The U.S. Maternal Health Crisis
A Critical Look at the U.S. Maternal Health Crisis Numbers
Introduction
At Moonshot Press, our mission within the Democracy of Opportunity initiative is to ignite change and inform the public about critical issues—like the ongoing maternal health crisis in the United States. The recent proposal from the Centers for Medicare and Medicaid Services (CMS) introduces new regulations to address this issue, highlighting a crisis that impacts racial and ethnic minorities disproportionately. But there's more to the story when we look closely at the statistics. A recent discussion by Saloni Dattani suggests that changes in how maternal deaths are measured could be influencing reported rates. Here, we break down these complex elements to foster understanding and action.
The Stark Reality of Maternal Health in the U.S.
According to CMS, the United States faces a severe maternal health crisis, with a maternal mortality rate that significantly surpasses those of other high-income countries. In 2022, the U.S. reported 22 maternal deaths per 100,000 live births—a figure alarmingly higher than rates in countries like Canada, France, and the United Kingdom, which reported rates as low as 8.6 per 100,000. The situation is especially dire for racial and ethnic minorities, with Black women and American Indian/Alaska Native women experiencing markedly higher risks of pregnancy-related deaths.
A Closer Look at the Statistics
Dattani’s analysis introduces a critical perspective, suggesting that the rise in reported maternal mortality rates in the U.S. largely stems from a change in how these deaths are measured, rather than an actual increase in deaths. This change was implemented gradually from 2003 to 2017 through the introduction of a “pregnancy checkbox” on death certificates, leading to a gradual increase in reported deaths as more states adopted this new method.
The “pregnancy checkbox” section of death certificates in the United States. This section was added to death certificates in some states in 2003, and was then gradually adopted across all other US states. The figure is adapted from Catalano et al. (2020).
Impact of Measurement Changes
The adjustment aimed to capture more maternal deaths by flagging any that might have been related to pregnancy, childbirth, or postpartum complications. However, this change also led to discrepancies and potential overcounting. Some deaths previously unlinked to pregnancy began to be recorded as maternal deaths, inflating the statistics. Moreover, this modification varied by state, which created inconsistencies in national data.
The Dual Edges of Data Collection
While the new measurement method has improved the identification of maternal deaths, it has also introduced challenges:
Increased Visibility: The change has undoubtedly brought more attention to maternal health issues and has highlighted areas needing urgent public health interventions.
Statistical Inflation: On the downside, the gradual state-by-state adoption of the checkbox led to what appears as a sharp increase in maternal mortality rates over a decade, potentially distorting the public's perception of the crisis’s escalation.
Engaging with the Data
As we respond to CMS’s call for public comments, it’s crucial to understand these nuances. The proposed regulations offer a foundation to address these disparities, but they also require us to look critically at the data and what it truly represents about maternal health in the U.S. By engaging with this information, citizens can better understand the landscape of maternal health and contribute more effectively to shaping policies that reflect real needs and conditions.
Conclusion
The maternal health crisis in the U.S. is complex, influenced by both genuine health disparities and the methodologies used to report and analyze health data. As part of Moonshot Press's commitment to fostering informed civic engagement, we encourage our readers to participate in the public comment period, armed with a deeper understanding of the statistics and stories behind the headlines. Together, we can advocate for a holistic (salutogenic) approach that not only addresses the crisis but also builds a foundation for long-term maternal well-being.
Get Involved
Join Moonshot Press in shaping a healthier future for mothers and babies. Subscribe, participate in discussions, and use your voice to influence the changes we urgently need. Your engagement is crucial in navigating this complex issue and ensuring that every mother has the chance to thrive.
Articles
Saloni Dattani (2024) 'The rise in reported maternal mortality rates in the US is largely due to a change in measurement'
Maternal Mortality Rates in the United States, 2022 | CDC
Maternal mortality rates in the United States, 2019
JAMA : Addressing the Public Health Crisis of Maternal Mortality: A National Research Agenda
Commonwealth Fund, June 2024).Insights into the U.S. Maternal Mortality Crisis: An International Comparison
Scientific American: “Why Maternal Mortality Rates Are Getting Worse across the U.S.”
National Public Radio (NPR): “The number of people dying in the U.S. from pregnancy-related causes has more than doubled in the last 20 years.”
New study challenges scale of maternal health crisis in the US | CNN
How bad is maternal mortality in the U.S.? A new study says it's been overestimated
The Maternal-Mortality Crisis That Didn’t Happen
Eliminating Racial Disparities in Maternal and Infant Mortality. Center for American Progress.
The Artificial Intelligence Prompt for ChatGPT4o
You are an expert in simplifying statistical information for the public. You are an excellent writer and editor . You are now part of the Moonshot Press team working on the effort to address the proposed CMS regulations regarding Standards for Obstetrical Services in Hospitals and Critical Access Hospitals. Here is the statement on the justification of the CMS regulation regarding Standards for Obstetrical Services in Hospitals and Critical Access Hospitals. The statistics and level of the maternal crisis has been questioned. Our effort is to provide a way for citizens to engage with regulations. The first section is from the actual CMS regulation and it followed by an article The rise in reported maternal mortality rates in the US is largely due to a change in measurement that questions the statistics. Please write an article for the general public that will be used as part of our initiative to Reimagine Maternal well being. Please explain and highlight the differences in these statistics. Thanks