A Maternal Mortality FAIL in the U.S.

By Alicia Ely Yamin

mothersilocontrast-copyWhile the Republicans cynically stall efforts on health reform to gain political advantage and the Democrats wrangle over special deals, too many people continue to die in this country because they lack access to care. A report released today from Amnesty International highlights the scandalous fact that every day in the richest country in the world 2 to 3 women die in pregnancy and childbirth.

As Deadly Delivery: THE MATERNAL HEALTH CARE CRISIS IN THE USA notes, the U.S. “spends more than any other country on health care, and more on maternal health than any other type of hospital care. Despite this, women in the USA have a higher risk of dying of pregnancy-related complications than those in 40 other countries. “ For example, the likelihood of a woman dying in childbirth in the U.S. is five times greater than in Greece.

Perhaps even more scandalous, “African-American women are nearly four times more likely to die of pregnancy-related complications than white women. These rates and disparities have not improved in more than 20 years.”

Amnesty’s report rightly asserts that this is not just a public health scandal; it reflects widespread violations of women’s human rights, including the right to life, the right to freedom from discrimination, and the right to the highest attainable standard of health. Patterns of marginalization and exclusion in this society are exacerbated by a discriminatory and dysfunctional health system.

Throughout the health care reform debates, there has been scarcely a mention of health care being a fundamental human right. But the fact is that the U.S. is the only industrialized nation in the world that does not recognize a legal entitlement to health care.

Despite the fact that health care is treated as a commodity and not a right in this country, the US is bound by some international legal obligations that bear on addressing the root causes of maternal mortality. Amnesty’s report points out that the US is a party to the International Covenant on Civil and Political Rights and the International Convention on the Elimination of All Forms of Racial Discrimination and a signatory to the International Covenant on Economic, Social and Cultural Rights. And, just as with prohibitions on torture, international standards in this area do apply to the United States.

At the United Nations this week, the Commission on the Status on Women is celebrating its fifty-fourth session, which is a particularly important one because this year marks the fifteenth anniversary of the Beijing Conference where then-first lady Hillary Clinton proclaimed “women’s rights are human rights.” At this session the US delegation, together with other states, introduced a resolution to recognize the need for strengthening efforts to combat maternal mortality around the world. Amnesty’s report vividly shows that the U.S. urgently needs to start strengthening its efforts at home.

Join us in calling on President Obama to establish an Office of Maternal Health to lead government effort to reduce the appalling U.S. death rate for women having babies.

Alicia Ely Yamin is the Joseph H. Flom Fellow on Global Health and Human Rights at Harvard Law School and on the Advisory Boards of the International Initiative on Maternal Mortality and Human Rights.  She serves as a special advisor to Amnesty International on maternal mortality and human rights.  She also blogs on human rights issues for change.org.

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18 thoughts on “A Maternal Mortality FAIL in the U.S.

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  2. It's interesting that Amnesty International is taking up this issue. I am of the extreme opinion that all maternal deaths are preventable with adequate medical care. That said, I wanted to leave a comment because you reminded me of an article that I read years ago in the Philadelphia Inquirer. The year was 1986 or 1987–the article's author mapped the city of Philadelphia by neighborhood ( generally zip code) and income, and gave statistics on infant deaths,and, I think deaths in childbirth for each neighborhood. The difference was astonishing–generally by income level, which cannot, of course, exclude race. The rates went from what would rival a third-world nation to very low–some of the lowest anywhere. The article is probably available through the Inquirer's website–I don't have a copy, or I would append it here.
    epaburke

  3. It’s interesting that Amnesty International is taking up this issue. I am of the extreme opinion that all maternal deaths are preventable with adequate medical care. That said, I wanted to leave a comment because you reminded me of an article that I read years ago in the Philadelphia Inquirer. The year was 1986 or 1987–the article’s author mapped the city of Philadelphia by neighborhood ( generally zip code) and income, and gave statistics on infant deaths,and, I think deaths in childbirth for each neighborhood. The difference was astonishing–generally by income level, which cannot, of course, exclude race. The rates went from what would rival a third-world nation to very low–some of the lowest anywhere. The article is probably available through the Inquirer’s website–I don’t have a copy, or I would append it here.
    epaburke

