The Sad Truth About U.S. Maternal Morbidity and What Can Be Done

Our country’s maternal mortality rates (MMR) may not be top of mind right now, while our nation struggles to overcome COVID-19, an economic recession, systemic racism, and climate change. But America’s failure to properly address maternal morbidity, despite the fact that every other developed nation has done so, is indicative of some serious underlying issues related to healthcare access, widespread misinformation, and racial and economic inequality.

What are maternal morbidity rates in the U.S.?

Earlier this year, the U.S. Centers for Disease Control (CDC) released its maternal mortality estimate for 2018. Based on their report, there were 17.4 maternal deaths per 100,000 live births in the U.S. in 2018, which means 658 women died either during pregnancy or within 42 days of giving birth. These numbers may not seem overly alarming until you compare them with other developed nations. The average maternal mortality rate for high-income countries is 11 deaths per 100,000 live births, and in some countries, including Norway and Italy, rates were as low as 2 per 100,000 live births in 2017. 

If we zoom out and consider the entire world, the U.S. is doing better than many underdeveloped countries. For example, the average MMR for low-income countries in 2017 was 462 deaths per 100,000 births. However, regions with high maternal mortality rates like southern Asia and sub-Saharan Africa have actually achieved substantial reductions in MMR over the past two decades, while the U.S. has seen a slow but steady increase. Between 2000 and 2017, southern Asia’s MMR fell from 384 to 157 deaths per 100,000 live births, and sub-Saharan Africa’s rate declined by 40%. Meanwhile, in the United States, the MMR has risen from 7.2 deaths per 100,000 live births in 1987 to 16.9 in 2016.

The sad truth is that hundreds of women die in the U.S. from preventable pregnancy-related causes each year. As with many other health indicators in the U.S., clear racial disparities exist when it comes to maternal mortality. Between 2011 and 2016, the CDC reported the following maternal mortality rates broken down by race: 

• Black non-Hispanic women: 42.4 deaths per 100,000 live births
• American Indian/Alaskan Native non-Hispanic women: 30.4 deaths per 100,000 live births
• Asian/Pacific Islander non-Hispanic women: 14.1 deaths per 100,000 live births
• White non-Hispanic women: 13.0 deaths per 100,000 live births
• Hispanic women: 11.3 deaths per 100,000 live births

Based on these numbers, Black mothers are more than three times as likely to die from pregnancy-related causes than white and Hispanic women. Although these numbers sound disturbing, they are not necessarily surprising, given the systemic racism and economic inequality within our country and healthcare system. 

Why are U.S. MMR rates so high?

No clear and easy answers exist to explain why the maternal morbidity rates within the U.S. are higher than every other wealthy nation. However, several factors are likely contributors. 

For one, many women in the U.S. are having children later in life, which can increase pregnancy risks. Our country’s fragmented healthcare system bears some of the blame, because millions of Americans don’t have health insurance, and uninsured mothers may have difficulty receiving quality care. Also, many pregnancies are  unplanned, which means that prevalent chronic health issues, including heart disease, diabetes, and hypertension, are sometimes left unaddressed prior to pregnancy. Evidence also suggests that mothers in the U.S. undergo a high rate of unnecessary C-sections, which pose a greater risk of life-threatening complications.

For many years, analysts focused primarily on decreasing infant mortality rates in the U.S., because many believed maternal mortality had largely been solved. To be fair, the data on maternal morbidity has been scarce or unreliable over the years, and even the current estimates are probably conservative. Ideally, both mothers and their children should receive the highest level of care, and now that we have a better grasp on the issue, hopefully we can begin to address it in a holistic and intersectional way.

How can we address the issue of maternal morbidity?

Individuals can only do so much to address mammoth issues like maternal morbidity within the U.S.. As we’ve noted, maternal morbidity interconnects with other systemic issues, ranging from racism and economic inequality to fractured healthcare and mass misinformation. 

A good first step in addressing MMR might be to promote good public health and broach issues that contribute to maternal mortality, such as unplanned pregnancy and sexual and reproductive health. Educational entertainment provides a perfect vehicle for disseminating this kind of important public health information.

At Population Media Center (PMC), we’ve had measurable success reaching audiences and encouraging positive behavior change related to sexual and reproductive health in countries around the world, including the U.S. Our hit television program East Los High featured episodes involving teen pregnancy, family planning, and reproductive health. Researchers concluded that East Los High had a “wide audience reach, strong viewer engagement, and a positive cognitive, emotional, and social impact on sexual and reproductive health communication and education.”

As with all PMC radio and television programs, East Los High combines entertainment industry insights and behavior theory to create engaging characters and storylines that combat deeply ingrained social norms. The show not only holds the interest of viewers with cliff-hangers, plot twists, relatable characters, and engaging storylines, but it also allows audiences to learn from the mistakes of fictional characters and avoid the same missteps in their own lives.  

East Los High and other PMC shows, including Último Año (“Last Year”) and the brand new Vencer el Miedo (“Overcome the Fear”), which premiered on Univision this year, all work to address issues such as unintended pregnancy through engaging, theory-based entertainment. The hope is the combined impact of these shows and other PMC programs can help reverse issues like maternal mortality and other barriers to PMC’s overarching mission: creating a sustainable planet with equal rights for all. 

Discover how world population size relates to sustainability and public health.

Just as maternal mortality rates are exacerbated by systemic racism, economic inequality, and misinformation, the world’s wildly unsustainable population growth has profound impacts on nearly every issue known to humankind. See how everything is connected in our World Population Day infographic.