Introduction
Maternal mortality is caused by pregnancy, independent of its duration and location, the death of a woman, which arises during pregnancy or within 42 days of its termination. According to the World Health Organization, the United States has the highest maternal mortality rate of any developed country. The rise has occurred even as maternal mortality has declined in less advanced countries worldwide. In 2018, there were 17 deaths for every 100,000 births; 24 deaths per 100,000 births in 2020 (Davis et al., 2019). In the U.S., there are persistent disparities in pregnancy-related deaths between women of different racial and ethnic groups. Maternal mortality is an issue that scientists have been researching for decades, but there is still no consensus on its reasons and prevention methods.
Thus, it is essential to examine maternal mortality rates, statistics, and causes in the United States. At the same time, it is imperative to compare this data with similar information for other states and establish connections. After analyzing the methods of combating this phenomenon, which scientists and physicians propose. Consequently, the paper will explore the scientific literature on the selected topic to identify the extent to which the scientific community has researched it.
Literature Review
The article by Creanga (2018) provides an overview of maternal mortality data and its limitations in the United States. The paper applies a method of analyzing two significant sources of national-level maternal mortality, specifically the national death statistics and the Pregnancy Mortality Surveillance System. Within the time frame, Creanga (2018) examines mortality rates between 1900 and 2007. At the same time, it explores the effect of racial differences on pregnancy mortality between 1987 and 2013. The article’s author determined that compared to 1987, maternal mortality increased from 7.2 deaths per 100,000 live births to 17.3 mortality in 2013. The study found that the higher mortality rate persisted among non-Hispanic white women and that Hispanic females had better health conditions.
An article by Lister et al. (2019) argues that black women are more prone to maternal death due to a number of factors. For example, the development of cardiovascular disease or the influence of racial discrimination on their care. The researchers investigated racial variation in mortality from 2005 to 2014 through a review of existing literature and reports published by the government. However, in contrast to Creanga (2018), this article indicates possible solutions to the problem that include both national and supranational policies. For instance, it educates Black women about the negative impact of comorbidities or additional heart insurance for females with complicated pregnancies.
It is essential to mention that the study by MacDorman et al. (2016) examined maternal mortality in the United States from 2000 to 2014. Significantly, the observational research covered official statistics from all nation and established rates for all U.S. states. Therefore, it is indicated that California demonstrated a decreasing trend and Texas an improving one. Accordingly, it is reasonable to consider that this article complements and extends the specified data Creanga (2018). Although, MacDorman, Declercq, Cabral, and Morton (2016) confirmed the general tendency of higher maternal deaths in the U.S.
The study by Neggers (2016) notes that maternal mortality is not common in the United States, although its risk is not diminishing. Hence, the conclusions of this article differ from those previously researched. The author analyzed 1987 and 2011 statistics for women ages 25-29 and 35-39. He found that younger women had a lower risk of maternal mortality. The author concluded this based on comparing statistics not only by U.S. agencies, that is, NCHS and PMSS. The researcher also reviewed information from global organizations such as the international WHO, UNICEF, and UNFPA, suggesting that the author’s data was verified and reliable. However, the characteristic feature of the article is that Neggers (2016) proposed a modification for the U.S. medical system. That is, conducting systematic confidential investigations of maternal deaths, through which the care provided is evaluated. Accordingly, the analysis of each maternal death enables the future elimination of such deficiencies.
The article by Nove et al. (2014) applied a survey and analysis of data from 144 states. The results established a J-shaped curve for the age distribution of maternal mortality with marginally increased risk of mortality in adolescents compared to women aged 20-24. However, the rate was also high among females aged 45 and older, indicating age-related problems that can cause maternal deaths. Thus, this complements the research by Neggers (2016) and explains the influence of the age factor on maternal mortality. It is significant to highlight that Nove, Matthews, Neal, and Camacho (2014) established that economic and demographic variables of different states affect mortality levels, but their influence is not crucial.
It should be noted that an important study of maternal mortality worldwide in the broad period between 1990 and 2005 was conducted by Hill, Thomas, AbouZahr, Walker, Say, Inoue, and Suzuki (2007). Their article proves that the highest maternal mortality rates are in Asia and Africa. As in the paper Neggers (2016), international data on maternal mortality are used and analyzed based on statistical estimation. The study by Hill et al. (2007) suggests increased investment in maintaining pregnancies of women from Africa and Asia to address the problem. A similar focus of the research is the article by McAlister & Baskett (2006). The authors investigated the relationship between education and social status of different women in various countries and maternal mortality rates. They used polynomial regression analysis with a sample of 148 countries. Thus, they also established that the level of high development of the population has a significant role in reducing maternal deaths. At the same time, the authors also recommended expanding investment in women’s education in non-developed countries. That is because women’s awareness of pregnancy risks and possible complications will reduce maternal mortality.
