17 ms·

U.S. maternal death rate increasing at an alarming rate

78 points by johntfella 2y ago

ZeroGravitas 2y ago
In case you're familiar with the recent controversy about whether this is a statistical artifact: > There's actually been a lot of controversy about whether or not the increase that's been observed is a true increase or is an artifact of how we're now collecting data,” Khan said. “But when we examined deaths only in the states that had already adopted the checkbox and did it the exact same way, we captured an increase with acceleration in the last three years.
- michaelt 2y ago
  Yes - for further context, there's been a big statistical increase in maternal deaths in the US in part due to changes in reporting. [1] There was strong evidence that the US wasn't reporting all maternal deaths that meet the WHO definition; pregnancy and birth are major medical events, and can easily aggravate other medical conditions. But often you couldn't extract that information from the cause of death reported on a death certificate. So the US added a 'pregnant or recently pregnant?' checkbox to cause of death reports, and started counting all deaths with the box checked, minus accidents, suicides and falls. So even if a woman had a terminal illness before getting pregnant, that would still count as a maternal death. Then they gradually rolled out the new form one state at a time, over the course of 15 years - so instead of seeing a clear step in the data, there's a long gradual increase. This makes measuring any real changes in maternal death rates extremely challenging. However, this report says maternal death rates are rising even after accounting for the changes in reporting. [1] https://www.bbc.co.uk/programmes/p0j74zfs https://www.bbc.co.uk/programmes/p0j74zfs
  - kingkawn 2y ago
    By your logic there isn’t an increase in maternal deaths because they were already this high for a long time before and nobody cared, arguably an even worse situation. There is no way to spin this that isn’t societal neglect of pregnancy.
    - prmoustache 2y ago
      The fact the pregnant box is ticked doesn't mean the death is related to pregnancy. You can get pregnant with terminal cancer and it is unlikely to end well regardless of the pregnancy. The poster above just says it makes analysis of historical statistics difficult, he is not jumping to conclusion.
    - fluoridation 2y ago
      First, where does the "nobody cared" come from? Second, so what you're saying is that any maternal deaths at all means society is neglecting pregnant women? Because your argument applies even if we believe there's zero maternal deaths per year and later we find out there's actually one per year.
      - kylebenzle 2y ago
        [flagged]
        kingkawn 2y ago
        Yah yah what a skillful strawman you can build
        dang 2y ago
        Please don't respond to a bad comment by breaking the site guidelines yourself. That only makes things worse. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Edit: it looks like you've been repeatedly breaking the site guidelines in other places too: https://news.ycombinator.com/item?id=40892949 https://news.ycombinator.com/item?id=40892949 https://news.ycombinator.com/item?id=40845307 https://news.ycombinator.com/item?id=40845307 If this keeps up, we're going to have to ban you. We've had to warn you about this quite a few times in the past, and it's not cool. If you'd please review https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it. (Btw I've warned the GP in a couple other places in this thread, just in case it seems like the mods are taking sides)
oldpersonintx 2y ago
"While this study wasn’t able to explore specific causes of death, a large body of prior research, much of it published by Khan, has found cardiovascular disease (hypertensive disorders, heart failure and stroke) is a major contributor to poor maternal health outcomes." tl;dr: obesity ("hypertension") but why stop at maternal deaths? obesity is driving premature death rates in every category this is a national crisis but no one wants to say it out loud because someone's feelings will be hurt
- lotsofpulp 2y ago
  Basically every healthcare professional has been saying it out loud for decades. Its proxy, body mass index (BMI), is on every checklist and some city level political leaders have even been able to tax beverages with sugar. The Obamas, and Michelle Obama specifically, addressed it directly (14 years ago): https://letsmove.obamawhitehouse.archives.gov/ https://letsmove.obamawhitehouse.archives.gov/
- kingkawn 2y ago
  There’s also the ongoing closure of labor and delivery wards across the country, especially in rural America. There’s been an increase in retirements and burnout among experienced obgyn’s too. But I guess none of the complicating factors make for as good of a straw man for the inane point you’d like to use these women’s suffering to prove.
  - ecjhdnc2025 2y ago
    Obesity, like Brexit, is a multiplier for the negative outcomes of complicating factors.
    - kingkawn 2y ago
      saying that we should only think of it when someone’s trying to talk about women’s health is misogyny
      - 2y ago
Olesya000 2y ago
[dead]
HPsquared 2y ago
Why don't these types of article ever show a graph? EDIT: And their "recent" data point is 2021... Of course health outcomes would be worse in that year for various reasons.
- ljf 2y ago
  Some useful graphs here: https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison https://www.commonwealthfund.org/publications/issue-briefs/2... Black women in the US are almost 10 times as likely to die during/after childbirth, compared to all women in the UK (and white women in the US are almost 4 times as likely to die as in the UK). This 2024 report (pdf) has 2022 data, which is lower than 2021, but still above the average of the pervious 10 years: https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022/maternal-mortality-rates-2022.pdf https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022...
  - rayiner 2y ago
