If You’re Pregnant, You’ve Been F****d: Maternal Mortality in the U.S.

After reading Deadly Delivery: The Maternal Healthcare Crisis in the USA, an Amnesty International report released last Friday, my first thought was of a speaker I heard at a conference years ago who aptly said, “If you’re pregnant, you’ve probably been fucked.” Maternal mortality is an enormous problem in the US.

The statistics are maddening:

  • Maternal mortality ratios in the U.S. have increased in recent decades, from a low of 6.6 deaths per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006.
  • Women in the U.S. have a higher risk of dying of pregnancy-related complications than women in 40 other countries.
  • More than two women die every day in the U.S. from pregnancy-related causes.
  • African American women are at especially high risk, nearly four times more likely to die of pregnancy-related complications than white women.
  • Approximately half of maternal deaths in the U.S. are preventable.
  • These statistics belie the fact that the U.S. spends more than any other country on health care, and more on maternal health than any other type of hospital care.

“This is not just a public health emergency,” says Amnesty International, “it is a human rights issue.”

Pulled from over a hundred interviews with focus groups, as well as information from state health departments and Medicaid programs, the report presents a wide scope of failures, ranging from discrimination to language barriers to inadequate staffing to lack of oversight. Here’s are some highlight quotes:

  • “We don’t insure a house on fire.” Statement reportedly made by an insurance company representative when turning down a request from Tanya Blumstein, who was unable to purchase private health insurance with any U.S. company while she was pregnant.
  • “If you go to apply to the Medicaid system, you need a ‘proof of pregnancy’ letter, with the due date, the date of your last period and the gestational age of the baby. Where do you get that kind of a letter? A doctor. [But] if you have no Medicaid, how are you going to get to the doctor to get that letter?”Jennie Joseph, certified professional midwife, Winter Garden, Florida.
  • “Well, she might as well have an epidural; we’re practicing veterinary medicine here.” Anesthesiologist in response to a Spanish-speaking woman who did not want an epidural, reported to Amnesty International by a registered nurse.

Lynn Paltrow, executive director of National Advocates for Pregnant Women, recently posted about the report:

“A journalist asked if I thought the title [Deadly Delivery] was an ‘over-exaggeration.’ My answer was that if you are privileged enough to have access to the best of America’s health care system it might seem that way, but if you are one of the tens of millions of people with little to no health care coverage then the title might actually be a profound understatement.”

Even while maternal deaths overall remain low, the fact that the rate is rising shows the intersection of multiple discriminations. Nan Strauss, researcher and co-author of the report, told CNN:

“The thing that really struck us was that these problems hit women of color [and] low-income [women] particularly hard, but every woman who is going through pregnancy in this country is at risk.”

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Danielle Roderick is a writer and full spectrum doula in Los Angeles. She's written for Ms. magazine, The Hairpin, The Awl, Splitsider and Delirious Hem.