Experts: U.S. Childbirth Deaths on Rise

Tom Davis sits with his children, from left, Matthew, 12, Jacob, 13, and Ethan, 6, on June 11, 2007, in Chatham, Va. Davis lost his wife, Elizabeth, in 2000, after she gave birth to Ethan. Davis is now raising his sons alone. U.S. women are dying from childbirth at the highest rate in decades, new government figures show. (AP Photo/Don Petersen) (Don Petersen - AP)

"There's an inherent risk to C-sections," said Dr. Elliott Main, who co-chairs a panel reviewing obstetrics care in California. "As you do thousands and thousands of them, there's going to be a price."

Excessive bleeding is one of the leading causes of pregnancy-related death, and women with several previous C-sections are at especially high risk, according to a review of maternal deaths in New York. Blood vessel blockages and infections are among the other leading causes.

Experts also say obesity may be a factor. Heavier women are more prone to diabetes and other complications, and they may have excess tissue and larger babies that make a vaginal delivery more problematic. That can lead to more C-sections. "It becomes this sort of snowball effect," said King, who is now medical director of maternal-fetal medicine at Riverside Methodist Hospital in Columbus, Ohio.

The age of mothers could be a factor, too. More women are giving birth in their late 30s and 40s, when complications risks are greater.

Other characteristics of the maternal mortality rate include:

_Race: Studies have found that the maternal death rate in black women is at least three times greater than is it is for whites. Black women are more susceptible to complications like high blood pressure and are more likely to get inadequate prenatal care.

_Quality of care: Three different studies indicate at least 40 percent of maternal deaths could have been prevented.

Sometimes, there is no clear explanation for a woman's death.

Valerie Scythes, a 35-year-old elementary schoolteacher, died in March at a hospital in New Jersey _ the state with the highest Caesarean section rate. She had had a C-section, as did another teacher at the same school who died after giving birth at the same hospital two weeks later.

However, Scythes died of a blocked blood vessel and the other woman died from bleeding, said John Baldante, a Philadelphia attorney investigating the death for Scythes' family.

"I'm not sure there was any connection between the two deaths," Baldante said.

Also mysterious was the death of Tim Davis' 37-year-old wife, Elizabeth, who died a day after a vaginal delivery at a Danville, Va., hospital in September 2000.