Healthcare in America is often touted as the best in the world (at least Americans think so), and in terms of technological innovation it might be true. But when it comes to maternal care and health, the United States, in some respects, lags behind other nations. Birth-giving moms are having a tougher go at it, comparatively speaking, in areas such as maternal mortality rates, lack of prenatal care and inadequate postpartum care. As reported by time.com two years ago, an American woman faced a one-in-1,800 chance of maternal death, as reported by the Save the Children charity, making the U.S. the worst in that category among the world's developed countries. Here are some more eye-opening numbers if you buy into that America is No. 1 in the world in healthcare mantra: American women are 10 times more likely, per romper.com, to die from a pregnancy-related issue than women in Belarus, Poland and Austria. Also, according to the 2015 State of the World's Mothers report, a global index that uses a variety of data to rank the best and worst places in the world to be a mother, the United States ranked 33rd out of 179 surveyed countries. Maternal care figured prominently in that data. Those are not the kind of statistics you would expect from a nation that in 2015 alone spent more than $3 trillion in health care, according to cms.gov (the Centers for Medicare and Medicaid Services). That works out to just under $10,000 a person. Whatever bang we are getting for those bucks doesn't seem to be making much of a noise when it comes to taking care of soon-to-be-pregnant moms, those who are pregnant and those who have recently given birth. As for the upward trend of maternal deaths in America, as seen over the last several decades, experts attribute the increased incidences of death to three factors, mainly: a decline in overall health, due in some part to increased rates of obesity and cardiovascular disease, and the aforementioned issues regarding prenatal care and postpartum care that could be, should be, better than they are. Here's a breakdown of a half-dozen of the major issues being contended with today when it comes to maternal care:
- Insufficient prenatal care. About one million American women a year give birth to babies without having been given adequate medical attention during the pregnancy. That statistic, from the U.S. Department of Health and Human Services, sounds an alarm when you consider that such women are three to four times more likely to die in childbirth than women who do receive proper prenatal care.
- Deficient postpartum care. The genesis of this issue could be that in America, the post-birth focus tends to be almost totally aimed at the newborn baby, while Mom fades into the background. Most health plans only cover one visit to a health-care provider about six weeks after birth unless she suffers a complication covered by the plan. By comparison, per romper.com, in much of Europe, multiple postpartum visits are allowed.
- Nonexistent Protocols for Childbirth Emergencies: As shocking as this might sound, many hospitals don't have standard procedures in place to handle childbirth-related emergencies. It has been reported that about 40 percent of pregnancy-related deaths are potentially preventable. Three of the most common childbirth emergencies are hemorrhage, blood clots and severe hypertension (high blood pressure).
- Increasing obesity. The Centers for Disease Control and Prevention (CDC) has reported that nearly half of women are overweight or obese before they give birth. Obesity is one of the leading causes of mortality in the OB/GYN field, says Dr. Michael Brodman, Department of Obstetrics, Gynecology and Reproductive Science chairman at New York's Mount Sinai Health System, as quoted by CNN. Risks during pregnancy most closely aligned with the mom's obesity include gestational diabetes and preeclampsia (blood pressure issues). Like with childbirth emergencies, protocols for dealing with obese moms-to-be are lacking in hospitals.
- Maternal smoking. Women who smoke for years have been strongly advised to put away the packs of cigarettes during the pregnancy, both out of concern for health risks for the baby (e.g., preterm birth, sudden infant death syndrome [SIDS]) as well as health concerns for the mom (for such possible complications as problems with the placenta to her water breaking prematurely). In 2013, per the CDC, about 20 percent of women smoked in the first three months of pregnancy, and one in 10 during the last three months. In addition, about 5 percent of women used illegal drugs while pregnant.
- Extended Childbearing Years. Romper.com describes it as a catch-22: medical science is now providing options for women giving birth later in life, but with that comes older moms and thus a higher risk of developing complications during pregnancy, such as placenta prevue. Also, older women are more likely to have chronic disease conditions going into pregnancy, such as high blood pressure, diabetes and chronic heart disease—all conditions that can lead to problems during pregnancy and childbirth.