The “Lost Mothers” project by ProPublica and NPR is a sweeping examination of why the U.S. is perhaps the most dangerous place in the industrialized world in which to give birth. The pieces at the center of the project focused on maternal deaths and near-deaths, looking at why life-threatening complications occur, why black women are much more likely to die and nearly die than white women, and why providers often fail to implement safety protocols that could prevent needless harm.
Other major pieces examined why state and federal governments do such a poor job counting maternal deaths, why giving birth in Great Britain is so much safer than in the U.S., and how women and families can advocate to improve care for themselves and others.
Among the project’s significant findings:
– Maternal deaths are almost invisible, shrouded by medical institutions, regulators, and state maternal mortality review committees. The lessons that might be learned are often lost as well.
– Lack of standards and protocols to treat obstetric emergencies is a major factor in many maternal deaths and near-deaths. Some hospitals and doctors resist such protocols, even though they have been shown to reduce life-threatening complications such as hemorrhage, severe preeclampsia and blood clots.
– In recent decades, under the assumption that it had conquered maternal mortality, the American medical system has focused more on fetal and infant safety and survival than on the mother’s health and well-being. This has led to more preventable maternal complications and deaths.
– Many maternal deaths and near-misses occur during the postpartum period, often days or weeks after new mothers have been sent home. Yet postpartum care is often inadequate, especially for low-income women of color.
– The disproportionate toll on African Americans is the main reason the U.S. maternal mortality rate is so much higher than that of other affluent countries. Black expectant and new mothers in the U.S. die at about the same rate as women in countries such as Mexico and Uzbekistan.
– Life-threatening complications have risen even faster than maternal mortality. For every U.S. woman who dies as a consequence of pregnancy or childbirth, up to 70 suffer hemorrhages, organ failure or other significant complications, amounting to more than 1 percent of all births. The annual cost to women, their families, taxpayers and the health care system runs into billions of dollars.
– Hospitals that disproportionately serve black women are much more likely to have high rates of life-threatening complications, such as severe hemorrhage.
– Data collection on maternal deaths is so flawed and under-funded that the federal government no longer even publishes an official death rate.