    Why are you comparing black women in the U.S. to mostly white women in the UK? The maternal mortality rate for black women in the UK is about 4 times higher than for white women in the UK: https://lordslibrary.parliament.uk/maternal-mortality-rates-in-the-black-community/ https://lordslibrary.parliament.uk/maternal-mortality-rates-...
    - ljf 2y ago
      True, but I was just referring to the data on the linked site.
      - hollerith 2y ago
        OK, then, why are you linking to a site/page that compares black women in the U.S. to mostly white women in the UK?
        2y ago
dscottboggs 2y ago
Gee, I wonder what changed between '19 and '21
- dscottboggs 2y ago
  something that caused an increase in risk of heart attack and stroke?? I dunno what that would be
  - deleted 2y ago
    [deleted]
  - pcdoodle 2y ago
    A buggy product perhaps?
  - PierceJoy 2y ago
    You must be referring to covid. Thankfully we have vaccines to reduce our risk of short and long term side effects.
    - dscottboggs 2y ago
      I'm six times vaccinated and still can't work full time 11 months out from catching covid so good luck with that idea. And I know people who are doing worse than I am. "Vaccination is like having an airbag. Avoiding contact is like keeping your hands on the wheel."
- LadyCailin 2y ago
  Would be interesting to compare the rates across different countries in the same time period. If they didn’t increase elsewhere, then it isn’t covid, but rather an American specific problem. The fact that healthcare isn’t a guaranteed right is certain to have some effect somewhere in American health data, just depends where exactly it shows up.
  - ljf 2y ago
    Check out this (also linked elsewhere in this post): https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison https://www.commonwealthfund.org/publications/issue-briefs/2... Compares US to other developed countries, and compares other things such as maternity leave and other health care opportunities. Note that some of the biggest risk area in the US is the 41 days AFTER child birth, where the US sees some of the worst results.
deleted 2y ago
[deleted]
austin-cheney 2y ago
I suspect this is due to the intermingled effects of biology and politics. * Consider that with the loss of Roe v Wade many states, including my own, have adopted draconian policies towards abortion without consideration for medical necessity. * Consider also the study indicated the most increased risk age groups are late 20s and early 30s. What’s interesting is there was a study published December indicating first time mothers in the 16-20 age group when compared to the 21-25 age group were about 20% less likely to experience detrimental risks of regular vaginal births. The numbers held identical when compared between the US and third world countries without common access to advanced medical care. The study concluded that age is among the most serious of factors with regards to maternal health of first time mothers and this could explain why males developed a selective preference for younger females.
- keiferski 2y ago
  The recent Roe decision was in 2022. The study covers 2014-2021.
  - anonym29 2y ago
    [flagged]
  - avidphantasm 2y ago
    But “red” states have been making reproductive healthcare harder and harder to access during the study period. One hypothesis to test is whether there are increases in mortality in such states after controlling for factors outside of access to reproductive healthcare. This will likely be hard to tease out because health outcomes tend to be worse in general in such states.
    - dredmorbius 2y ago
      That's a fair point and one that had occurred to me. The point would be stronger with some substantiation. If you've any ready to hand that would be useful.
    - 2y ago
everdrive 2y ago
Does anyone have any idea why? The much higher mortality rate for black women especially stands out. People have often remarked on this as evidence of racism, but does anyone know the actual mechanism here? Are black women less fit to survive a risky procedure in the first place? Are facilities actually treating black women worse? Do black women primarily only have access to inferior facilities? (if so, do women of other races also have worse outcomes at said facilities?) The article refutes increasing maternal age, which would have been my next guess. I don't have answers, just questions and guesses. If anyone's got anything definitive, I'd love if they weighed in.
- okeuro49 2y ago
  Black women are more likely to suffer from comorbities, such as obesity: > 56.9 percent for black women. It stands at 36.2 percent for white women [1] Obesity increases the risk of maternal mortality. [1] https://www.self.com/story/black-women-health-conditions https://www.self.com/story/black-women-health-conditions
- Barrin92 2y ago
  there's a few obvious things, poverty and worse economic conditions and thus worse medical care, higher rates of obesity, as the article points out cardiovascular diseases are generally considered to be a driver of mortality rates. As for racism, a known observation is that black women in particular are treated as "tough" and tend to not have symptoms taken as seriously, as far as I'm aware that even holds when the doctors are black. It's a bad and very old stereotype.
- sdfgtr 2y ago
  [flagged]
- tantalor 2y ago
  My guess would be the drop in teen pregnancy has increased the average age of the mother, which I assume increases the mortality.
- ZeroGravitas 2y ago
  American parental leave policies are a bit of an outlier when compared with other OECD: https://qz.com/1275938/22-american-mothers-on-what-its-like-to-go-back-to-work-after-maternity-leave https://qz.com/1275938/22-american-mothers-on-what-its-like-... If rich mothers give up work after giving birth and poor mothers return quickly to work, that could have an impact. And in America, rich/poor and white/black trends are big confounders.
kkfx 2y ago
[flagged]
- skeeter2020 2y ago
  >> Of course this post will probably be massively downvoted You overestimated how much people would care about your cute, linkbait post that doesn't actually contain any information other than hinting at a hot take and a couple of obfuscated links.
