Maternal Mortality: A US Public Health Crisis

J. Phillip Gingrey, MD

Disclosures

Am J Public Health. 2020;110(4):462-464. 

In This Article

Abstract and Introduction

Introduction

I became an obstetrician and gynecologist in Marietta, Georgia, decades ago because I believed it would be a happy specialty. Helping to bring 5200 babies into the world certainly affirmed that belief. I also had the good fortune to practice for many years when maternal deaths steadily dropped. That trend began to reverse itself about 25 years ago and the United States, in my view, now faces a crisis. It is one that the US Congress and all participants in our health care system must address with urgency.

In 1986, when the Centers for Disease Control and Prevention (CDC) began tracking maternal deaths, seven women for every 100 000 live births died during pregnancy, during childbirth, or in the weeks and months following. By 2016, the annual rate had jumped to 17 women for every 100 000 live births.[1] In 2014, according to the CDC's latest statistics, 50 000 women faced dangerous complications from pregnancy and childbirth. Think about all the medical advances that have occurred in recent times, and yet the risks associated with pregnancy have not declined. These figures say to me we are failing women during what should be a most wondrous time of their lives. No developed nation has a more shameful record. It particularly saddens me that among the 50 states, my home state of Georgia sits near the bottom.[2]

Figure 1.

Three Most Frequent Causes of Pregnancy-Related Deaths, by Time Relative to the End of Pregnancy: Pregnancy Mortality Surveillance System, United States, 2011–2015
Source. Centers for Disease Control and Prevention, https://www.cdc.gov/mmwr/volumes/68/wr/mm6818e1.htm?s_cid=mm6818e1_w.

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