The Maternal Health Crisis in the United States

Despite being a developed, high-income country, the United States has one of the poorest outlooks when it comes to maternal health. According to the World Health Organization, “maternal health refers to the health of women during pregnancy, childbirth and the postnatal period… Although important progress has been made in the last two decades, about 295 000 women died during and following pregnancy and childbirth in 2017. This number is unacceptably high” (World Health Organization). Despite participation in the Millennium Development Goals (MDGs) and spending more than any other country on hospital-based maternity care, the maternal mortality ratio (MMR) in the U.S. remains at about 17 deaths per 100,000 live births (Chan School of Public Health).?

Even more detrimental is that this statistic widens by race. Black and Indigenous women are 3 times more likely to die from pregnancy compared to white women. Women of all races today are twice as likely to die from pregnancy complications than their mother was a generation before and the US is the only high resource nation with consistent rising maternal mortality rates. Factors that go into these statistics are decreased access to healthcare services, structural racism, implicit bias, and underlying chronic conditions. What we’re seeing is that generally, women of color lack access to high quality reproductive health education and resources, they also face discrimination in healthcare settings. Maternal mortality rates are highly affected by socioeconomic status and geography. Women living in poverty and women in certain states experience higher MMRs than the national average because of lack of access and equitable care.?

How can we combat this issue?

We need to focus on educating providers, clinics and people leading the programs such as the Supportive Pregnancy Care program sponsored by March of Dimes, to push the need for expecting mothers to attend prenatal visits as well as keep up to date with their doctors’ appointments. Prenatal care prevents complications and informs women about important steps they can take to protect their infant. The percentage of women in less urban areas living below the poverty line is even lower, compromising broader areas of their health as well. There needs to be a shift toward culturally specific and relevant conversations that cover the health issues these groups of women face specifically. Black women are more likely to not have their needs and voices heard in the healthcare setting so it will be imperative to make sure these women have the tools and confidence to find a provider that meets their needs and if they can’t, then to help them take control of their healthcare. The Biden administration’s proposal to extend Medicaid coverage to one year postpartum would provide millions of lower-income women with needed health care during the postpartum period. Comprehensive reproductive health coverage among other proposals, including expanding and diversifying the maternal care workforce, could decrease the number of preventable deaths and also reduce racial and ethnic inequities in U.S. maternal deaths (Commonwealth Fund).

Works Cited

Chan School of Public Health. “Maternal Health in the United States – Maternal Health Task Force.” Maternal Health Task Force, https://www.mhtf.org/topics/maternal-health-in-the-united-states/. Accessed 4 February 2023.

Commonwealth Fund. “The U.S. Maternal Mortality Crisis Continues to Worsen: An International Comparison.” Commonwealth Fund, 1 December 2022, https://www.commonwealthfund.org/blog/2022/us-maternal-mortality-crisis-continues-worsen-international-comparison. Accessed 4 February 2023.

World Health Organization. “Maternal health - GLOBAL.” World Health Organization (WHO), 2023, https://www.who.int/health-topics/maternal-health#tab=tab_1. Accessed 4 February 2023.