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Why are pregnancy-related deaths rising in the U.S.?

·Senior Editor

The 360 is a feature designed to show you diverse perspectives on the day’s top stories.

Speed read

What's happening: Pregnancy-related deaths are rising in the United States, and according to a new report from the Centers for Disease Control and Prevention, 60 percent of those deaths are preventable. The U.S is the only developed country in the world in which maternal mortality rates are rising.

About 700 women die from complications related to pregnancy or childbirth in the U.S. each year, the CDC reported. That number includes deaths recorded at some point during a pregnancy, during and immediately after childbirth, and for up to a year postpartum. Women of color had significantly higher rates of maternal mortality. Black women in particular were more than three times as likely to have a pregnancy-related death.

Why there's debate: Though pregnancy-related deaths — relative to other causes of death for women — are considered rare, the CDC's report raises questions about how and why rates within the United States could be getting worse when they are improving in other developed countries.

The high rates of maternal mortality in the United States have been attributed to a combination of factors including lack of access to insurance and medical care, poorly equipped hospitals and an insufficient focus on postpartum health.

Others point to the stark racial variation in death rates as evidence of institutional racism within U.S. medical and health care systems. Celebrities such as Serena Williams and Beyoncé have drawn attention to the issue by sharing stories of their own health challenges related to pregnancy.

What's next: The need to lower high maternal mortality rates has become an increasingly common issue for lawmakers in recent years. Congress passed two bills aimed at addressing the problem in December. Last week, Sen. Corey Booker and Rep. Ayanna Pressley introduced a bill calling for expanded Medicaid coverage for mothers. Sen. Kamala Harris and Sen. Elizabeth Warren have floated their own proposals as part of their presidential campaign platforms.

California is seen as a model for national programs. The state has cut its rate of women dying in childbirth by more than half since 2006.

Perspectives

Racial bias makes black women less likely to get the care they need.

"The cause is a social one, and the suspected assailant is chronic stress brought on by being a black woman in this country." — Priska Neely, LAist

"Recent studies have indicated that implicit biases can result in doctors spending less time with black patients. When seen, black patients’ reports of pain are often discounted or underestimated." — Jason Kuruvilla, Rachel Mayer and Alison Dingwall, Baltimore Sun

Placing blame on mothers lets flaws in the medical system go unchecked.

"First, everyone — from doctors to the media to the public — needs to stop blaming women for their own deaths." — Monica R. McLemore, Scientific American

"At least 30 states have avoided scrutinizing medical care provided to mothers who died.... Instead, many state committees emphasized lifestyle choices and societal ills in their reports on maternal deaths." — Laura Ungar, USA Today

Bad insurance coverage blocks women from potentially life-saving care.

"The only way to solve America’s maternal mortality problem is to fix its insurance problem. That’s the clear takeaway from a widening pool of research. The majority of deaths involving pregnancy and childbirth aren’t happening in the delivery room, they’re happening after a woman has a baby — sometimes months after." — Julia Belluz and Nina Martin, Vox

Delivery rooms lack standardized procedures for treating childbirth emergencies.

"The analogy would be if you had a cardiac arrest and everyone had their own way of doing CPR. We've made big advances in emergency care by having some basic standardized approaches to emergencies. That's what we're bringing to maternity care now." — Stanford Medicine professor Elliott Main quoted by NPR

There aren't enough doctors in rural areas.

"Maternity care is disappearing from America’s rural counties, and for the 18 million women of reproductive age living in those areas, pregnancy and childbirth are becoming more complicated — and more dangerous." — Adriana Gallardo and Nina Martin, ProPublica

Doctors focus on the baby's health at the expense of the mother’s.

"Today those conditions are entirely treatable, but they persist because medical attention focuses overwhelmingly on the child, not the mother.… These legislative and medical efforts are symptoms of a culture that values fetal health and development over the health and safety of mothers." — Melissa Reynolds, Washington Post

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