Rita Henley Jensen: The time is now for the Senate to focus on maternal health; the death of a new or expectant mother is a disaster for her family and her community
Editor’s Note: Rita Henley Jensen is a journalist and founder and editor in chief emerita of Women’s eNews. She is also the founder of the Jane Crow Project, a journalism project that investigates women’s maternal health in the United States. The views expressed in this commentary are solely those of the author.
I believe I can speak for millions of mothers in America, Republican and Democrat alike, when I say that the 13 men in the Senate drafting its version of the contentious health care bill to repeal and replace Obamacare can skip the whole breakfast in bed thing for Mother’s Day.
That’s not what we need from them. What current and future American mothers need right now is much more attention to their health – especially an increase in our survival rates in childbirth. Mother’s Day is an excellent time for the drafting committee shaping the Senate’s version of the healthcare bill to take a moment to focus on the rising numbers of US women dying while giving birth or from complications of pregnancy.
Here’s something they should spend some time thinking about: the maternal mortality rate for American women is rising, when elsewhere across the globe it is shrinking. In fact, according to the World Health Organization, between 1990 and 2015, maternal mortality worldwide dropped by 44%, but the United States is one of only a few countries – including Zimbabwe and North Korea – in which the rate of deaths of pregnant and new moms went up. The estimated maternal mortality rate (per 100,000 live births) for 48 states and Washington, DC (excluding California and Texas, analyzed separately) increased by 26.6%, from 18.8 in 2000 to 23.8 in 2014. California showed a declining trend, whereas Texas had a sudden increase in 2011–2012.
The WHO data show that American moms are more than three times as likely to die in childbirth than Canadians, while the Centers for Disease Control and Prevention has said that African American women are three times as likely as white women to die as a result of pregnancy in the US. A recent investigation by NPR and ProPublica put in human terms the grief and explained several of the underlying reasons the US has the worst rate of maternal deaths in the developed world.
The primary reasons cited in the project were doctors and nurses not being properly trained to recognize the urgency and danger of hemorrhage and a form of high blood pressure related to pregnancy and birth.
This issue isn’t usually the first thing that comes to mind when the question of women’s health comes up in the political arena; in this case, Senate lawmakers may have been absorbed instead in other points embedded in the health bill: coverage (or lack thereof) for pre-existing conditions such as pregnancy – as well as contraception, abortion and Planned Parenthood’s funding.
The time is now for the Senate to focus on maternal health. The death of a new or expectant mother is a disaster for her family and her community. And it’s intolerable for politicians – or anyone else – to give this problem short shrift, particularly in light of a recent analysis from the independent CDC Foundation. It found that nearly 60% of those mothers’ deaths are preventable.
This is time-is-of-the-essence important because a mother will surely die today – about three do every day.
It would demonstrate an act of true Mother’s Day caring if the senators could put aside their beliefs about other reproductive health issues to really think about how their healthcare bill can incorporate the practices that could reduce maternal mortality – even if only for the amount of time it takes to prepare bacon, pancakes, orange juice and coffee for a beloved mother. Let’s call it an hour and a half; two hours if two eggs and warmed maple syrup are added.
These are the two biggest points the 13 drafting senators need to absorb during that time and act on now.
We need better data: the CDC has not published an official maternal mortality rate since 2007.This means we officially don’t know that more pregnant women and mothers are dying than a decade ago.
We need to learn lessons of what to do (and not to do): two of our nation’s largest states are potential templates for best (and worst) practices in this area: outliers and were not included in the CDC Foundation’s analysis: California, where maternal mortality rate has actually sunk since 2000, and Texas, where the rate has doubled.
California’s maternal mortality rate dropped by more than half, from 17 deaths per 100,000 live births in 2006 to 7 deaths in 2013, according to the California Department of Public Health. Those figures refer to deaths from obstetric causes within 42 days postpartum.
These happy outcomes are not a miracle of modern medicine. In 2006, the state formed the California Maternal Quality Care Collaborative with the goal of reducing maternal deaths from two major killers: hemorrhage and soaring high blood pressure. And the members worked hard and together, created a strategy and went to work.
Texas, meanwhile, took a different path. The state, as the Senate members know full well, began in 2011 to shut down Planned Parenthood, other sources of reproductive health care and abortion clinics. The state’s budget for family planning was cut by two-thirds forcing 82 family planning clinics to close – a third of which were Planned Parenthood centers. The maternal mortality rates began to rise dramatically. Between 2000 and 2010, 72 Texan women died from pregnancy-related causes. In the following two years, 148 Texan women lost their lives due to complications of pregnancy and childbirth. The authors of the public health maternal mortality report doubt that the cuts directly caused the surge in deaths but did not speculate on what the cause could be. Activists point to the closure of the clinics. Regardless, I am confident the nation’s and especially Texan parents-to-be find the data troubling.
Yes, Texas has taken dramatic steps to reduce the availability of contraception and abortion and California makes both more widely available. But that’s not the only difference. In California, stakeholders worked together to achieve substantive results and save the lives of new and expectant mothers. Texas, not so much.
One final fact: federally funded Medicaid pays for approximately 50% of all births in the United States. While the 13 Senators are looking at the Medicaid budget, they might wish to keep in mind that half of the nation’s new mothers relied on this federal health insurance to care for them while they were pregnant and gave birth. Expand it, and more moms survive. Cut it, and we could have a maternal mortality rate higher than Zimbabwe.
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To those 13 senators, I say: We are only asking for an hour and a half; two at the most. I like to believe the senators take the time and say to themselves: Let’s seize this moment to make a dramatic improvement in women’s health that would receive bi-partisan support. That’s exactly what the families of this nation need to hear from us right now.