A comprehensive study establishing the causes of maternal mortality is the article by Kuriya et al. (2016). The analysis of Health Care Cost and Utilization Project data from 2003 and 2011 examined 1102 maternal deaths. Therefore, sepsis and an unreliable reduction in venous thromboembolism were identified as reasons for loss of relevance. At the same time, bleeding and hypertensive disorders remain the primary mortality factors. However, as in Lister et al. (2019), it is indicated that cardiovascular disease, in most cases, complicates pregnancy and leads to death. This article was based on international sources, same as Neggers (2016) and an article by Nove et al. (2014).
Collier and Molina (2019) try to explain the growing maternal mortality rate in the United States. At the same time, they argue that measures to enhance safety and quality of care during pregnancy, childbirth, and postpartum are essential for better maternal health. Hence, similar to most previous studies, they examine official statistics in the U.S. until 2018. Accordingly, they note significant common causes of death, that is, bleeding, cardiovascular disease, and racial and educational disparities. This research is different, though, in that it offers a range of interventions to address the problem. For example, multidisciplinary care for high-risk individuals, better communication between providers and patients concerning early prevention of issues, and addressing racism and social inequalities.
It is significant to mention that research on this topic continues to be conducted by scientists. For example, an article Douthard et al. (2021) examines maternal mortality in the United States from 1990 to 2018 based on national and international reports. The study by Douthard et al. (2021) confirms that African American women have higher mortality rates than Hispanic and white females. The authors already consider a significant public investment to reduce this problem but establish that the issue requires to be resolved at the legislative level. Consequently, they propose an innovative expansion of current Medicaid coverage after childbirth. At the same time, they suggest intensifying research on biomedicine to create a still unknown reason for mortality and explore a possible solution.
Conclusion
Therefore, it can be mentioned that researchers have been studying maternal mortality for several decades. In this way, they were capable of establishing the fundamental reasons and proposing general methods of solving this issue. Nevertheless, the authors agreed that African-American women are at higher risk than Hispanic ones. Although the United States is the leader among developed nations, Asia and Africa have the most death rates. However, there is controversy about the primary predictors of maternal mortality. Moreover, scholars have recently started to propose reasonable solutions to this problem, which still require more research. Hence, I consider that scientists have investigated the theme of maternal mortality from all sides, but it remains a relevant discussion to this day.
References
Collier, A. R. Y., & Molina, R. L. (2019). Maternal mortality in the United States: Updates on trends, causes, and solutions. Neoreviews, 20(10), 561-574.
Creanga, A. A. (2018). Maternal mortality in the United States: A review of contemporary data and their limitations. Clinical Obstetrics and Gynecology, 61(2), 296-306.
Davis, N. L., Smoots, A. N., & Goodman, D. A. (2019). Pregnancy-related deaths: Data from 14 US maternal mortality review committees. Education, 40(36), 8-2.
Douthard, R. A., Martin, I. K., Chapple-McGruder, T., Langer, A., & Chang, S. (2021). US maternal mortality within a global context: Historical trends, current state, and future directions. Journal of Women’s Health, 30(2), 168-177.
Hill, K., Thomas, K., AbouZahr, C., Walker, N., Say, L., Inoue, M., & Suzuki, E. (2007). Estimates of maternal mortality worldwide between 1990 and 2005: An assessment of available data. The Lancet, 370(9595), 1311–1319.
Kuriya, A., Piedimonte, S., Spence, A. R., Czuzoj‐Shulman, N., Kezouh, A., & Abenhaim, H. A. (2016). Incidence and causes of maternal mortality in the USA. Journal of Obstetrics and Gynaecology Research, 42(6), 661-668.
Lister, R. L., Drake, W., Scott, B. H., & Graves, C. (2019). Black maternal mortality-the elephant in the room. World Journal of Gynecology & Womens Health, 3(1). doi: 10.33552/wjgwh.2019.03.000555
MacDorman, M. F., Declercq, E., Cabral, H., & Morton, C. (2016). Is the United States maternal mortality rate increasing? Disentangling trends from measurement issues short title: US maternal mortality trends. Obstetrics and Gynecology, 128(3), 447. doi: 10.33552/wjgwh.2019.03.000555
McAlister, C., & Baskett, T. F. (2006). Female education and maternal mortality: A worldwide survey. Journal of Obstetrics and Gynaecology Canada, 28(11), 983-990.
Neggers, Y. H. (2016). Trends in maternal mortality in the United States. Reproductive Toxicology, 64, 72–76.
Nove, A., Matthews, Z., Neal, S., & Camacho, A. V. (2014). Maternal mortality in adolescents compared with women of other ages: Evidence from 144 countries. The Lancet Global Health, 2(3), 155-164.