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Published On: 1.29.2015 North Carolina

America Slips to 31st as The Best Place to be a New Mother

 

A new report from Save The Children shows that the U.S. has increasing maternal death rates and trauma due to pregnancy and childbirth, compared to the rest of the world.

Somalia continues to be the most dangerous country to be a mother where one out of seven births end in death of the mother. Finland ranks No. 1 where the odds are one in 12,000. The United States has fallen to Number 31, falling behind countries like Iran and Romania.

In fact, the U.S. maternal mortality rate is on the increase along with only eight other countries in the world  — joining Afghanistan and seven African countries.

“The U.S. position is surprising,” said Carolyn Miles, CEO of Save the Children. “When we first started doing this study 15 years ago, the U.S. was No. 4.”

Many countries have made significant improvements within the last ten years and have “leapfrogged” over the U.S. while America has “failed to improve”.

The study cites risk factors for American expectant mothers:

  • Waiting to have babies later in life
  • Having more C-sections
  • Complications due to obesity and diabetes
  • Unnecessary C-sections

The United States is ranked No. 3 in the world for C-sections, with 30% electing surgical deliveries.

New mothers in America experience unequal treatment. In Scandinavia, with universal healthcare, moms have much better outcomes – unlike the U.S.  “What is really striking in the U.S. is the inequality,” said Miles.

According to the report, 18 new mothers died for every 100,000 live births in 2013, which is double Saudi Arabia and Canada. “A black woman in New York has a worse mortality rate than a woman in Iraq,” Miles said.

The largest increase in deaths was in women aged 20 to 24.

rise in obesity and diabetes play a role, although it is difficult to isolate a single cause. Obesity is a leading cause with a higher risk of hypertension and C-section delivery where the birth canal may be obstructed and a much greater chance for infection, where bacteria gets into fat deposits where it multiplies more quickly.

Birth by Appointment

The trend to induce early delivery by scheduling births (Convenience Births) is of concern. Women are encouraged to complete a full 40 weeks of pregnancy before induction.

While being done with pregnancy may seem tempting during those last few weeks, inducing labor is associated with increased risks including prematurity, cesarean surgery, hemorrhage and infection.

Pulmonary embolism and hemorrhaging — or uncontrolled bleeding — are two of the top causes of maternal mortality. After birth when the placenta separates, the uterus clamps down to stanch the bleeding, but if the womb is tired and may be infected from long labor, or suffers other complications the prevent shrinking, a woman can lose her entire blood volume in 10 minutes.

Keeping Mom Safe

Some countries, like Afghanistan, have had great success with mother mortality rates through the use of trained midwives and birth attendants, and the same idea can be applied in the U.S., said Miles, by putting a focus on community healthcare in poor neighborhoods.

“Our health care systems really don’t cater to the most disadvantaged people,” said Miles. “It’s a blanket system that gives many people access, but ignores high-risk populations.”

The Affordable Care Act seeks to get coverage for more women and mandates that insurance covers 100% of prenatal care, maternity care and contraception.

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