The Washington PostDemocracy Dies in Darkness

Our maternal mortality rate is a national embarrassment

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The United States ranks near the bottom of the world's wealthy countries when it comes to the number of women who die from complications of pregnancy and childbirth, according to new data from the World Health Organization. American women die in pregnancy or childbirth more than twice as often as women in Canada. Even worse, the United States is one of only a few countries -- including Zimbabwe and North Korea -- where the mortality rate has risen since 1990.

In the U.S., 14 out of every 100,000 mothers died due to complications of pregnancy or childbirth. That puts it between Qatar (13 deaths) and Bahrain (15) in the ranking of all 184 countries for which the WHO has data. The United States is ranked 46 out of those 184 countries, barely in the top 25 percent. By contrast, in Canada only 7 out of 100,000 mothers died in pregnancy or childbirth. American women are over four times as likely to die in pregnancy or childbirth as women in Greece, Iceland or Poland, where the rate is 3 out of every 100,000.

We're one of the world's wealthiest countries, and we spend way more on healthcare than other rich nations. So how did we end up here?

For starters, you can see parallel trends in our infant mortality rate relative to other countries, too. Part of it is access to quality health care: poor American moms have less access to care, and may not even be covered by insurance at all. This isn't the case in many other countries, where health-care access is universal. So in the United States, the mothers who need care the most may be getting the least of it, which naturally leads to higher maternal mortality rates.

There's a similar dynamic at work in other health outcomes, too -- like life expectancy, for instance, where the United States is a huge outlier compared to other countries.

On the other hand, maternal mortality in the United States is a drop in the bucket compared to rates seen in some very poor countries. In Rwanda, for instance, the rate is 290 out of 100,000 -- 20 times the U.S. rate. The rate in Mali is 587 per 100,000, and in Sierra Leone it's an astonishing 1,360 out of 100,000. In that country, one mother dies for every 100 children born.