Which Developed Country Is The Most Dangerous To Give Birth?

BellyBelly recognises the importance of preparing positively for birth.

Some of the following statistics and stories might be frightening to read, regarding the most dangerous places to give birth.

BellyBelly has no intention of increasing fear surrounding birth.

However, knowledge is power, and we believe in providing information and resources to help parents make informed decisions about their care.

Overall, giving birth is safe, even in the US. The purpose of these investigations and articles is to raise awareness that we can, and should, make it even safer.

Around 3.9 million births occur in the US each year. A recent USA Today investigation, Deadly Deliveries, found about 50,000 US mothers face serious injury and 700 die every year due to childbirth related complications.

This means your overall risk of serious injury and death remains low.

The main concern about the current rates of childbirth related injury and death is, as research shows, more than of half of these cases could be prevented by following well known and established maternity care guidelines.

Shockingly, the US is the only developed country in which the risk of death has increased in recent years. Every other developed country continues to see a decline in injury and death during childbirth, or at least a rate that isn’t increasing.

In the US, there are approximately 26.4 maternal deaths per 100,000 births. Canada, England, France and Japan, on the other hand have rates less than 10 deaths per 100,000 births.

Why Is The US The Most Dangerous To Give Birth?

USA Today investigative reporter, Alison Young, said during a CBS This Morning interview:

“Experts say that about 50 percent of the deaths of women from childbirth-related causes could be prevented if they were given better medical care, and that’s a really surprising thing given that we’re one of the wealthiest countries in the world and we spend so much on medical care.

“We’re not just talking about the women who die, we’re talking about 50,000 U.S. women who are suffering life-altering harms”.

Investigators found the two biggest causes of serious injury and death before, during and after birth were haemorrhage and severe hypertension. These two problems require close monitoring and quick action.

There are guidelines to manage both conditions. However, many care providers simply ‘eyeball’ blood loss rather than attempt to measure and assess warning signs properly.

In cases of hypertension, some women are even sent home before their blood pressure has been properly managed. This puts them at risk of stroke or even death.

If more than 50% of deaths are preventable, then we are clearly failing to do everything we know we can do to protect US birthing mothers. This is an important public health issue, and one which needs to be tackled quickly and seriously.

There are many theories and investigations trying to pinpoint the cause of our abysmal maternity care statistics, and to find solutions.

You can read What’s Killing America’s New Mothers? 4 Things You Need To Know to learn about some theories regarding causes and solutions.

Why Do Health Care Providers Miss Warning Signs Or Ignore Guidelines?

As a community doula, I spend time working with medically high-risk pregnant and postpartum mothers. I provide non-medical support, but often urge them to contact care providers.

On more than one occasion, I have seen newly postpartum mothers with a known history of hypertension experiencing severe headaches and struggling to reach their medical providers.

Rather than being monitored in the hospital to be sure their hypertension is under control, they are sent home. They must care for their new babies, and hope they don’t need to rush back to the hospital.

Just a few weeks ago, a newly postpartum Florida woman died after paramedics didn’t rush her to the emergency room. Her mother had called 911 after the woman had exhibited symptoms of a stroke.

USA Today investigators uncovered similar stories. In 2015, a South Carolina woman YoLanda Mention died less than a day after she was discharged. The final check of her vital signs, before she left the hospital, should have served as a warning sign. Her blood pressure was 175/94,  but she was still discharged.

The next day she died of a stroke in a hospital emergency department waiting room as the warning signs were continually ignored.

Texas woman, Beatriz Garcia, alleged in federal and state lawsuits she almost bled to death when her medical care providers were slow to intervene after failing to quantify her blood loss. During the incident, her heart stopped. She ultimately required a hysterectomy to stop the blood loss. Due to the resulting damage, she is now awaiting a kidney transplant.

Medical negligence is a risk in all areas of medicine, but it should be rare, especially in childbirth. Even more so when so much money is spent on healthcare in the US, and when there are such well known and well established guidelines.

Birth will always carry some inherent risk. Women who give birth in a wealthy country, however, where there is access to modern medical care, should expect to have some of the best outcomes. Nevertheless, in the US we’re seeing trends that go against those of every other developed nation.

These examples are extreme cases, of course. But it is important for the public to be aware of this issue. Why?

First, we need to push for improvements in maternity care. And second, until we see those improvements, self-education and advocacy are vital.

A labouring and newly postpartum woman shouldn’t have to fight for lifesaving care, but at this point it seems to be necessary.

How Can I Reduce My Risks Of Childbirth Complications?

Childbirth related death and injury can be very complicated. There are many variables when it comes to birth outcomes. However, we know the US can improve because every other developed country has done so.

Australia is comparable with the US in some aspects of maternity care. In both countries women have the option of midwifery or obstetrician prenatal and birth care. The difference, however, is that Australia isn’t seeing an increase in childbirth related death.

Nevertheless,  it is vital for women in both countries to be active participants in their prenatal and birth care. We might not be able to change the system overnight, but mothers can make some choices that might reduce their risks during birth.

This doesn’t take away healthcare providers’ responsibility to practise according to guidelines, but self-education and advocacy can prove to be lifesaving.

Some things that might reduce your risks:

• Arrange a preconception appointment before trying to conceive. Although not all pregnancies are planned, if you’re planning to become pregnant, it can be helpful to meet with your midwife or doctor to discuss your current health. If you have risk factors for hypertension, diabetes, etc. there might be ways to reduce your risks before conception and pregnancy.
• Make an informed decision about your maternity care provider. If you’re in the US, you can learn more here; if you’re in Australia, you can learn more here.
• Make childbirth and postpartum education an important part of your pregnancy. An independent childbirth class can help you make informed decisions, and learn about preventative care and any red flags for complications.

The BellyBelly Immersion program is designed to help parents feel prepared and increase the likelihood of a positive birth experience. Click here to learn more.

Birth is a normal physiological process. It often progresses quite well without intervention. We live in a time when we have access to modern obstetrics, which can save lives in the rare instances when birth doesn’t unfold well, and yet we see an increased risk of serious injury and death in the US.

There are many theories about the increased risk, and probably many causes. As a whole, the US is not as healthy as it should be – even outside of maternity care. This situation increases risks during childbirth. Other nations face similar problems, however, and still have better outcomes.

More enforcement and better use of known guidelines, patient education and advocacy, and continued research into public health will, we hope, bring the US back up to par with other developed nations. In the meantime, be an active participant in your healthcare and do everything to reduce your risks.