U.S. Maternal Deaths Highest Among Peer Nations

by Nick Gier, Professor Emeritus, University of Idaho

Pregnancy shouldn’t kill women—in fact
in other rich countries it very rarely does.
—Amanda Stevenson, University of Colorado Boulder

We remain the most dangerous developed country to give birth in.
—Dr. Elizabeth Cherot of the March of Dimes

In 2020, American mothers died during pregnancy or one year after childbirth at a rate more than 3 times that of their European counterparts (21 per 100,00 live births vs. 6 per 100,000). In 2021 the U.S. rate shot up to 34.

Far More European Mothers Survive

European mothers receive much better prenatal and postnatal care, which includes paid maternity leave that sometimes involves weekly check-ups. Furthermore, European nations train many more midwives than we do, and they competently add to comprehensive maternal care. Finally, European women have ready access to abortion if pregnancy or birth threatens their lives.

Some would say that the U.S. has more poor immigrant mothers to deal with, but Germany, which has welcomed 1 million new arrivals (mostly Syrians refugees) since 2015, lost only 4 mothers per 100,000 in 2020. Sweden has taken in more Iraqi refugees than any other country and they lost 5 birthing mothers.

Eileen Crimmins, professor at the University of Southern California states: “There is just no reason for a rich country to have poor maternal mortality.” The Center for Disease Control and Prevention has predicted that with proper medical care “84% of pregnancy-related deaths in the U.S. are preventable.”

            Blue States Do Much Better

Not surprisingly, many more mothers survive in blue states than in “pro-life” red states. The lowest blue states’ maternal death average is 15 per 100,000, while the highest red states were at 38 deaths per 100,000.

California, even with millions of Hispanic mothers, does best with only 10 deaths in stark contrast to Arkansas’ 44. Again, the principal difference is access to quality health care, which in California, means Women, Infants, and Children programs in every county.

Based on new data after the Supreme Court decision overturned Roe v. Wade, researchers at the University of Colorado Boulder estimate that maternal deaths will increase by 24%. The guiding factor is that 48 times fewer women die from legal abortion than from pregnancy, and there will be many more pregnancy-related deaths in states that have, in essence, banned abortions.

Infant Mortality Also Up

U.S. infant mortality (already the highest among peer nations and highest in red states) is also rising in anti-abortion states. A study by the Gender Equity Policy Institute found that “infants born in states with abortion bans were 30% more likely to die than those in supportive states.” 

This stands to reason because more women with difficult pregnancies in red states will be at risk of losing their fetuses and well as their own lives. CNN reporters are rightly concerned that “doctors fearing criminal charges will usually not perform abortions until the fetus’s heart has stopped or the pregnant person is in critical condition.” This is obviously too late for both lives. This is definitely not a pro-life result.

CNN reports that “in Texas, infant deaths fell steadily by 15 percent from 2014 to 2021. Since Texas banned abortion after six weeks in 2021, infant deaths have spiked by 12% percent. Deaths by genetic defect have risen by 22%.” Everything possible should be done to save the life of the mother if her fetus is genetically impaired.

Black Mothers More at Risk

Sadly, but not surprisingly, American Black mothers are nearly three times less likely to survive childbirth. There are several reasons for this disparity—socioeconomic and lack of available health care, but the principal one is implicit racial bias.

Dr. Monique Rainford of Yale School of Medicine explains that “caregivers may think they are doing the right thing for their pregnant patient, but their implicit bias against the woman’s race affects the care they deliver.”

Gynecologist Veronica Gillispie-Bell offers this shameful fact: “A Black woman with a college degree is 1.6 times more likely to die from pregnancy or childbirth than a white woman with less than a high school diploma. We know of countless accounts, including my own, of Black women presenting for medical care and being ignored.”

Idaho: Maternal Care Desert

According to the March of Dimes, 2.2 million women of childbearing age live in a maternity care desert — an area with virtually no access to birth centers or obstetric providers. (This desert is found overwhelmingly in counties that voted for Donald Trump.) Idaho is now adding to this deficit, as two rural hospitals have ceased providing obstetric services.

In March of this year, Bonner County General Health in Sandpoint announced that it “will stop labor and delivery services, citing doctor shortages and the ‘political climate.’ Highly respected, talented physicians are leaving. Recruiting replacements will be extraordinarily difficult.”

Idaho Abolishes Maternal Committee

For years Idaho has been embarrassed in the national news for having, for example, the highest number of white nationalists and accompanying militias. Now we have become the only state not to have an official committee to review maternal mortality. Such an annual review is imperative given the fact that in 2020 our pregnant mothers died at a rate of 42 per 100,000 live births.

Liz Woodruff, executive director of the Idaho Academy of Family Physicians, was “incredibly disappointed.” She continued: “The state of Idaho should support a committee that works toward preventing the deaths of pregnant women. This should be easy.”

One could conclude, after passing draconian abortion laws, even one that would chase down women who seek abortions out of state, that Idaho Republicans really don’t respect women or care about their lives. This conclusion is even more firm after the abolition of the maternal mortality committee.

As Laura Clawson Daily Kos writes: “Valuing life is the official reason for abortion bans, but on measure after measure, the states banning abortion show just how little they really value life.”

Postscript. I want to acknowledge anyone who “felt bad” about the contents of this column (or any of mine that portray our country in a bad light). Many say that if I don’t love my country, I must leave it (Hello, Denmark?). My answer is that I choose to stay and love my country and do everything that I can to make it better.

Nick Gier of Moscow taught religion and philosophy at the University of Idaho for 31 years. He was coordinator of religious studies from 1980 to 2003. Read his columns on abortion at nfgier.com/?s=abortion, and many others at nfgier.com. Email him at ngier006gmail.com.

U.S. Maternal Deaths Highest Among Peer Nations

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