What Are the Risk Factors for Maternal Mortality?
According to the U.S. Centers for Disease Control and Prevention (CDC), about 700 women in the United States die each year due to complications from pregnancy or childbirth. Perhaps surprisingly, the incidence of maternal mortality has gone up in the past few decades. In 1987, the rate was 7.2 deaths per 100,000 live births; in 2016, the rate had skyrocketed to 16.7 deaths per live birth—more than double. And in 2018, it had risen still more, to 17.4.
In fact, the United States has one of the highest rates of maternal mortality in the developed world. Countries considered our “peer” countries have not seen the same increase in maternal mortality as the United States over the past thirty years.
Looking at those figures, you may reason that even the higher number is not that high; after all, 99,983 out of every 100,000 women who give birth do not die. But the small number of women who do die in childbirth or from pregnancy-related complications are wives, daughters, sisters, friends, and mothers. More of them are dying than used to. And, according to the CDC, more of them are dying than need to. The CDC estimates that 60% of these deaths could have been prevented. What’s more, for every maternal death, there are over 80 women who experience a severe complication.
When we speak of “maternal mortality,” most people tend to think about women who die in childbirth. In reality, deaths in this category can occur during pregnancy, at delivery, or up to a year after the birth, in the postpartum period from causes connected to the pregnancy or birth. The CDC estimates that about one-third of pregnancy-related deaths happen in each of these time frames
The Role of Race in Maternal Mortality
If you have heard about maternal mortality in the news lately, chances are it had something to do with the role race plays. There is a fairly large racial disparity in maternal mortality rates. The 16.7 per 100,000 figure cited above is for all women. But the rate for Black non-Hispanic women is 42.4 deaths per 100,000 live births, compared with 30.4 deaths for Native American and Alaskan Native women, 13.0 for white non-Hispanic women, and 11.3 for Hispanic women.
It’s unlikely that race or ethnicity directly affects the likelihood that a woman will die in childbirth or as the result of a pregnancy-related complication. Instead, the disparity may stem from a lack of access to prenatal or postpartum care, from a documented tendency of some doctors to take the pain report and concerns of some women less seriously, as well as other factors that could amount to medical malpractice.
Age and Maternal Mortality
While there is no age at which women are “safe” from pregnancy-related complications or death, maternal mortality increases sharply with age. The age group with the most maternal deaths is 35 years and older, with more than double the rate of the group with the next highest death rate, women aged 30-34.
Primary Causes of Maternal Mortality
There are, of course, other factors that are linked with maternal mortality. More than a third of pregnancy-related deaths are the result of heart disease or stroke. Still others stem from obstetric emergencies. For instance, severe bleeding and amniotic embolism (when amniotic fluid gets into the mother’s bloodstream) are the leading causes of death during and just after delivery.
During the first week after birth, severe bleeding continues to be a threat, as do infection and high blood pressure. In the year following the birth, cardiomyopathy, or weakening of the heart muscle is the main cause of death.
Sometimes pregnancy-related complications and death are unpredictable and unavoidable. Often, however, a woman will exhibit risk factors or express concerns, only to have them ignored or minimized by her obstetrician or other medical professionals responsible for her care. This may happen to women who are young, uneducated, lacking resources, or for whom English is not their first language.
However, even wealth and fame are not necessarily protective. Tennis great Serena Williams had multiple risk factors: race, age, and a history of blood clots, when she developed a pulmonary embolism (blood clot that has traveled to the lungs) and felt shortness of breath. Knowing her own history, she tried to persuade her medical team that she needed a CT scan, only to be met with resistance. Fortunately, she insisted—something many women don’t do, assuming that their doctor knows best.
Her fears were confirmed: coughing fits following her C-section had caused her incision to open and blood clots to form. One traveled to her lung, causing the shortness of breath that led her to seek help. While it’s wonderful that Serena Williams was able to advocate for herself, a woman should not have to persuade her doctor to investigate troubling symptoms during or after pregnancy. If you have suffered complications from pregnancy or childbirth that your doctor did not take seriously, or if you lost a loved one due to pregnancy-related death, we invite you to contact our law office to schedule a consultation.
The information in this blog post is provided for informational purposes only and is not intended to be legal advice. You should not make a decision whether or not to contact a qualified medical malpractice attorney based upon the information in this blog post. No attorney-client relationship is formed nor should any such relationship be implied. If you require legal advice, please consult with a competent medical malpractice attorney licensed to practice in your jurisdiction.