by DINA FINE MARON
Statistics have suggested a sharp increase in the number of American women dying as a complication of pregnancy since the late 1980s, but a closer look at the data hints that all is not as it seems
There is no charity walk to raise awareness about the 700 to 800 women that die each year during pregnancy or shortly after giving birth in the U.S. There are no dedicated colored-plastic wristbands. But statistics in recent years have revealed a worrisome trend: the rate of maternal mortality in the U.S. has more than doubled in the past few decades. Whereas 7.2 women died per 100,000 births in 1987, that number swelled to 17.8 deaths per 100,000 live births in 2009 and 2011. The uptick occurred even as maternal mortality dropped in less-developed settings around the world. Now women giving birth in the U.S. are at a higher risk of dying than those giving birth in China or Saudi Arabia. The reason for this disturbing trend has eluded researchers, however.
So what exactly is it about being in a family way that is getting worse in America? According to some experts at the U.S. Centers for Disease Control and Prevention (CDC), perhaps nothing. A deeper dive into the mortality data and the conditions under which they were collected suggests that the apparent doubling may not necessarily mean that more mothers are dying than ever before. Instead, administrative issues in the past may have camouflaged a problem that is only now coming to light.
Statistics for 40 states and the District of Columbia, gleaned from death certificates, indicate that whereas the reported maternal mortality rate from 1999 to 2002 was 9.8 per 100,000 live births, it jumped to 20.8 per 100,000 live births for the period 2010 to 2013. But the numbers in the latter period may have been affected by a small change in the forms that are filed when a person dies. Until relatively recently most states relied on a death certificate form that was created in 1989. A newer version of the form, released in 2003, added a dedicated question asking whether the person who died was currently or recently pregnant—effectively creating a flag for capturing maternal mortality. Specifically, this recently introduced question asks if the woman was pregnant within the past year, at the time of death or within 42 days of death.
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