Why is Childbirth So Dangerous in America?
"Kira deserved better. My sons deserved better. Women all over this country deserve better." - Charles Johnson
It’s Breast Cancer Awareness Month and you’re probably seeing pink everywhere. We figured it was a good time to look at another less marketed health crisis: maternal mortality. - Amber & Katie
The rate of death in childbirth has doubled in the last twenty years the U.S. while decreasing nearly everywhere else in the world. The rate is 18 deaths in 10,000 births, or about 700 deaths each year. Another 50,000 people experience severe maternal morbidity, serious short- or long-term health conditions or outcomes.
Those numbers are already surprising for a high-income, high-tech country, but it gets worse. First, a full 60% of these deaths and half of injuries are deemed preventable. Meaning: there is something inherently dangerous or negligent about the way our health system treats childbirth. Second, Black Americans are a full 3 to 4 times more likely to die in childbirth than White Americans, regardless of income or education level. Black babies are twice as likely to die in their first year of life. Meaning: there is something inherently racist about the way our health system treats childbirth.
You may not have heard these numbers, but you’ve probably heard about Beyoncé or Serena Williams having near-death postpartum experiences. The fact that two of the best resourced women in America--whose names are synonymous with success, health and control--shared this experience raises red flags.
What’s to blame? To start, there is a clear connection to the high rate of unnecessary c-sections which exponentially increase the chance of complications and infection. Other causes: poor prenatal and postpartum care, insufficient care protocols related to complications after birth (like weighing blood loss or tracking blood pressure medication), lack of standardized study of cases of maternal death or harm, and institutional racism.
We could go on about the alarming data, but the stories really bring it home. Kira Johnson’s story is unforgettable and heart wrenching. [The story is upsetting, clicking the link is optional.] Hear her husband Charles describe the way Kira’s providers failed her. He tells the story of the worst day of his life over and over across the country now, as part of the organization he formed: 4Kira4Moms.
Charles took the story to Congress and worked with Rep. Jaime Herrera Beutler (R-WA) to pass H.R. 1318 - Preventing Maternal Deaths Act of 2017. The bill funded the establishment of formal Maternal Mortality Review Committees in every state to collect, analyze, and report on pregnancy-related deaths and requires health departments to train providers and improve the quality of care. It became law in December 2018.
Donate to 4Kira4Moms to support Kira’s family’s continued advocacy and storytelling, including the establishment of maternal mortality reviews in every state.
Advocate for the passage of the “Maximizing Outcomes For Moms Through Medicaid Improvement And Enhancement Of Services (MOMMIES) Act” (S. 1343/H.R. 2602). Every Mother Counts has details and prompts for letters and calls to Congress.
Join the March of Dimes Advocacy Network to receive alerts about how to improve health outcomes for parents and babies.
Connect with the Black Mamas Matter Alliance and watch their 2018 Congressional Briefing on Policies to Improve Black Maternal Health in the United States.
Sign a petition to stop the addition of work requirements to Medicaid eligibility, or call on congress to strengthen the ACA. Access to Medicaid insurance coverage is critical for low-income people to access proper prenatal care; half of births are paid for by Medicaid.
Like Medicaid, Planned Parenthood supports reproductive health outcomes for patients with limited resources. Keep their doors open by joining their advocacy, patronizing a clinic, or donating today.
Make plans to attend the March for Moms in Washington DC in May 2020 and learn about the coalition.
Fight bias. Check out our past issue on confronting White supremacy for links.
Expectant parents can check out resources from the Leapfrog Group to reduce their risk of unnecessary cesarean deliveries which increase the risk of complications. Having a trained doula attend birth can also improve birth outcomes.
Work in healthcare? Familiarize yourself with the Joint Commission’s new Provision of Care, Treatment, and Services standards for pregnancy and postpartum that are (finally) coming online for accredited hospitals in 2020. Or look into California’s Maternal Quality Care Collaborative’s QI Academy to learn how they cut their mortality rate in half.
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References
Reproductive Health: Data and Statistics | U.S. Centers for Disease Control and Prevention
Severe Maternal Morbidity in the United States | U.S. Centers for Disease Control and Prevention
We Had No Idea How Much Physical Danger Stillbirth Can Cause | Rewire News
Nothing Protects Black Women From Dying in Pregnancy and Childbirth | ProPublica
Reversing The Rise In Maternal Mortality | Health Affairs
Bias In Medicine | Last Week Tonight with John Oliver
Reproductive Injustice: Racial and Gender Discrimination in U.S. Health Care | Center for Reproductive Rights, National Latina Institute for Reproductive Health and SisterSong
Beyoncé, Serena Williams open up about potentially fatal childbirths, a problem especially for black mothers | The Washington Post
Serena Williams: What my life-threatening experience taught me about giving birth | CNN
Hospitals know how to protect mothers. They just aren’t doing it. | USA Today
Black Women’s Maternal Health: A Multifaceted Approach to Addressing Persistent and Dire Health Disparities | National Partnership for Women and Families
Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions | NeoReviews
Reducing Maternal Mortality | The New York Times
How Can We Reduce Black Maternal Mortality? | Mother Jones
Charles Johnson shares the tragic story of his wife Kira's death hours after giving birth | 4Kira4Moms
Widowed father works with congresswoman on legislation to prevent maternal deaths | ABC News
Beyond The Preventing Maternal Deaths Act: Implementation And Further Policy Change | Health Affairs Blog
Medicaid and Reproductive Health | Planned Parenthood Action Fund
Linked & Loud illuminates complex problems and connects readers with the individuals and organizations working to solve them. Each week, we go beyond horrifying headlines to empower readers to take progressive action.