Maternal mortality is when a pregnancy-related death occurs during or within one year of pregnancy and was caused by a pregnancy complication, a chain of events initiated by pregnancy, or aggravation of an unrelated condition by the physiologic effects of pregnancy.
While maternal mortality has continued to trend downward around the world, the numbers in the United States have continued to increase. Moreover, in the United States, huge disparities exist within populations, with Black and Native American/Indigenous women at much higher risk of maternal mortality and morbidity than white women. Nationwide, Black women are three to four times more likely to die from pregnancy related complications and Indigenous/Native American women are twice as likely to die than white women.
In certain rural and urban areas, this disparity increases even more. For example, in New York City, one of the wealthiest cities in the world, Black women were 12 times more likely than white women to die from pregnancy associated causes between 2006 to 2010. We believe this points to a larger problem of structural racism within our country, both in the healthcare system, as well as in access to care, insufficient insurance coverage and the long term effects of stress from a lifetime of racism.
Doctors of the World has been involved in the issue of maternal mortality on the international stage for years as part of our sexual and reproductive health and rights pillar of action. A huge part of our mission is to bear witness, spotlight injustices, and advocate for healthcare infrastructure solutions. This initiative is our attempt to engage in advocacy that speaks directly to this disturbing public health issue within the United States.
This is a multi-faceted problem that requires multiple systems level policy changes at the state and federal levels. However, something we can do immediately and with urgency is to draw attention to the crisis by centering it as an important policy issue in the upcoming election. To this end, Doctors of the World has launched the H.E.A.T. Campaign, a voter education and advocacy initiative to highlight the public health crisis of maternal mortality and the unconscionable racial disparities that exist within our country.
Petersen EE, Davis NL, Goodman D, et al. Racial/Ethnic Disparities in Pregnancy-Related Deaths — United States, 2007–2016. MMWR Morb Mortal Wkly Rep 2019;68:762–765. DOI: link
Davis NL, Smoots AN, Goodman DA. Pregnancy-Related Deaths: Data from 14 U.S. Maternal Mortality Review Committees, 2008-2017. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.
Munira Z. Gunja et al., What Is the Status of Women’s Health and Health Care in the U.S. Compared to Ten Other Countries? (Commonwealth Fund, Dec. 2018). link
We finally have a new US maternal mortality estimate. It’s still terrible. (Vox, January 30, 2020) link
CDC Pregnancy Mortality Surveillance System. link
Pregnancy Associated Mortality in New York City 2006-2010. link
Black mothers in the U.S. are dying at similar levels as mothers in underdeveloped countries. This is unacceptable and it is time for a change.