Rising Maternal Death Rate in the US: C-sections, VBACs and evidence-based care

by Crystal Paradis-Catanzaro

“A lot of people think that the United States is the best place in the world to have a baby, and that’s just not true. It’s the most dangerous place in the developed world to have a baby.” This statement by artist and birth justice advocate Michelle Hartney may sound like an exaggeration, but it’s hard to argue with the statistics. Hartney is part of a growing movement fighting for women’s right to choose when it comes to their maternal health care.

The US is one of only eight countries — and the only developed country — with a rising maternal death rate. The World Health Organization reports that from 1990–2013 the maternal mortality ratio more than doubled, from 12 to 28 deaths per 100,000 births. Women who lack health insurance and women of color are at an even higher risk. WHO also reports about half of maternal deaths in the U.S. are preventable. While more data is needed to identify specific causes, some of the contributing factors identified include a lack of consistent maternal care across states and regions and a sharp increase in unnecessary medical interventions. Many of these interventions are against the wishes of mothers.

One in three women will now have a cesarean, in spite of the CDC’s estimate that less than 15 percent are medically necessary (some sources claim that rate is actually closer to 2 percent). If a woman wants to have a vaginal birth after cesarean (VBAC), a procedure maternal health care providers from obstetricians to midwives agree is very safe under the right circumstances, she may not have that option. C-sections have a three times higher risk of death and come with increased risks including infection, blood clots and chronic pain. But a lack of information on the risks of C-sections, epidurals and labor-inducing drugs like Pitocin — and safe, natural alternatives — lead many women to comply under pressure from doctors or hospitals to undergo this procedure.

In spite of living in a time of assumed medical progress, many women lack both choice and access when it comes to how to have their babies. Maternity wards in rural areas across the country are closing altogether. A decline in birth rate combined with a population more reliant on lower-paying Medicaid coverage means that hospitals are losing money in rural maternity wards. Hospitals in rural New Hampshire are following this trend. In the past 13 years, maternity wards closed in Colebrook, Lancaster and Wolfeboro. For women in these regions, some of whom may not have access to reliable transportation, this means longer commutes not only for the delivery of their babies, but also for basic prenatal care — a significant factor in maternal health.



Read the rest of this post on Medium: Maternal mortality and access to evidence-based care or at seacoastonline.com.

This article was originally published in the combined Seacoast Sunday edition of The Portsmouth Herald and Foster’s Daily Democrat.