  - kkfx 2y ago
    Links works for me, two pdfs from the WHO of some years ago about vaccines in economical terms and trends.
- nemomarx 2y ago
  Is there any evidence US usage of vaccines is higher than in the UK or Europe etc? It doesn't seem that way to me.
  - kkfx 2y ago
    Specifically for vaccines, I can't answer, for meds in general, USA tend to use much more then the EU.
jcfrei 2y ago
I'm gonna risk sounding dismissive here but the article very cautiously points at a cause: "While this study wasn’t able to explore specific causes of death, a large body of prior research, much of it published by Khan, has found cardiovascular disease (hypertensive disorders, heart failure and stroke) is a major contributor to poor maternal health outcomes." Hypertensive disorders are typically associated with obesity so the reason could be that there's an increasing share of pregnancies happening with people who are overweight. I leave the sociodynamic interpretation of this up to the reader.
- SamuelAdams 2y ago
  Yes it seems odd how the medical community (and American patients in general) don’t really want to talk about obesity anymore. Being obese and carrying a baby to term is risky. Everything is much more complicated. I do wonder if they make the BMI of mothers available in a publicly available dataset somewhere, it would be interesting to test your hypothesis.
  - lotsofpulp 2y ago
    >Yes it seems odd how the medical community (and American patients in general) don’t really want to talk about obesity anymore. That is not what it looks like to me. Body mass index (BMI), a proxy for obesity, is a relevant statistic in almost every wellness exam. https://www.cdc.gov/obesity/index.html https://www.cdc.gov/obesity/index.html https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity https://health.gov/healthypeople/objectives-and-data/browse-... The hottest new medicine is a medicine that reduces obesity. See Novo Nordisk market cap change: https://companiesmarketcap.com/novo-nordisk/marketcap/ https://companiesmarketcap.com/novo-nordisk/marketcap/
- tonmoy 2y ago
  Obesity rates increased slightly between 2014 to 2021, but I’m not sure that will account for doubling of mortality rate. It could mean that more obese people are having kids than before, but that would be far from trivial to prove
bentt 2y ago
We don’t know how to talk about metabolic disease because we are afraid of offending people.
refurb 2y ago
”The U.S. National Center for Health Statistics, the branch of the Centers for Disease Control (CDC) charged with collating health and vital statistics, has published three separate reports elaborating in excruciating detail on one crucial fact about U.S. maternal mortality: It is measured in a vastly more expansive way than anywhere else in the world.” "But the U.S. case is particularly beguiling, since the United States now tracks all deaths of women who were pregnant, not only women who gave birth. Women who miscarried early or had abortions—whether officially reported or not—are also counted in the checkbox method." https://archive.is/Sm38N https://archive.is/Sm38N
incomingpain 2y ago
>more people are having children later in life, so we wanted to investigate this question. However, we found that’s not why we’re seeing a spike in the number of maternal deaths,” when we shifted this way in the last 60 years, mortality was decreasing. This wouldn't be my go-to guess. >While this study wasn’t able to explore specific causes of death it's public data in quite a number of places in the world. Generally speaking it's bleeding or blood related things; heart, or blood brain stroke type. Women during birth have the same problems as high G fighter pilots. Gotta tighten all your muscles. >Black individuals are three times more likely to die from pregnancy-related deaths than white individuals. Randomly tacked onto the end. The thing about statistics on race, it's really hard to rule out all the other factors and make conclusions. It's not some sort of allegation that black moms are systematically being killed.
- anyonecancode 2y ago
  > The thing about statistics on race, it's really hard to rule out all the other factors and make conclusions. It's not some sort of allegation that black moms are systematically being killed. When I see people argue that systemic racism is a driver, they're not arguing that there's a conspiracy directly targeting people of color. Rather, they're arguing that racism drives things that create conditions where people of color disproportionately suffer harm. A classic example of this from several decades ago is redlining, which prevented people of color from moving into safer neighborhoods, and undermined the neighborhoods they were able to buy homes in. Settlement patterns have long-term generational effects, so while it would be incorrect to say that predominately black neighborhoods have higher levels of asthma, violence, poverty etc as a deliberate plot, it's absolutely true to say that those are consequences of direct racism from several decades ago. I don't think this should be a particularly controversial point. Where I think it gets more controversial is two points -- 1. What redress, if any, should people downstream from historical racism have? They're still suffering the effects, after all. 2. What patterns and decisions are happening _now_ that will similarly have downstream generational effects? I'm not going to even attempt to suggest answers to those, just hoping to illuminate the framing here.
  - incomingpain 2y ago
deleted 2y ago
[deleted]
landosaari 2y ago
Related post [0] (not having enough). Do US doctors relay this risk to their patients? [0] https://news.ycombinator.com/item?id=41037116 https://news.ycombinator.com/item?id=41037116
big-green-man 2y ago
> In that same period, the overall maternal mortality rates in the U.S. nearly doubled, from 16.5 to 31.8, with the largest increase of 18.9 to 31.8 occurring from 2019 to 2021. 31.8 what? Football fields? I'm guessing per 100k, but this is a .edu domain for Christ's sake.

