by MOIRA DONEGAN
What do we make of a nation that has made giving birth so dangerous – yet forces more and more women to do it?
America is in a maternal health crisis. According to new CDC data released this week, the rate of maternal mortality – defined as deaths during pregnancy or within 42 days of giving birth – rose by 40% in 2021. At a rate of 33 deaths for every 100,000 live births, 1,205 women died of maternal causes that year. That rate was more than twice as high for Black women, whose maternal mortality rate was 70 deaths for every 100,000 live births. The latest federal compilation of data from reviews of maternal deaths suggests that 84% were preventable.
Experts believe that 2021’s spike in maternal mortality can be attributed at least partly to the Covid-19 pandemic, though it’s not clear exactly how. Perhaps infection and exposure to the virus made pregnant women more vulnerable; perhaps the pandemic caused some women to delay or forgo prenatal care as hospitals strained to treat the surge of virus patients and shutdowns made all kinds of care harder and riskier to get.
But even before Covid-19, America has long been an outlier in maternal deaths, with dramatically higher rates of women dying in or as a result of childbirth than in peer nations. America has 10 or more times the rate of pregnancy-related death in Australia, Austria, Israel, Japan and Spain.
The women reflected in 2021’s data died from high blood pressure and from infections; they died from hemorrhage, and from blood clots, and from strokes. They died because doctors incorrectly administered epidurals, or botched C-section procedures, and they died because they weren’t given oxygen when they needed it.
More broadly, they died because pregnancy is a totalizing physical experience, one that challenges and changes the body in profound, irreversible ways that are kept from public discussion by ignorance and taboo, and they died because they lived in a country where medicine is rationed and unaffordable, where women’s healthcare has been starved of both talent and investment, and where disregard for both public health and for female pain has left vast swaths of pregnant people vulnerable in ways that reflect more on the values of their society than on the fragility of their bodies.
They also died, it should be said, from racist negligence. The racial disparities in the data are staggering: Black women are dramatically more likely to die in childbirth. Some of this can be attributed to the broad health disparities between Black Americans and other groups – the result of the strains of poverty, overwork, exposure to pollution, and vulnerability to violence that have long kept Black people in the US physically overtaxed and under-cared for.
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