Despite its enormous
wealth and highly advanced technology, the United States lags far behind other
industrialized countries — and even some developing ones — in providing
adequate health care to women during pregnancy and childbirth.
The U.S. ranks 41st in a new analysis of maternal mortality rates in 171
countries released by a group of U.N. public health experts on Friday. The
survey shows that even South Korea is ahead of the United States.
“Women are unnecessarily dying from pregnancy and childbirth complications
because the U.S. is moving in a wrong direction,” said Beneva Schulte of Women
Deliver, a Washington-based group that campaigns for women’s reproductive rights
and access to public health care.
Based on 2005 estimates, the U.N. analysis suggests that one in 4,800 women in
the United States carries a lifetime risk of death from pregnancy. By contrast,
among the 10 top-ranked industrialized countries, fewer than one in 16,400 faces
a similar situation.
The reason? In many European countries and Japan in the industrialized world,
women are guaranteed good-quality health and family planning services that
minimize their lifetime risk.
Many independent experts and sympathetic legislators hold the current U.S.
public health policy responsible for its dismal record because some 47 million
U.S. citizens have no access to health insurance. Most of the uninsured are
African Americans and other minorities.
“We must ensure that pregnant women are covered,” said Rep. Lois Capps, D-Calif.
“Even if we have the best technology, not everyone has the access to health
Capps added that the scope of the problem could be even worse than it appears.
“We have to improve our data collection,” she said. “I don’t think we have all
U.N. experts who prepared the analysis said they developed a new approach for
estimating maternal mortality that seeks both to generate estimates for
countries with no data and to correct available data for underreporting and
They said inconsistency in data on deaths and on classification of those deaths
creates broad uncertainties in many places, even in developed countries. But all
estimates almost certainly understate the problem.
Responding to inquiries by IPS, a U.S. public health official identified “racial
disparity” as the most significant factor underlying the high U.S. maternal
mortality rate. “Black women are four times more vulnerable than whites,” said
Eve Lackritz, chief of the Maternal and Infant Health branch of the Centers for
Disease Control and Prevention.
In Lackritz’s view, obesity and hypertension are two leading causes of
pregnancy-related risks in the United States. “We have to be more responsive,”
she said. “This is one of our big problems.”
The U.S. situation within the industrialized world aside, the other end of the
spectrum shows there are 10 countries — all of them in Africa except for
Afghanistan — where high fertility and shattered health care systems are
causing extreme risks for pregnant women.
According to researchers, in countries like Somalia, Mali, Chad, and Niger, on
average more than one in every 15 women is likely to die of pregnancy-related
causes. In Niger, the estimate suggests that one in seven women is vulnerable to
death during pregnancy.
This analysis comes at a time when many development activists and U.N. officials
are trying to evaluate how far the world has progressed in meeting the
millennium development goals agreed upon by world leaders some seven years ago.
When the world leaders attended a summit in New York in September 2000, they
agreed that the goals must be achieved by 2015. That commitment included policy
initiatives to reduce maternal mortality by 75 percent.
Many experts believe that in the past seven years nothing much has changed for
the millions of poor women with regard to their economic wellbeing and access to
As reported by the British medical journal the Lancet this week, at the current
pace, there is almost no hope that the world will be able to achieve the 75
Annually, about 20 million women undergo unsafe abortions, which, according to
the journal, is a major factor in maternal deaths and illness.
Reproductive rights activists say governments must take drastic steps to reverse
the situation if they are serious in meeting the goal regarding maternal
mortality rates in the next seven years.
“We still have the situation we had 20 years ago,” said Ann Starrs of the
independent group Family Care International in a statement. “Half a million
women die every year from the complications of childbirth.”
A recent study by Harvard University professor Ken Hill found that between 1990
and 2005, maternal deaths did fall, but by less than 1 percent a year. Hill and
many other researchers estimate that at least 10 million to 20 million women
suffer injuries from the complications of childbirth every year.
Experts say this suffering could be easily avoided if international donors
contributed just $6.1 billion within the next seven years.
From Oct. 18-20, more than 1,500 world leaders are planning to convene in London
for “Women Deliver,” a global conference that will focus on creating political
will and strengthening health systems to prevent the death of “one woman every
minute of every day during pregnancy or childbirth.”
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