78 points by johntfella 2y ago

In case you're familiar with the recent controversy about whether this is a statistical artifact: > There's actually been a lot of controversy about whether or not the increase that's been observed is a true increase or is an artifact of how we're now collecting data,” Khan said. “But when we examined deaths only in the states that had already adopted the checkbox and did it the exact same way, we captured an increase with acceleration in the last three years.

michaelt 2y ago
Yes - for further context, there's been a big statistical increase in maternal deaths in the US in part due to changes in reporting. [1] There was strong evidence that the US wasn't reporting all maternal deaths that meet the WHO definition; pregnancy and birth are major medical events, and can easily aggravate other medical conditions. But often you couldn't extract that information from the cause of death reported on a death certificate. So the US added a 'pregnant or recently pregnant?' checkbox to cause of death reports, and started counting all deaths with the box checked, minus accidents, suicides and falls. So even if a woman had a terminal illness before getting pregnant, that would still count as a maternal death. Then they gradually rolled out the new form one state at a time, over the course of 15 years - so instead of seeing a clear step in the data, there's a long gradual increase. This makes measuring any real changes in maternal death rates extremely challenging. However, this report says maternal death rates are rising even after accounting for the changes in reporting. [1] https://www.bbc.co.uk/programmes/p0j74zfs https://www.bbc.co.uk/programmes/p0j74zfs
- kingkawn 2y ago
  By your logic there isn’t an increase in maternal deaths because they were already this high for a long time before and nobody cared, arguably an even worse situation. There is no way to spin this that isn’t societal neglect of pregnancy.
  - prmoustache 2y ago
    The fact the pregnant box is ticked doesn't mean the death is related to pregnancy. You can get pregnant with terminal cancer and it is unlikely to end well regardless of the pregnancy. The poster above just says it makes analysis of historical statistics difficult, he is not jumping to conclusion.
  - fluoridation 2y ago
    First, where does the "nobody cared" come from? Second, so what you're saying is that any maternal deaths at all means society is neglecting pregnant women? Because your argument applies even if we believe there's zero maternal deaths per year and later we find out there's actually one per year.
    - kylebenzle 2y ago
      [flagged]
      - kingkawn 2y ago
        Yah yah what a skillful strawman you can build
        dang 2y ago
        Please don't respond to a bad comment by breaking the site guidelines yourself. That only makes things worse. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Edit: it looks like you've been repeatedly breaking the site guidelines in other places too: https://news.ycombinator.com/item?id=40892949 https://news.ycombinator.com/item?id=40892949 https://news.ycombinator.com/item?id=40845307 https://news.ycombinator.com/item?id=40845307 If this keeps up, we're going to have to ban you. We've had to warn you about this quite a few times in the past, and it's not cool. If you'd please review https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it. (Btw I've warned the GP in a couple other places in this thread, just in case it seems like the mods are taking sides)

