Though it’s important to reduce maternal mortality worldwide, let’s not forget to address the needs of mothers in the U.S.
The Lancet recently released news that the global maternal mortality has declined – these results are controversial in that other estimates don’t exactly agree. I am not going to discuss the controversy surrounding the data as the debates focus on developing countries, not developed countries like the US and Western Europe
One area that struck me was the US maternal mortality rate. This is the chances of a women dying due to pregnancy.
The US always did poorly compared to the rest of the developed world…but the news is getting worse. According to the Lancet article, the US maternal mortality was 13 deaths per 100,000 live births in 2000 (confidence interval 12-15) but in 2008 had risen to 17 deaths per 100,000 live births. To put that in context, this rate is more than twice the estimate for Canada, Japan, Australia, South Korea, Singapore and 21 of the 22 Western European countries.
Some have stated that the apparent increase is related to changes in definitions, but it is also likely that the United States’ poor results in maternal mortality rates are tied to its having the highest teenage pregnancy rate in the developed world. In 1998 there were 1,671 births per 1,000,000 capita compared with less than 700 births per 1,000,000 capita for the other countries listed. Why does this matter? Pregnant teenagers and their infants face significantly greater health risk than pregnancy women in their 20’s; this includes a maternal mortality rate of five times higher in the developing world.
Within all the debates in the United States about health care reform one thing that was missing was a set of clear facts. As people rally for better maternal care around the world, let’s also make sure that the United States takes better care of its own mothers.
Howard Steven Friedman works as a statistician and health economist for the United Nations. He has been a lead modeler on a number of key United Nations projects including the ICPD @ 15 Costing, High Level Task Force on Innovative Financing, and the Adding It Up reports. He is credited with being the lead developer of the tool used for costing the health-related Millennium Development Goals. He is also an adjunct professor at School of International and Public Affairs at Columbia University. Prior to joining the United Nations, Howard ran Analytic Solutions LLC, which provides consulting services in designing, developing and modeling data. This work also included teaching data mining and modeling techniques for major international corporations and foreign governments. Prior to that, he was a Director at Capital One, where he led teams of statisticians, analysts and programmers in operations and marketing. Howard is the author of over 35 scientific articles and book chapters in areas of applied statistics, health economics with recent publications in the American Journal of Gastroenterology, Current Medical Research & Opinion, Clinical Therapeutics, Inflammatory Bowel Disease, Journal of Managed Care Pharmacy, Clinical Drug Investigation and Value in Health. Howard Friedman received his BS from Binghamton University in Applied Physics and a Masters in Statistics, along with a Ph.D. in Biomedical Engineering from Johns Hopkins University.