Maternal Mortality Rising in the US? What About Mother's Day?

Mother's Day is celebrated in most countries around the world -- mothers everywhere are honored for their central role in maintaining happy families and healthy societies. But in poor countries, Mother's Day is too often a sad time.
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Mother's Day is celebrated in most countries around the world -- mothers everywhere are honored for their central role in maintaining happy families and healthy societies. But in poor countries, Mother's Day is too often a sad time. In 2008, a woman died every 90 seconds somewhere in the world as a result of childbearing, leaving behind hundreds of thousands of children to grow up motherless.

But even mothers in the U.S. don't fare as well as one might expect. Not long ago we could celebrate how well we supported pregnancy and the birth process. In 1980, only 12 women died as a result of childbearing in North America (the U.S. and Canada) for every 100,000 live births -- the lowest of any region in the world. But something has happened since then: in 2008, the maternal mortality rate had increased by nearly 50% in the U.S., to 17 per 100,000 births. The rate was unchanged in Canada.

The U.S. is virtually alone in this trend. In every other region of the world -- except for the areas of Africa hardest hit by AIDS -- maternal deaths have been reduced substantially. Birthing women in the U.S. are now more than twice as likely to die as their counterparts in western European countries.

What is happening to pregnant women in the U.S., one of the richest countries in the history of the world? We know that the maternal death rate for African-American women is nearly three times higher than the rate for women of other races. We also know that rate of medical interventions -- such as unnecessary caesarian sections -- is high in this country, and that these interventions increase the risk of complications and death for pregnant women. In recent years, it has become harder for pregnant women in many parts of the country to access good care, a result of the growing inequality we see in many spheres of life. But the precise cause of the increased maternal death rate remains a mystery.

A healthy mother is critically important because of the attention she gives her baby during those first few months of life. Current research shows that maternal care the first 1,000 days of a baby's life, from conception through age two, heavily influences the child's later health -- with the effects extending into middle age and beyond. A vast range of problems from adult drug abuse to diabetes can be related back to the quality of the pregnancy and early care that a child receives.

Every new mother needs uninterrupted time with her baby to mother, to breastfeed, and to bond closely with her infant, without financial stress or having to leave her newborn with substitute caregivers. But for all our talk about "family values," the U.S. is one of only five countries in the world that don't legally mandate paid maternity leave for new mothers. This is a national disgrace. When mothers return to work, they search in vain for quality, affordable day care, finding that public support to care for young children is only available when they reach pre-school age, through the Head Start program. We can do better.

Is it all bad news this Mother's Day? No. Fortunately there is growing public awareness of the value of supporting women, including in their pivotal role as moms. The Affordable Care Act assures that a full range of reproductive health services will be available to women, by mandating that insurance plans cover preventive services such as family planning and eliminating co-pays for that care. Some of our forward-looking congressional representatives from both parties have put forward legislation that would, for example, permit states to exempt single parents with small children from the need to work outside the home in order to qualify for public assistance (HR bill 4379). Another would support a national toll-free parent helpline that would provide information and assistance to parents and caregivers of children, with the aim of preventing child abuse and strengthening families (Senate bill 2293).

Every woman in America -- and everyone who ever had a mother -- should actively support these kinds of efforts to recognize the special needs of mothers and help them fulfill their critically important role. There is much that could be done. Support for mandatory parental leave, for example, would be a giant step toward improving the life chances for today's children. Is it asking too much that we join the rest of the developed world by making sure that mothers can stay home with their newborn infants?

Maybe one day we can again proudly say that we're a nation that truly honors and celebrates motherhood.

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