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What is happening with the U.S. pregnancy mortality rate?

Blissful Doula Pregnancy Mortality

1987 was the first year that the Centers for Disease Control and Prevention began collecting data on pregnancy mortality. 2012 is some of the most recently available data. Here’s the arc from 1987 to 2012 in visual form:

USA Pregnancy Mortality Rate

As you can see, the rate is going up. In fact, it has doubled.

As of these 2012 numbers, the pregnancy mortality rate was about 17.8 deaths within every 100,000 live births.

If you look at more recent numbers, however, it’s about 23.8 deaths per 100,000 live births. What’s worse: between 2000 and 2014, the pregnancy mortality rate rose 27 percent in the United States. In 157 other countries, the rate dropped. At that last link, they even call this “a national embarrassment.”

There’s no definitive reason for the increase, although the common reasons given in most articles are:

  • Women having children later, on average
  • Pre-existence of diabetes or heart/blood conditions
  • The rate of C-Section use in the United States

The last bullet is interesting. C-Section use is about 32 percent in the United States, or roughly 1 in 3 births. That’s double the recommended percentage from the World Health Organization.

I just want to be careful in this section that I’m not advocating for any specific approach to your pregnancy and delivery. As a doula, I’ve worked with different kinds of mothers who wanted all different kinds of experiences, and I understand the need for a C-Section in certain cases. But you can’t ignore it as a factor in these numbers, either.

There’s also this, from WBUR:

The study says access to health insurance or health care may contribute to increased maternal mortality. Almost half of the counties in the U.S. do not have a practicing OB-GYN or midwife. Texas had the highest or nearly highest uninsured rate in the country during this period. Between 2010 and 2012, as Texas was closing some women’s health clinics, the mortality rate in that state doubled.

31 industrialized nations report pregnancy mortality data to the OECD, and right now, the U.S. — off the 23.8 per 100,000 figure above — would rank No. 30 in pregnancy mortality rate. Only Mexico would be behind us.

I’m not a medical doctor, so I won’t belabor a ton of these different points. Let me offer a few quick items in summary, though.

  • In general, pregnancy is safe. While it’s a massive concern that the number is rising, it’s still less than 25 out of 100,000 live births where maternal death may occur. I wouldn’t let any of these numbers make you not want to be pregnant.
  • … that said, it is a time of risk: And it is true that people are having children later and later, in part because of concerns about their savings rate.
  • Your best bet is to… Do research, see a doctor, and assess your health risks. Put a lot of thought, and effort, into your birth plan and how you want to bring a child into the world. This is one of the biggest decisions of your life, and a moment you will remember forever. It shouldn’t be taken lightly. If you’re at risk, work with people who understand the risks and can mitigate them. Even if you’d prefer a doula/midwife to a conventional OB/GYN delivery, we can always point you towards doctors who specialize in your risk area. In any geographic area, people responsible for helping bring life into the world are a huge network. We may operate at different points along the network, but we can all refer out to the best resources for your specific needs.

If you have any questions, feel free to message me. I’d be happy to talk more about it.

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My service area includes in and around Boston, Central and Western MA, including Amherst, Acton, Boston, Brookline, Cambridge, Groton, Lincoln, Newton, Northampton and Wellesley.

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