  4. The most cost effective and woman-friendly solution would be to bring midwifery into mainstream maternity care. European countries with well established midwifery care provide excellent maternity care at much lower cost than the US obstetric model. The medicalization of pregnancy and childbirth causes more problems than it solves. Midwives are the lead professionals for childbirth in the UK where I live and work and are trained to recognize complications requiring obstetric intervention. At the same time midwives are skilled in helping women with complex problems maintain as much normality as possible. All women in the UK receive aftercare from a midwife for the first ten days following childbirth. I have contributed to the development of innovative undergraduate midwifery curricula for direct entry students (non-nurses) and would welcome the opportunity to act as a consultant for any public university in the USA wishing to develop a similar program.

  5. The most cost effective and woman-friendly solution would be to bring midwifery into mainstream maternity care. European countries with well established midwifery care provide excellent maternity care at much lower cost than the US obstetric model. The medicalization of pregnancy and childbirth causes more problems than it solves. Midwives are the lead professionals for childbirth in the UK where I live and work and are trained to recognize complications requiring obstetric intervention. At the same time midwives are skilled in helping women with complex problems maintain as much normality as possible. All women in the UK receive aftercare from a midwife for the first ten days following childbirth. I have contributed to the development of innovative undergraduate midwifery curricula for direct entry students (non-nurses) and would welcome the opportunity to act as a consultant for any public university in the USA wishing to develop a similar program.

  6. The maternal & infant mortality rate in this country is appalling. It's time we ask the "United Nations" to intercede for the citizens of the USA in an effort to achieve health care as a basic human right.

  7. The maternal & infant mortality rate in this country is appalling. It’s time we ask the “United Nations” to intercede for the citizens of the USA in an effort to achieve health care as a basic human right.

  8. The maternal & infant mortality rate in this country is appalling. It’s time we ask the “United Nations” to intercede for the citizens of the USA in an effort to achieve health care as a basic human right.

  9. The maternal & infant mortality rate in this country is appalling. It’s time we ask the “United Nations” to intercede for the citizens of the USA in an effort to achieve health care as a basic human right.

  10. The maternal & infant mortality rate in this country is appalling. It’s time we ask the “United Nations” to intercede for the citizens of the USA in an effort to achieve health care as a basic human right.

  11. The maternal & infant mortality rate in this country is appalling. It’s time we ask the “United Nations” to intercede for the citizens of the USA in an effort to achieve health care as a basic human right.

  12. Although the USA has appaling medical care the UK is not a whole lot better, yes there is good service most of the time, however the standard of medical care in the UK falls below acceptable standards

  13. Although the USA has appaling medical care the UK is not a whole lot better, yes there is good service most of the time, however the standard of medical care in the UK falls below acceptable standards

  14. Pingback: “Deadly Delivery” in the News | Human Rights Now - Amnesty International USA Blog

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  16. I appreciate Amnesty's taking up this issue. You seem to recognize the complexity of the problem. The peer reviewed medical literature, as you know, highlights the difficulty in defining interventions proven to reduce maternal morbidity and mortality. Nonetheless, your campaign and e-mailings are misleading, and not up to your standards. For example, the e-mail solicitation I received highlights the unfortunate case of Julie LeMoult. Her case may be a rallying point for process of care or malpractice reform. It is not germane to what appear to be your target outcomes. You can do better than sentimental demagoguery, and usually do.

  17. I appreciate Amnesty’s taking up this issue. You seem to recognize the complexity of the problem. The peer reviewed medical literature, as you know, highlights the difficulty in defining interventions proven to reduce maternal morbidity and mortality. Nonetheless, your campaign and e-mailings are misleading, and not up to your standards. For example, the e-mail solicitation I received highlights the unfortunate case of Julie LeMoult. Her case may be a rallying point for process of care or malpractice reform. It is not germane to what appear to be your target outcomes. You can do better than sentimental demagoguery, and usually do.

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