Bringing a child into the world is without a doubt one of life’s most special joys. Every day in the U.S. an average of 10,800 children are born (a new baby every 8 seconds). As the leader of the free world, the U.S. has some of the best healthcare facilities, doctors, and hospitals on the planet. So why is it, then, that the mortality rate for mothers has been steadily rising in the U.S. over the last few decades?
USA TODAY recently published findings from a 4-year investigation led by reporter Alison Young into the surprisingly high number of mothers who are dying during childbirth. The investigation yielded truly startling data, and when one looks at the numbers, it’s easy to see: the U.S. is now the “most dangerous” developed nation in the world in which a mother can give birth.
Their investigation combed through more than 500,000 pages of internal hospital quality records and studied cases of over 150 women who had their childbirths go wrong.
Women are dying and suffering life-altering injuries during childbirth not because the U.S. lacks in terms of preventable technology or medical equipment, but because hospitals and doctors are not following long-known safety protocols when it comes to delivering babies.
Investigation Findings Should Alarm Us All
Birth injuries have been common – or at least more common than many think – for, unfortunately, most of human history. In early America, during the 17th, 18th, and 19th centuries, it was quite common for mothers to sustain injuries or die during an especially difficult childbirth.
But those days are long behind us, and with the 20th century came a sharp decline the amount of injuries women and babies sustained during the birthing process. As we marched into the 21st century, developed countries around the world have lowered their rates of maternal death and injuries by aggressively monitoring care and learning from errors. Somehow, as the mortality rates have steadily decreased in the rest of the developed world – western Europe, especially – they have trended in the opposite direction in the U.S.
From 1990 to 2015, the Lancet Journal’s study of maternal mortality shows that deaths per 100,000 births in Germany fell from 20 to 9, in France from 17 to 8, and in Japan from 13 to 6. Yet over the last 2 decades, the maternal mortality rate in the U.S. has climbed each year, from 17 deaths per 100,000 births in 1990 to 26.4 in 2015.
This, of course, is counterintuitive: One should rightly expect that with growth in technology, medicine, and medical knowledge, the death rates among childbearing mothers would continue to decrease, year over year. And while this is mostly true for the rest of the developed world, the U.S. has instead found itself to be the country with the highest maternal mortality rate.
The USA TODAY investigation found that each year, 50,000 American mothers are severely injured during childbirth and 700 others die. Most of these deaths and injuries can be attributed to 2 main and preventable causes: hemorrhaging and severe hypertension; the latter of which requires hospital staff and doctors to keep a close watch on a patient’s blood pressure and blood loss levels. Blood-level complications can cause mothers to die of stroke, blood clots, or infection. The mothers who survive such injuries aren’t off scot-free; instead they’re left paralyzed or unable to have more children.
These figures are obviously much too high. So, what are the reasons behind our country’s counterintuitive increase?
Better Technology Does Not Stop Blood Loss
Many of the solutions to the high-mortality problem are cheap, inexpensive, and unrelated to technology, the investigation found. They are also the same fundamental protocols that have been recommended for years. Doctors and medical staff should be weighing bloody pads to better track patient blood loss. When it comes to high blood pressure, which can lead to stroke and irreversible brain damage, doctors should be giving mothers medication sooner, within an hour of high blood pressure being detected.
In a televised interview on CBS, reporter Alison Young commented on the issue of preventable death and injuries:
“Experts say that about 50 percent of the deaths of women from childbirth-related causes could be prevented if they were given better medical care and that's a really surprising thing given that we're one of the wealthiest countries in the world and we spend so much on medical care. We're not just talking about the women who die, we're talking about 50,000 U.S. women who are suffering life-altering harms.”
As the USA TODAY investigatory team states quite poignantly, “every year, thousands of women suffer life-altering injuries or die during childbirth because hospitals and medical workers skip safety practices known to head off disaster.”
What seems to be happening is that, when it comes to monitoring the amount of blood loss among mothers, doctors and hospital staff seem to be “eyeballing” it, rather than taking specific measurements that would help determine whether or not a mother is at risk. This lack of attention to detail is widespread in the U.S. Big and small hospitals alike, as well as birthing centers with the most-up-to-date, state-of-the-art technology, are all part of the problem.
Babies Are Affected, Too
Similar to the rate of maternal mortality, the U.S. has also seen a steady rate of birth injuries that affect newborns. Cerebral palsy (CP), for example, is a neurological condition that effects a child’s motor function abilities and is caused by a medical error that is made before, during, or slightly after childbirth. The rate of cerebral palsy in the U.S. is 4 out of every 1,000 babies. Other common birth injuries include:
- Erb’s palsy
- Skull fracturing
- Facial-nerve damage
- Bleeding or lack of oxygen inside the brain
Of course, all of these injuries are preventable. Advanced medical technology and standardized safety protocols are readily available at a majority of American birthing centers.
Yet, as the healthcare sector continues to grow and thrive financially, expecting mothers and babies are left behind while corporations continue to seek and reap high profit margins. Mothers are dying, newborns are being irreversibly injured, and each year over 250,000 Americans die from preventable medical errors, making such errors the third-leading cause of death in the U.S.
A Safer Approach?
Solutions to such a major problem lie mostly in training and protocol development and adherence. Doctors and hospitals need to not only have better prevention protocols, they need to implement them across the board – without question.
Young writes, “These things have been known for many years as things that need to be done but it needs to be made a priority at hospitals. One of the things that is being advocated for… is having medical checklists.”
While the U.S. on the whole seems to be letting down new mothers, 1 state – California – has followed our European and Asian counterparts on the path to lower maternal mortality. California’s hospitals have incorporated practices that have cut the state’s overall maternal mortality rate in half. Massachusetts and Nevada, while not quite on California’s level, have also succeeded in lessening such instances of mortality.
According to data, it is the less-progressive states in the U.S. that have failed to incorporate the same safety measures. Louisiana (58.1 deaths per 1,000 births), Georgia (48.4), and Indiana (43.6) are the bottom 3 states when it comes to maternal mortality.
Interested in where your state fits into the bigger picture? The full USA TODAY story, which you can read here, details the numbers state-by-state in an interactive map.