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Monday, August 21, 2017

This post is the first in the Roosevelt Institute’s National Women’s Health Week series, which will address pressing issues affecting the health and economic security of women and families in the United States. Today, a look at why conservative policies at the state level are leading to increased maternal mortality rates.

For much of the last decade, maternal mortality rates (MMRs) have declined globally. But in the United States, they have consistently increased and are now at one of the highest points in the last 25 years. If conservatives have their way with social and economic policy, it’s unlikely the U.S. will make significant strides to improve the health of mothers in the near future.

According to a report released last week in the The Lancet, the U.S. now ranks 60th out of 180 countries for maternal deaths. China is number 57. Only seven other countries experienced an increase in MMR over the past 10 years. They include Greece, Afghanistan, and South Sudan. The report estimates that for every 100,000 births, 18.5 mothers die in the U.S. By comparison, 13.5 women die in Iran, 6.1 in the United Kingdom, and only 2.4 in Iceland.

It is no coincidence that the U.S. MMR has increased as poverty rates have steadily climbed. In 2010, Amnesty International released a report that showed women living in the lowest-income areas were twice as likely to suffer a maternal death. States with high rates of poverty were found to have MMRs 77 percent higher than states with fewer residents living below the federal poverty level. Women of color have poverty rates more than double those of white women, and black women are 3-4 times as likely to die from pregnancy-related causes.

The numerous factors that contribute to the high U.S. MMR are complex, as are the solutions required to effectively address the problem. However, one solution is already in place and is working. The Affordable Care Act (ACA) will significantly improve maternal health by mandating coverage of pre-natal, maternity, and post-partum care in all insurance plans. But some of the women in greatest need will remain uninsured and at increased risk because of the refusal of 21 states to expand Medicaid. Many of those states have among the nation’s highest rates of poverty and maternal mortality.

Expanding Medicaid would save women’s lives. A 2010 study conducted in New York City showed that the MMR for women with no insurance was approximately four times higher than for insured women, and that the rate for women insured by Medicaid was comparable to that of women with private insurance.

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