and lobbyists have been pushing to get the bill attached to a must-pass public health bill, like the opioid crisis packages that the Senate and House health committees are voting on next week. 

It’s not clear if that will happen. The opioids bill released Tuesday by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) didn’t include it, though it could be added in via a manager’s amendment. A Democratic aide said Murray supports the bill being added in markup next week. 

Murray also said in a statement from her office she’s hopeful to vote “as quickly as possible on some important steps toward prioritizing maternal health and collecting better data about threats to new mothers’ lives.” 

Heitkamp said she would be pushing for that vote to happen.

 “We have a whole series of bills that we think really address incredibly challenging problems in America that people aren’t paying attention to. So we’re just going to round up those and start making some noise,” she said, referring, in part, to her maternal mortality bill. 

“We’ve been negotiating to get a number of our bills embedded in a couple of proposals out of the [Health, Education, Labor and Pensions Committee]. We’re hopeful that as things move over there, some of the ideas … will have a chance to find their way into legislation that we’re moving out this year.” 

On the House side, Herrera Beutler’s bill has been stuck in the Energy and Commerce Health Subcommittee for more than a year. A GOP committee aide couldn’t say if it would be included in the opioid package. 

“There isn’t anything specific holding it back, except for general inertia and congressional bandwidth,” said Cynthia Pellegrini, senior vice president for public policy and government affairs at the March of Dimes. 

“It’s a much better situation to be in than having actual organized opposition, but we’re still pushing the boulder uphill.” 

Rep. Michael Burgess (R-Texas), an OB-GYN and chairman of the Energy and Commerce Health Subcommittee, said in a statement through his office that he will “continue to seek solutions” to maternal mortality, but didn’t offer a timeline for Herrera Beutler’s bill. 

However, he said a necessary step in combating the issue is “improving the quality for the data reported.” 

Energy and Commerce Chairman Greg Walden (R-Wash.) also could not provide a timeline for considering the bill, saying he “would have to check.”

“I know it’s an issue, and we’re just so focused on opioids right now.”