Every year in the United States, an estimated 600 to 800 women die from pregnancy or childbirth complications, and tens of thousands experience severe complications, from shock to kidney failure.
And these numbers appear to be growing.
The rate of severe complications related to labor and delivery rose almost 200 percent from 1993–2014, the latest year for which statistics are available, according to the U.S. Centers for Disease Control.
And while maternal mortality fell by almost half globally in recent years, several studies indicate it’s on the rise in the U.S. The maternal death rate increased by 27 percent from 2000–2014 for 48 states and Washington, D.C., according to an analysis published in the American Journal of Obstetrics & Gynecology. Among wealthy countries, the U.S. ranks near last place and also falls behind many poorer countries, such as Bosnia and Herzegovina and Libya.
What are the causes of maternal deaths in the U.S., and how can we prevent them and the rising tide of near misses? We spoke with Dr. Mary D’Alton, who is drawing national attention to the problem and working toward making pregnancy and childbirth safer.
As chair of the Department of Obstetrics and Gynecology at NewYork-Presbyterian/Columbia University Medical Center and director of services at NewYork-Presybterian Sloane Hospital for Women, Dr. D’Alton specializes in high-risk pregnancies. She also serves as co-chair of the Safe Motherhood Initiative, which has implemented changes in New York State hospitals to reduce maternal deaths and serious complications. On Mother’s Day 2018, NewYork-Presbyterian/Columbia will open what’s thought to be the nation’s first multidisciplinary center to focus specifically on caring for pregnant women with complex medical and surgical conditions.
Why aren’t maternal deaths going down in the United States?
The nature of women delivering children over the last 20 years has significantly changed. Number one, many pregnant women are older, and as women age they are more likely to have more complications medically and surgically. Obesity, which is on the rise, also increases risk in pregnancy, and women today are more likely to have chronic hypertension (high blood pressure) and diabetes.
Another factor we see in our center, thanks to medical and surgical advancements, is that women who have had organ transplants, have a history of cancer, or suffer from a chronic condition, such as cystic fibrosis or congenital heart disease, are becoming pregnant. These are women who previously were not considering pregnancy and are now becoming pregnant.