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Excerpted From: Julia Wood, Improving Outcomes for New Mothers in the United States, 27 Southwestern Journal of International Law 187 (2021) (Note and Comment) (124 Footnotes) (Full Document)


NoPictureAvailable03The United States has a shockingly high maternal mortality rate. Conservative estimates put the maternal death rate between 700-900 deaths per year, which is more than double since 1987. Research shows that it is more dangerous to give birth in 2020 than it was 40 years ago. What is even more shocking is that research also shows that at least 60% of these deaths are preventable.

The maternal mortality rate, also called the pregnancy-related mortality ratio, is the number of pregnancy-related deaths for every 100,000 live births. The Centers for Disease Control and Prevention (CDC) defines pregnancy-related deaths as the “death of a woman while pregnant or within 1 year of the end of a pregnancy - regardless of the outcome, duration or site of the pregnancy - from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.” This definition is taken from the World Health Organization (WHO) and is used by all countries, allowing for comparisons of maternal mortality rates between countries.

The maternal mortality rate has more than doubled in the U.S. from 7.2 deaths per 100,000 in 1987 to 18 deaths per 100,000 live births in 2014, according to the U.S. Dept. of Health and Human Services (HHS). The CDC released a report in January 2020 listing the U.S. maternal mortality rate for 2018 at 17.4. This ranks the U.S. 55th worldwide, according to WHO, just behind Russia. The U.S. is ranked tenth out of ten when compared to similarly wealthy countries. This number could be a drastic undercount since the CDC number does not count births for women over forty-four nor do they count deaths that happen after forty-two days postpartum. By the CDC's own admission, 24% of maternal deaths occur six weeks or more after birth.

Maternal mortality can vary depending upon a few factors. African American women are three to four times more likely to die from pregnancy-related causes than Caucasian women, and Native American women are three times more likely to die from pregnancy related causes than Caucasian women. The number of maternal deaths also differs depending upon the state where the mother gives birth. California currently has the lowest maternal death rate with a 4.5 out of 100,000 while Louisiana has the highest with 58.1.

The U. S. needs to lower its maternal mortality rate. Completely fixing the problem will require addressing many broad aspects of law and society, such as healthcare access, income inequality, and systemic racism within the medical field. This paper will focus on smaller incremental changes that can be made to existing healthcare laws and practices that would immediately help. Drawing from California, Germany, and Finland these changes can be a model for how federal standards should be set and implemented.

[. . .]

These four proposed laws would have an immediate impact on keeping new mothers alive. These proposed laws need to be implemented on the federal level because states have failed to address the problem of rising maternal mortality in the two decades in which it has been happening. Even as some states investigate and propose changes to help, others have failed to even provide data on the subject. While some states have changed insurance laws to make access to post-natal care easier, others have not. The Federal Government needs to step in and pass common-sense laws that could be implemented quickly within our existing insurance framework and help save the lives of women.

There is not going to be a quick fix for some of the problems that the United States has within the healthcare industry, but by passing the proposed laws, the maternal mortality rate will decline, while the larger issues within the healthcare industry are researched, analyzed and addressed. When the health of the mother is protected, the new baby and family thrive; this is good for all people.

J.D. Candidate, Southwestern Law School (2021).

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