The U.S. continues to have a much higher maternal death rate than all other high-income nations, according to new research.
The report, released by The Commonwealth Fund on Tuesday, found this was true despite a decline in deaths since the COVID-19 pandemic.
Within the U.S., the rate of maternal death is by far the highest for Black women. And an alarming share of these deaths — over 80% — are likely preventable, the research shows.
There’s something to be learned from other wealthy nations who, unlike the U.S., report virtually no maternal deaths. That’s due to policies and systems in place that provide support to women during the perinatal period.
In 2022, there were 22 maternal deaths for every 100,000 live births in the U.S., according to the report. That figure is double, and in some cases triple, the number of other countries studied.
In half of the nations in the analysis, there were fewer than five deaths for every 100,000 live births in 2022. That same year, the maternal death rate in Norway was zero.
Nearly 2 in 3 maternal deaths in the U.S. occur during the postpartum period. The study said U.S. women “are the least likely to have supports such as home visits and guaranteed paid leave during this critical time.”
The U.S. and Canada have the lowest number of OB-GYNs and midwives. In both of those countries, plus South Korea, OB-GYNs outnumber midwives; but data shows that may not be optimal.
Care led by midwives has been shown to be comparable to, if not better than that provided by OB-GYNs, the report says. Aside from the U.S., Canada and South Korea, midwives greatly outnumber OB-GYNs in most other nations.
"High-quality postpartum care is intended to ensure the physical and emotional recovery of mothers and their babies and can help reduce maternal deaths," says the study. "Visits by a midwife or a nurse are associated with improved mental health and breastfeeding outcomes as well as reduced health care costs."
“Home visits give providers an opportunity to address maternal and mental health concerns as well as to assess the mother’s available supports and social drivers of health, including needs for food, housing, financial security, and protection from domestic violence,” the report says.
All countries studied other than the U.S. guarantee at least one home visit within a week of giving birth. There are some Medicaid programs that do cover such visits in the U.S.
There are about 7 million women in the U.S. who live in a county without a hospital or birth center that offers obstetric care. The report estimates this will worsen in the coming years.
