It’s a grim reality: New mothers in the United States die at higher rates than any other developed nation in the world — around 18 deaths for every 100,000 live births, according to the Centers for Disease Control and Prevention (CDC).
This rate has more than doubled since the late 1980s, and the United States is one of few countries where the rates are increasing rather than decreasing. It's such a serious issue that the House Ways and Means Committee recently launched an investigation into how to prevent maternal death.
Mortality rates for new moms are lower in Washington state than most other states. A USA Today investigation about maternal deaths found that Washington’s rate is 13.8 deaths for every 100,000 births, below the national average. They identify Louisiana as the state with the highest death rate, at 58.1 deaths per 100,000 births.
A review of maternal mortality published by the Washington State Department of Health in July 2017 counted 69 total deaths in 2014 and 2015. Sixteen of these were classified as “pregnancy-related,” meaning pregnancy or childbirth complications were a direct cause of death. The remaining 53 were classified as “pregnancy-associated,” meaning the deaths occurred within one year of a woman giving birth but were not thought to be caused by pregnancy. (This includes deaths caused by car accidents, homicide, suicide or from an illness like cancer.)
Though life-threatening complications from pregnancy or childbirth are rare, that doesn’t necessarily make them less scary. Experts across the country are working to better understand why maternal death rates are so high in the United States, but the answers are complicated. Here’s what you need to know.
Multiple potential causes of maternal death
Though experts still don’t know exactly why maternal mortality rates are increasing, they do know one thing: there’s no single cause. Many factors — such as the health of individual moms, poor access to healthcare, inability of healthcare providers to recognize an emergency, and obstacles in delivering efficient care — likely combine to create a perfect storm.
One major factor is chronic disease. Women who have high blood pressure, diabetes or another pre-existing condition are at higher risk for complications during pregnancy and for needing a C-section. C-sections are generally riskier than vaginal delivery, despite at times being medically necessary.
Mothers who are older than 35 or who are obese may be at greater risk for complications. Barriers accessing care and unplanned pregnancy can also contribute.
However, just because a mom has several risk factors doesn’t necessarily mean she’s automatically in greater danger. Women who seem perfectly healthy can still have last-minute complications that threaten their lives, things like preeclampsia, blood clots, sepsis or hemorrhage, says Carol Salerno, M.D., medical director of Childbirth Services at UW Medical Center - Northwest.