oldpersonintx 2y ago

"While this study wasn’t able to explore specific causes of death, a large body of prior research, much of it published by Khan, has found cardiovascular disease (hypertensive disorders, heart failure and stroke) is a major contributor to poor maternal health outcomes." tl;dr: obesity ("hypertension") but why stop at maternal deaths? obesity is driving premature death rates in every category this is a national crisis but no one wants to say it out loud because someone's feelings will be hurt

lotsofpulp 2y ago
Basically every healthcare professional has been saying it out loud for decades. Its proxy, body mass index (BMI), is on every checklist and some city level political leaders have even been able to tax beverages with sugar. The Obamas, and Michelle Obama specifically, addressed it directly (14 years ago): https://letsmove.obamawhitehouse.archives.gov/ https://letsmove.obamawhitehouse.archives.gov/
kingkawn 2y ago
There’s also the ongoing closure of labor and delivery wards across the country, especially in rural America. There’s been an increase in retirements and burnout among experienced obgyn’s too. But I guess none of the complicating factors make for as good of a straw man for the inane point you’d like to use these women’s suffering to prove.
- ecjhdnc2025 2y ago
  Obesity, like Brexit, is a multiplier for the negative outcomes of complicating factors.
  - kingkawn 2y ago
    saying that we should only think of it when someone’s trying to talk about women’s health is misogyny
    - 2y ago

Olesya000 2y ago

[dead]

HPsquared 2y ago

Why don't these types of article ever show a graph? EDIT: And their "recent" data point is 2021... Of course health outcomes would be worse in that year for various reasons.

ljf 2y ago
Some useful graphs here: https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison https://www.commonwealthfund.org/publications/issue-briefs/2... Black women in the US are almost 10 times as likely to die during/after childbirth, compared to all women in the UK (and white women in the US are almost 4 times as likely to die as in the UK). This 2024 report (pdf) has 2022 data, which is lower than 2021, but still above the average of the pervious 10 years: https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022/maternal-mortality-rates-2022.pdf https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022...
- rayiner 2y ago
  Why are you comparing black women in the U.S. to mostly white women in the UK? The maternal mortality rate for black women in the UK is about 4 times higher than for white women in the UK: https://lordslibrary.parliament.uk/maternal-mortality-rates-in-the-black-community/ https://lordslibrary.parliament.uk/maternal-mortality-rates-...
  - ljf 2y ago
    True, but I was just referring to the data on the linked site.
    - hollerith 2y ago
      OK, then, why are you linking to a site/page that compares black women in the U.S. to mostly white women in the UK?
      - 2y ago

dscottboggs 2y ago

Gee, I wonder what changed between '19 and '21

dscottboggs 2y ago
something that caused an increase in risk of heart attack and stroke?? I dunno what that would be
- deleted 2y ago
  [deleted]
- pcdoodle 2y ago
  A buggy product perhaps?
- PierceJoy 2y ago
  You must be referring to covid. Thankfully we have vaccines to reduce our risk of short and long term side effects.
  - dscottboggs 2y ago
    I'm six times vaccinated and still can't work full time 11 months out from catching covid so good luck with that idea. And I know people who are doing worse than I am. "Vaccination is like having an airbag. Avoiding contact is like keeping your hands on the wheel."
LadyCailin 2y ago
Would be interesting to compare the rates across different countries in the same time period. If they didn’t increase elsewhere, then it isn’t covid, but rather an American specific problem. The fact that healthcare isn’t a guaranteed right is certain to have some effect somewhere in American health data, just depends where exactly it shows up.
- ljf 2y ago
  Check out this (also linked elsewhere in this post): https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison https://www.commonwealthfund.org/publications/issue-briefs/2... Compares US to other developed countries, and compares other things such as maternity leave and other health care opportunities. Note that some of the biggest risk area in the US is the 41 days AFTER child birth, where the US sees some of the worst results.

