Maternal mortality in developed nations, 1990-2015. The U.S. is alone in having an increasing mortality rate, the worst of all developed nations. Data: The Global Burden of Disease 2015 Maternal Mortality study as published in The Lancet medical journal. Graphic: USA TODAY

By Chris Heide
24 August 2018
(Second Nexus) – A USA TODAY report has determined that the United States has become the “most dangerous place to give birth in the developed world.”More than 700 women in the United States die from complications directly related to childbirth each year. In addition, more than 50,000 American women are severely injured as a result of childbirth on an annual basis. The report indicates that these injuries and deaths are the direct result of hospitals not following long-standard medical procedure.The study, which lasted four years, indicates that the United States now has the highest maternal death rate anywhere in the developed world. This is in stark contrast to many other developing nations, which are experiencing all-time low rates in maternal deaths. [This finding corroborates earlier studies by CDC and NPR/ProPublica. –Des]Many of the long-standing medical procedures are fairly simple. They include monitoring risks for hemorrhage, to administering appropriate medications to control hypertension. In essence, American maternity care has become too lax. The result is the increase in maternal mortality- something that could be easily minimized. Also, it was noted that African American women suffer maternal deaths at an even higher rate than Caucasian women.“Countries around the world have reduced maternal deaths and injuries by aggressively monitoring care and learning from mistakes,” USA Today reported. “The result has been two decades of steady or reduced maternal harms in the rest of the developed world — as US rates climbed … Women are left to bleed until their organs shut down. Their high blood pressure goes untreated until they suffer strokes. They die of preventable blood clots and untreated infections. Survivors can be left paralyzed or unable to have more children.”“Experts say that about 50 percent of the deaths of women from childbirth-related causes could be prevented if they were given better medical care and that’s a really surprising thing given that we’re one of the wealthiest countries in the world and we spend so much on medical care. We’re not just talking about the women who die, we’re talking about 50,000 U.S. women who are suffering life-altering harms,” USA Today investigative reporter Alison Young told “CBS This Morning” on Thursday.Why exactly are hospitals so lackadaisical with standard medical procedure? Dr. Steven Clark, a professor at Baylor College of Medicine, asserts that this kind of professional behavior has become standard practice.“Our medicine is run by cowboys today, where everyone is riding the range doing whatever they’re wanting to do. It’s a failure at all levels, at national organization levels and at the local hospital leadership levels as well,” he says. [more]

STUDY: The United States Has the Highest Maternal Death Rate In the Developed WorldMaternal mortaility in the U.S. by state. Data: Agency for Healthcare Research and Quality; Health Resources and Services Administration; Centers for Disease Control and Prevention; USA TODAY analysis. Graphic: USA TODAY

The Editorial Board
31 July 2018
(USA TODAY) – YoLanda Mention, who had just given birth to a baby girl at one of South Carolina’s top hospitals, should probably be alive today — certainly in a country with the world’s most advanced health care system.
But the 38-year-old wife and mother was sent home from the hospital in March 2015 with dangerously high blood pressure. That same night, she and her husband, Marco, returned to the ER.Though her blood pressure had climbed and she had an excruciating headache, she sat in the waiting room for hours, according to a lawsuit filed by her husband. By the time she was ushered into an exam room, she suffered a stroke. She died a few days later, leaving the couple’s three girls motherless.The right treatment at the right time — IV medication that costs less than $60 a dose — could well have saved her. Despite politicians’ claims that America has the best health care of any country, similar tragedies occur repeatedly across the United States, which today is the most dangerous place in the developed world to give birth.You read that correctly. About 700 mothers in America die each year in childbirth, many of them needlessly — a maternal death rate far higher than that of other developed nations, including Canada, France, Germany, Japan and the United Kingdom. And 50,000 mothers are severely injured each year in childbirth, USA TODAY found in an investigation published last week.About half of these deaths could be prevented, and half the injuries reduced or eliminated, through simple changes in care that doctors, hospitals and medical experts have known about for years. Yet too many “hospitals and medical workers skip safety practices known to head off disaster,” USA TODAYs Alison Young wrote. [more]

High maternal death rate shames America among developed nationsTrend in pregnancy-related mortailty in the U.S., 1982-2014. Graphic: CDC

