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Why Is US Maternal Mortality Rising?

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By    |   Monday, 05 Jun 2017 04:24 PM

The nation’s historically high infant mortality rate has fallen 15 percent in the last decade, but maternal mortality rates have continued to climb, new studies show.

While infant mortality received a lot of notoriety in recent decades, maternal mortality has largely flown under the radar, experts say. One reason, says an expert, is that the number of babies dying still dwarfs the number of childbirth-related deaths among women.

“More than 24,000 babies are stillborn in the U.S. each year, and a similar number die as neonates,” says Dr. Vincenzo Berghella, director of the division of maternal-fetal medicine at Thomas Jefferson University Hospital in Philadelphia. “While the number of maternal deaths is worrisome, it is in the hundreds per year, not thousands.”

Still, the U.S. ranks dead last among wealthy countries in maternal mortality. Women here are three times more likely to die from pregnancy-related problems than Canadian women, and six times more likely than Scandinavians. With the latest uptick, the U.S. has even fallen behind Vietnam, Iran, and Romania.

So why does the richest country in the world with the most sophisticated medical technology have such a dismal track record?

“I think much of the problem is related to our social care network,” says Berghella. “In Europe, 99 percent of pregnant women get prenatal care, where risks can be identified and monitored from the beginning. In the U.S., 10 to 15 percent don’t get care. Often, they are the poor, the homeless, the drug addicted.”

But the problem crosses all socio-economic lines. One stunning example is Lauren Bloomstein, a 33-year-old neonatal intensive care nurse and doctor’s wife from Moorestown, N.J. In October 2011, Bloomstein died less than a day after giving birth to her daughter Hailey.

The cause was preeclampsia, a severe pregnancy-induced hypertension that triggered a fatal stroke. While preeclampsia can usually be successfully treated with hypertension drugs, its symptoms can be misleading, and it can strike fast if not diagnosed early enough.

Several mistakes appear to have been made in Bloomstein’s tragic death. Among them: her blood pressure monitoring was spotty, her symptoms were misdiagnosed, and when her brain started hemorrhaging, there was a lack of platelets on hand to treat it.

“It’s never just one thing,” Roberta Gold, a member of the Council on Patient Safety, said about maternal mortality in Women’s Health Care Journal. “It’s always a cascading combination of things. It’s a slow-motion train wreck.”

A review by the New Jersey Department of Health faulted the hospital and staff where Bloomfield died for not properly following guidelines.

“The American College of Obstetricians and Gynecologists and other groups do a very good job of putting out guidelines and recommendations,” Berghella tells Newsmax Health. “It’s more a case of people not implementing the guidelines.”

Another factor that plays into our nation’s rising maternal deaths is the general health of the moms-to-be.

“Many people who are sick with a bad heart or kidneys, cancer, or something else are getting pregnant, which you don’t see as much in other countries,” explains Berghella. “We in the medical profession can accept that some people are willing to put their life at risk to have a baby, or we can do as other nations do and talk more about adoption and other options.”

But the key to reversing the rising maternal mortality trend may be to simply guarantee that everyone has access to good health care, as all other industrialized nations provide.

“All women need to be able to seek care as soon as possible,” says Berghella. “The CDC recommends preconception counseling with an obstetrician to figure out risks before people conceive. Some of them need to lose weight because obesity is a risk factor. Others may need treatment for risk factors like diabetes or drug addiction.

“If they can’t get preconception care, they should at least see someone as soon as they find out they are pregnant. Not all women can do that. Moving forward, we need societal help to prevent some of these maternal deaths.”

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Maternal mortality rates in the United States have continued to climb in recent years, new studies show. What's behind the troubling trend?
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Monday, 05 Jun 2017 04:24 PM
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