deleted 2y ago

[deleted]

austin-cheney 2y ago

I suspect this is due to the intermingled effects of biology and politics. * Consider that with the loss of Roe v Wade many states, including my own, have adopted draconian policies towards abortion without consideration for medical necessity. * Consider also the study indicated the most increased risk age groups are late 20s and early 30s. What’s interesting is there was a study published December indicating first time mothers in the 16-20 age group when compared to the 21-25 age group were about 20% less likely to experience detrimental risks of regular vaginal births. The numbers held identical when compared between the US and third world countries without common access to advanced medical care. The study concluded that age is among the most serious of factors with regards to maternal health of first time mothers and this could explain why males developed a selective preference for younger females.

keiferski 2y ago
The recent Roe decision was in 2022. The study covers 2014-2021.
- anonym29 2y ago
  [flagged]
- avidphantasm 2y ago
  But “red” states have been making reproductive healthcare harder and harder to access during the study period. One hypothesis to test is whether there are increases in mortality in such states after controlling for factors outside of access to reproductive healthcare. This will likely be hard to tease out because health outcomes tend to be worse in general in such states.
  - dredmorbius 2y ago
    That's a fair point and one that had occurred to me. The point would be stronger with some substantiation. If you've any ready to hand that would be useful.
  - 2y ago

everdrive 2y ago

Does anyone have any idea why? The much higher mortality rate for black women especially stands out. People have often remarked on this as evidence of racism, but does anyone know the actual mechanism here? Are black women less fit to survive a risky procedure in the first place? Are facilities actually treating black women worse? Do black women primarily only have access to inferior facilities? (if so, do women of other races also have worse outcomes at said facilities?) The article refutes increasing maternal age, which would have been my next guess. I don't have answers, just questions and guesses. If anyone's got anything definitive, I'd love if they weighed in.

okeuro49 2y ago
Black women are more likely to suffer from comorbities, such as obesity: > 56.9 percent for black women. It stands at 36.2 percent for white women [1] Obesity increases the risk of maternal mortality. [1] https://www.self.com/story/black-women-health-conditions https://www.self.com/story/black-women-health-conditions
Barrin92 2y ago
there's a few obvious things, poverty and worse economic conditions and thus worse medical care, higher rates of obesity, as the article points out cardiovascular diseases are generally considered to be a driver of mortality rates. As for racism, a known observation is that black women in particular are treated as "tough" and tend to not have symptoms taken as seriously, as far as I'm aware that even holds when the doctors are black. It's a bad and very old stereotype.
sdfgtr 2y ago
[flagged]
tantalor 2y ago
My guess would be the drop in teen pregnancy has increased the average age of the mother, which I assume increases the mortality.
ZeroGravitas 2y ago
American parental leave policies are a bit of an outlier when compared with other OECD: https://qz.com/1275938/22-american-mothers-on-what-its-like-to-go-back-to-work-after-maternity-leave https://qz.com/1275938/22-american-mothers-on-what-its-like-... If rich mothers give up work after giving birth and poor mothers return quickly to work, that could have an impact. And in America, rich/poor and white/black trends are big confounders.

kkfx 2y ago

[flagged]

skeeter2020 2y ago
>> Of course this post will probably be massively downvoted You overestimated how much people would care about your cute, linkbait post that doesn't actually contain any information other than hinting at a hot take and a couple of obfuscated links.
- kkfx 2y ago
  Links works for me, two pdfs from the WHO of some years ago about vaccines in economical terms and trends.
nemomarx 2y ago
Is there any evidence US usage of vaccines is higher than in the UK or Europe etc? It doesn't seem that way to me.
- kkfx 2y ago
  Specifically for vaccines, I can't answer, for meds in general, USA tend to use much more then the EU.

jcfrei 2y ago

I'm gonna risk sounding dismissive here but the article very cautiously points at a cause: "While this study wasn’t able to explore specific causes of death, a large body of prior research, much of it published by Khan, has found cardiovascular disease (hypertensive disorders, heart failure and stroke) is a major contributor to poor maternal health outcomes." Hypertensive disorders are typically associated with obesity so the reason could be that there's an increasing share of pregnancies happening with people who are overweight. I leave the sociodynamic interpretation of this up to the reader.