By Alison Young
27 July 2018
(USA TODAY) – Every year, thousands of women suffer life-altering injuries or die during childbirth because hospitals and medical workers skip safety practices known to head off disaster, a USA TODAY investigation has found.Doctors and nurses should be weighing bloody pads to track blood loss so they recognize the danger sooner. They should be giving medication within an hour of spotting dangerously high blood pressure to fend off strokes.These are not complicated procedures requiring expensive technology. They are among basic tasks that experts have recommended for years because they can save mothers’ lives.Yet hospitals, doctors and nurses across the country continue to ignore them, USA TODAY found.As a result, women are left to bleed until their organs shut down. Their high blood pressure goes untreated until they suffer strokes. They die of preventable blood clots and untreated infections. Survivors can be left paralyzed or unable to have more children.The vast majority of women in America give birth without incident. But each year, more than 50,000 are severely injured. About 700 mothers die. The best estimates say that half of these deaths could be prevented and half the injuries reduced or eliminated with better care.Instead, the U.S. continues to watch other countries improve as it falls behind. Today, this is the most dangerous place in the developed world to give birth.Identifying every hospital that doesn’t provide recommended care is next to impossible. There is no national tracking system for childbirth complications. Mothers tell harrowing tales of survival, but they often have no idea whether their doctors and nurses did something wrong.USA TODAY obtained more than a half-million pages of internal hospital quality records and examined the cases of more than 150 women whose deliveries went terribly wrong. Reporters contacted 75 birthing hospitals to track whether they follow recommended procedures.Together, these documents and interviews reveal a stunning lack of attention to safety recommendations and widespread failure to protect new mothers.At dozens of hospitals in New York, Pennsylvania and the Carolinas – where USA TODAY obtained records through federally funded quality programs – fewer than half of maternity patients were promptly treated for dangerous blood pressure that put them at risk of stroke. At some of those hospitals, less than 15 percent of mothers in peril got recommended treatments, the records show.Many hospitals across the country conceded in interviews with USA TODAY that they were not taking safety steps such as quantifying women’s blood loss or tracking whether moms with dangerously high blood pressure got proper medication in time.The lack of attention happens at hospitals big and small, from tiny community delivery units to major birthing centers that tout state-of-the art technology and training. It also happens in doctors’ offices when they miss or fail to act on signs of serious complications during pregnancy and after delivery.In Ohio, Ali Lowry bled internally after giving birth in 2013, but medical staff didn’t recognize and act on the warning signs for hours, according to records in a lawsuit that she has since settled. By the time she was airlifted to another hospital for lifesaving surgery, her delivery hospital had nearly run out of blood and Ali’s heart had stopped.In Texas, Beatriz Garcia nearly bled to death when doctors and nurses were slow to help her after not quantifying her blood loss, she alleged in federal and state lawsuits. Garcia’s heart stopped. She needed a hysterectomy. She’s now awaiting a kidney transplant.And in South Carolina, one of the state’s top hospitals sent YoLanda Mention home with her newborn despite her dangerously high blood pressure. When she returned to the emergency room with even higher blood pressure and an excruciating headache, the staff made her sit for hours in the waiting room, according to a lawsuit filed by her husband. She had a stroke while waiting, and later died.Today, YoLanda’s husband, Marco, is raising their three daughters alone in rural Nesmith. He balances work as a school bus driver with all the demands of raising kids on his own – cooking the meals, cleaning and getting three girls to schools and day care.He spends his evenings leading his church choir and reminding his girls about a mother who the youngest knows as a picture in a curio cabinet.“The girls, they ask when she’s coming home and I don’t know what to tell them,” Mention said, wiping tears. “It seems like a nightmare and I just need to wake up.” [more]

Hospitals know how to protect mothers. They just aren’t doing it.

14 November 2017 (CDC) – Women in the United States are more likely to die from childbirth or pregnancy-related causes than other women in high-income countries. More evidence is needed to understand the actual causes of death better, but research suggests that half of these deaths may be preventable. Racial disparities persist. The risk of pregnancy-related deaths for black women is three to four times higher than those of white women.
Watch this session of Grand Rounds to learn about efforts to analyze and prevent future deaths. Hear our speakers discuss the effects maternal deaths have on the family and on the community. You will also learn about how CDC has collaborated and intervened through public-private partnership efforts to prevent deaths associated with childbirth and pregnancy.

Meeting the Challenges of Measuring and Preventing Maternal Mortality in the United States