July 23rd, 2024

U.S. maternal death rate increasing at an alarming rate

The U.S. maternal mortality rate has surged, not just due to older age, affecting all age groups. Factors driving this rise need identification, especially among younger adults. Cardiovascular diseases impact maternal health significantly. Disparities exist among racial groups, with Black individuals at higher risk. National efforts are urged to tackle maternal health crisis.

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U.S. maternal death rate increasing at an alarming rate

The U.S. maternal mortality rate has nearly doubled between 2014 and 2021, with the largest increase occurring from 2019 to 2021, according to a study by Northwestern Medicine. Contrary to common belief, the rise is not solely due to older maternal age, as mortality rates increased across all age groups. The study emphasizes the need to identify other factors driving this acceleration, especially among younger adults under 35 years old. While the research did not delve into specific causes of death, prior studies suggest cardiovascular diseases play a significant role in maternal health outcomes. The study underscores the importance of understanding and preventing maternal deaths, which are largely preventable. The research also highlights the disparities in maternal mortality rates among different racial groups, with Black individuals being three times more likely to die from pregnancy-related causes than white individuals. The study calls for better national infrastructure and surveillance programs to address the root causes of the maternal health crisis.

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Link Icon 16 comments
By @jcfrei - 3 months
I'm gonna risk sounding dismissive here but the article very cautiously points at a cause: "While this study wasn’t able to explore specific causes of death, a large body of prior research, much of it published by Khan, has found cardiovascular disease (hypertensive disorders, heart failure and stroke) is a major contributor to poor maternal health outcomes."

Hypertensive disorders are typically associated with obesity so the reason could be that there's an increasing share of pregnancies happening with people who are overweight. I leave the sociodynamic interpretation of this up to the reader.

By @ZeroGravitas - 3 months
In case you're familiar with the recent controversy about whether this is a statistical artifact:

> There's actually been a lot of controversy about whether or not the increase that's been observed is a true increase or is an artifact of how we're now collecting data,” Khan said. “But when we examined deaths only in the states that had already adopted the checkbox and did it the exact same way, we captured an increase with acceleration in the last three years.

By @austin-cheney - 3 months
I suspect this is due to the intermingled effects of biology and politics.

* Consider that with the loss of Roe v Wade many states, including my own, have adopted draconian policies towards abortion without consideration for medical necessity.

* Consider also the study indicated the most increased risk age groups are late 20s and early 30s.

What’s interesting is there was a study published December indicating first time mothers in the 16-20 age group when compared to the 21-25 age group were about 20% less likely to experience detrimental risks of regular vaginal births. The numbers held identical when compared between the US and third world countries without common access to advanced medical care. The study concluded that age is among the most serious of factors with regards to maternal health of first time mothers and this could explain why males developed a selective preference for younger females.

By @everdrive - 3 months
Does anyone have any idea why? The much higher mortality rate for black women especially stands out. People have often remarked on this as evidence of racism, but does anyone know the actual mechanism here? Are black women less fit to survive a risky procedure in the first place? Are facilities actually treating black women worse? Do black women primarily only have access to inferior facilities? (if so, do women of other races also have worse outcomes at said facilities?) The article refutes increasing maternal age, which would have been my next guess.

I don't have answers, just questions and guesses. If anyone's got anything definitive, I'd love if they weighed in.

By @HPsquared - 3 months
Why don't these types of article ever show a graph?

EDIT: And their "recent" data point is 2021... Of course health outcomes would be worse in that year for various reasons.

By @incomingpain - 3 months
>more people are having children later in life, so we wanted to investigate this question. However, we found that’s not why we’re seeing a spike in the number of maternal deaths,”

when we shifted this way in the last 60 years, mortality was decreasing. This wouldn't be my go-to guess.

>While this study wasn’t able to explore specific causes of death

it's public data in quite a number of places in the world.

Generally speaking it's bleeding or blood related things; heart, or blood brain stroke type. Women during birth have the same problems as high G fighter pilots. Gotta tighten all your muscles.

>Black individuals are three times more likely to die from pregnancy-related deaths than white individuals.

Randomly tacked onto the end. The thing about statistics on race, it's really hard to rule out all the other factors and make conclusions. It's not some sort of allegation that black moms are systematically being killed.

By @dscottboggs - 3 months
Gee, I wonder what changed between '19 and '21
By @big-green-man - 3 months
> In that same period, the overall maternal mortality rates in the U.S. nearly doubled, from 16.5 to 31.8, with the largest increase of 18.9 to 31.8 occurring from 2019 to 2021.

31.8 what? Football fields? I'm guessing per 100k, but this is a .edu domain for Christ's sake.

By @refurb - 3 months
”The U.S. National Center for Health Statistics, the branch of the Centers for Disease Control (CDC) charged with collating health and vital statistics, has published three separate reports elaborating in excruciating detail on one crucial fact about U.S. maternal mortality: It is measured in a vastly more expansive way than anywhere else in the world.”

"But the U.S. case is particularly beguiling, since the United States now tracks all deaths of women who were pregnant, not only women who gave birth. Women who miscarried early or had abortions—whether officially reported or not—are also counted in the checkbox method."

https://archive.is/Sm38N

By @bentt - 3 months
We don’t know how to talk about metabolic disease because we are afraid of offending people.
By @landosaari - 3 months
Related post [0] (not having enough).

Do US doctors relay this risk to their patients?

[0] https://news.ycombinator.com/item?id=41037116

By @oldpersonintx - 3 months
"While this study wasn’t able to explore specific causes of death, a large body of prior research, much of it published by Khan, has found cardiovascular disease (hypertensive disorders, heart failure and stroke) is a major contributor to poor maternal health outcomes."

tl;dr: obesity ("hypertension")

but why stop at maternal deaths? obesity is driving premature death rates in every category

this is a national crisis but no one wants to say it out loud because someone's feelings will be hurt