SamuelAdams 2y ago
Yes it seems odd how the medical community (and American patients in general) don’t really want to talk about obesity anymore. Being obese and carrying a baby to term is risky. Everything is much more complicated. I do wonder if they make the BMI of mothers available in a publicly available dataset somewhere, it would be interesting to test your hypothesis.
- lotsofpulp 2y ago
  >Yes it seems odd how the medical community (and American patients in general) don’t really want to talk about obesity anymore. That is not what it looks like to me. Body mass index (BMI), a proxy for obesity, is a relevant statistic in almost every wellness exam. https://www.cdc.gov/obesity/index.html https://www.cdc.gov/obesity/index.html https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity https://health.gov/healthypeople/objectives-and-data/browse-... The hottest new medicine is a medicine that reduces obesity. See Novo Nordisk market cap change: https://companiesmarketcap.com/novo-nordisk/marketcap/ https://companiesmarketcap.com/novo-nordisk/marketcap/
tonmoy 2y ago
Obesity rates increased slightly between 2014 to 2021, but I’m not sure that will account for doubling of mortality rate. It could mean that more obese people are having kids than before, but that would be far from trivial to prove

bentt 2y ago

We don’t know how to talk about metabolic disease because we are afraid of offending people.

refurb 2y ago

”The U.S. National Center for Health Statistics, the branch of the Centers for Disease Control (CDC) charged with collating health and vital statistics, has published three separate reports elaborating in excruciating detail on one crucial fact about U.S. maternal mortality: It is measured in a vastly more expansive way than anywhere else in the world.” "But the U.S. case is particularly beguiling, since the United States now tracks all deaths of women who were pregnant, not only women who gave birth. Women who miscarried early or had abortions—whether officially reported or not—are also counted in the checkbox method." https://archive.is/Sm38N https://archive.is/Sm38N

incomingpain 2y ago

>more people are having children later in life, so we wanted to investigate this question. However, we found that’s not why we’re seeing a spike in the number of maternal deaths,” when we shifted this way in the last 60 years, mortality was decreasing. This wouldn't be my go-to guess. >While this study wasn’t able to explore specific causes of death it's public data in quite a number of places in the world. Generally speaking it's bleeding or blood related things; heart, or blood brain stroke type. Women during birth have the same problems as high G fighter pilots. Gotta tighten all your muscles. >Black individuals are three times more likely to die from pregnancy-related deaths than white individuals. Randomly tacked onto the end. The thing about statistics on race, it's really hard to rule out all the other factors and make conclusions. It's not some sort of allegation that black moms are systematically being killed.

anyonecancode 2y ago
> The thing about statistics on race, it's really hard to rule out all the other factors and make conclusions. It's not some sort of allegation that black moms are systematically being killed. When I see people argue that systemic racism is a driver, they're not arguing that there's a conspiracy directly targeting people of color. Rather, they're arguing that racism drives things that create conditions where people of color disproportionately suffer harm. A classic example of this from several decades ago is redlining, which prevented people of color from moving into safer neighborhoods, and undermined the neighborhoods they were able to buy homes in. Settlement patterns have long-term generational effects, so while it would be incorrect to say that predominately black neighborhoods have higher levels of asthma, violence, poverty etc as a deliberate plot, it's absolutely true to say that those are consequences of direct racism from several decades ago. I don't think this should be a particularly controversial point. Where I think it gets more controversial is two points -- 1. What redress, if any, should people downstream from historical racism have? They're still suffering the effects, after all. 2. What patterns and decisions are happening _now_ that will similarly have downstream generational effects? I'm not going to even attempt to suggest answers to those, just hoping to illuminate the framing here.
- incomingpain 2y ago

deleted 2y ago

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landosaari 2y ago

Related post [0] (not having enough). Do US doctors relay this risk to their patients? [0] https://news.ycombinator.com/item?id=41037116 https://news.ycombinator.com/item?id=41037116

big-green-man 2y ago

> In that same period, the overall maternal mortality rates in the U.S. nearly doubled, from 16.5 to 31.8, with the largest increase of 18.9 to 31.8 occurring from 2019 to 2021. 31.8 what? Football fields? I'm guessing per 100k, but this is a .edu domain for Christ's sake.