Women in the USA have a higher risk of dying of pregnancy-related complications than those in 40 other countries, according to a new report, Deadly Delivery: The Maternal Health Care Crisis in the USA, by Amnesty International. And while countries around the world are fighting to reduce maternal mortality to meet Millennium Development Goal 5, maternal mortality ratios have more than doubled in the US from 1987 to 2006.
The report states: "The USA spends more than any other country on health care, and more on maternal health than any other type of hospital care. Despite this… the likelihood of a woman dying in childbirth in the USA is five times greater than in Greece, four times greater than in Germany, and three times greater than in Spain."
As Sarah Boseley writes in The Guardian, “The damning report comes in a year of unprecedented international effort to reduce the death rate among mothers in developing countries, which will include a major conference called Women Deliver in Washington in the summer. The cause has been taken up by Secretary of State Hillary Clinton as well as Sarah Brown in the UK.”
When it comes to healthcare in the US, the lives of poor, uninsured, African American and Native American women are put at a much higher risk. There are severe obstacles that women in the US face when attempting to get necessary services, including: discrimination; financial, bureaucratic and language barriers to care; lack of information about maternal care and family planning options; lack of active participation in care decisions; inadequate staffing and quality protocols; and a lack of accountability and oversight.
While the report highlight the rise in maternal deaths, it also reveals that severe pregnancy-related complications that nearly cause death – known as near misses – are rising at an alarming rate as well, increasing by 25% since 1998. Currently nearly 34,000 women annually experience a "near miss" during delivery.
Amnesty International is calling on the US government to take the appropriate steps to end maternal mortality. They suggest:
1. The US Congress should direct and fund the Department of Health and Human Services to establish an Office of Maternal Health with a mandate that includes:
- improving maternal health data collection and review, in collaboration with agencies such as the Centers for Disease Control and Prevention;
- protecting the right to non-discrimination in maternal health care, in collaboration with the Department of Health and Human Services’ Office for Civil Rights and the Department of Justice; and
- recommending necessary regulatory and legislative changes to ensure that all women receive access to good quality maternal care.
2. The US Congress should increase funding for the Federally Qualified Health Center program in order to ensure an adequate number of health service facilities and health professionals in all areas, in particular in medically underserved areas.
3. Health departments in all states should ensure that pregnant women have “presumptive eligibility” or temporary access to Medicaid while their permanent application for coverage is pending.
4. Health departments in all states should improve maternal health data collection and review by:
- establishing a maternal mortality review board;
- including a maternal death checkbox on their standard death certificate; and
- mandating reporting of maternal deaths.