Friday, December 8, 2023

Maternal Mortality Rates - A Critical Health Issue

One of the key measures of health in various nations is maternal mortality.  In this posting, we'll compare the maternal mortality rate for the world's most advanced nations, those who are members of the OECD.

 

Here is a definition of maternal mortality from the World Health Organization:

 

"The annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy."

  

Let's start by looking at some background information on maternal mortality according to the World Health Organization:

 

Women in low-income countries have a higher lifetime risk of death of maternal death. A woman’s lifetime risk of maternal death is the probability that a 15-year-old woman will eventually die from a maternal cause. In high income countries, this is 1 in 5300, versus 1 in 49 in low-income countries.

 

Maternal mortality is unacceptably high. About 287,000 women died during and following pregnancy and childbirth in 2020 (nearly 800 women each day) with a death occurring every 2 minutes throughout 2020. Almost 95% of all maternal deaths occurred in low and lower middle-income countries in 2020, and most could have been prevented.

 

The high number of maternal deaths in some areas of the world reflects inequalities in access to quality health services and highlights the gap between rich and poor. The MMR in low-income countries in 2020 was 430 per 100,000 live births versus 12 per 100 000 live births in high income countries.  In 2020, almost 95 percent of al maternal deaths occurred in low- and lower-middle-income nations.

 

A late maternal death is “the death of a woman from direct or indirect obstetric causes, more than 42 days but less than one year after termination of pregnancy”. Like maternal deaths, late maternal deaths also include both direct and indirect maternal/obstetric deaths. Complications of pregnancy or childbirth can lead to death beyond the six-week (42-day) postpartum period, and the increased availability of modern life-sustaining procedures and technologies enables more women to survive adverse outcomes of pregnancy and delivery, and also delays some deaths beyond 42 days that postpartum period.

 

The causes of maternal deaths are mainly due to the following issues:

 

1.) severe bleeding (mostly bleeding after childbirth)


2.) infections (usually after childbirth)


3.) high blood pressure during pregnancy (pre-eclampsia and eclampsia)


4.) complications from delivery


5.) unsafe abortion


Now, let's look at maternal mortality data per 100,000 live births for OECD nations from the OECD.stat website noting that 2020 is the most current year for which data is available for most member nations in order of highest to lowest maternal mortality rate:

 

 

For comparison's sake and since data for 2020 is not available for four nations, data from the missing nations is as follows in the latest year for which data was actually available:

 

1.) France - 7.6 (2015)

2.) New Zealand - 13.6 (2018)

3.) Belgium - 7.6 (2018)

4.) United Kingdom - 5.5 (2017)

 

You'll notice that the United States has the fourth worst maternal mortality rate among its OECD peers and well above its the rates seen in its European peers and the 11.9 deaths per 100,000 live births average of all advanced nations. Another surprise is Canada with its socialized (but failing) medical system; at 8.4 deaths per 100,000 live births, its rate is below the OECD average but still has the 11th worst maternal mortality rate among its advanced economy peers.

 

While the world's public health officials wring their hands over the next pandemic, it would certainly appear that maternal mortality is a health issue that should also be of great concern, even among the world's so-called advanced economies. But then again, dying mothers just aren’t as sexy an issue as an infectious disease that can be “solved” using highly profitable pharmaceutical interventions.


1 comment:

  1. As usual, American statistics should be sorted by race. If that is done, it will likely turn out that the American maternal death is a mixture of African rates for blacks and European rates for whites.

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