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Why Are So Many US Women Dying in Childbirth?

Photograph by Twenty20

We’ve know for some time that the maternal death rate in the U.S. on the rise. In South Korea, the rate of women dying in childbirth fell from 20.7 deaths per 100,000 live births in 1990 to 12 today. In Germany, it's dropped from 18 to 6.5.

But here in the U.S., the number went from 7.2 deaths per 100,000 live births in 1987 to 24 in 2014, according to a new study in the September issue of Obstetrics & Gynecology.

While the authors of the study note that the startling increase is at least due in part to underreporting in the past, it still doesn’t explain why maternal death rate in the U.S. is so much higher than in other countries.

In an analysis by Vox, the underlying reason has to do with pre-existing chronic diseases. Decades ago, death during childbirth was often linked to hemorrhaging or an embolism, but today hemorrhages only make up 11.4 percent of pregnancy-related deaths, while deaths tied to embolisms have also declined.

Instead, cardiovascular diseases are the leading cause of death, second only to non-cardiovascular diseases such as diabetes.

"It’s a larger problem than just dealing with women during pregnancy, it’s the health of our society," Dr. William Callaghan, chief of maternal and infant health at the Centers for Disease Control and Prevention, told Vox. "Imagine a [pregnant] woman comes in with BMI of 40, and she’s 24 years old—that didn’t happen in the past year, it happened in the past 24 years."

Another finding that has experts concerned: Regardless of age, education, or similar lifestyles, black women are two to three times more likely to die from pregnancy complications than white women.

To better understand all the numbers, researchers say they need more reliable data. Fortunately, the CDC has partnered with the Association of Maternal and Child Health Programs to create state review boards that meet and examine maternal deaths, identifying potential issues from prenatal care to pre-existing conditions to find trends among the data and help health care providers figure out how to prevent and reduce maternal deaths.

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