Though many years ago, I remember clearly the birth of my two children. It was such a privilege to hold my wife’s hand and help coach her through safe labor and delivery. It is possible, I suppose, that I am overstating the impact of my coaching skills — though Sandy has assured me my presence was at least of some comfort. More importantly, our babies were delivered in a calm, safe hospital environment where skilled health workers mitigated the risks Sandy and the babies faced.
Not all births are like this, or course. I have seen delivery wards in Liberia and Tanzania that were not nearly as safe, where the conditions make childbirth far too risky and where too many women and infants die during delivery. Americares is working in these places to make childbirth safer by launching programs that educate local midwives to recognize signs of complications that can put lives at risk and result in lifelong disability — if the mother survives.
Efforts like this over the past few decades have been paying off. Between 1990 and 2015, maternal mortality worldwide dropped by about 44 percent, according to World Health Organization statistics. That’s good news.
Fatuma is happy because she has what she needs to deliver babies safely at the hospital where she works in rural Tanzania. Gloves, masks, delivery kits, running water, waste bins and training all work together to reduce risk during childbirth. Photo by Alex Ostasiewicz
The bad news, surprisingly, comes from here in the United States, which is now the most dangerous country in the developed world to give birth. From 1990 to 2015, most developed nations saw their maternal deaths rates fall or level off at below 10 deaths per 100,000 births. By contrast, the number here in the U.S. rose to 26.4.
It’s not for lack of spending: The U.S. spends more per person on health care than anywhere in the world. Instead, a USA Today report suggests that lack of attention to blood pressure problems and blood loss is a contributor to the relatively high maternal death rate in the U.S. — those very same things Americares education programs stress in the world’s least developed countries.
I suspect the reason for our country’s deadly slip is that we have taken our eyes off the basics. Our high-tech health system — one of the things that drives our health care costs so high — often seems to do better in the most complicated cases rather than the basic ones.
But it’s attention to the basics that saves lives — whether it’s a nurse catching the dangerously high blood pressure in a laboring woman or a doctor testing for high blood sugar in a patient. Skilled care at adequately-resourced health centers keeps people alive. That’s one of the reasons here at Americares we are focused on strengthening the capacity of local health centers and the health workers who staff them to safely address maternal health and many of the other most common health issues faced by communities impacted by poverty and disaster.
While maternal mortality is shockingly high in the U.S., it is still well below the global average. It is estimated that 830 women still die from pregnancy- or childbirth-related complications each day around the world. The new global target set as part of the United Nations Sustainable Development Goals is to reduce global maternal mortality to below 70 deaths per 100,000 births by 2030.
The United States should be leading the world reducing the danger of pregnancy and delivery, rather than being an outlier going the wrong way. Let’s all work to reverse this deadly trend.