AMERICA’S DWP CRISIS: DYING WHILE PREGNANT
Over the past 20 years, the world has seen remarkable progress in medical science. Gene editing, cancer immunotherapies, improved antibiotics, and robotic surgery—these just scratch the surface of our scientific breakthroughs.
Yet discovery hasn’t always translated into improved health care. And for one group of Americans, health care isn’t just sliding backwards, it’s falling off a cliff.
I’m talking about women who are pregnant.
Earlier this month, an analysis in the Journal of the American Medical Association (JAMA)revealed a shocking truth for American women. From 1999 to 2019, maternal mortality hasn’t just stopped improving, it’s actually worsened by over 100%.
That’s right. A pregnant woman today is more than twice as likely to die as a similar woman 20 years ago. In one of the world’s richest nations, how is this even possible?
First, let’s look at the study. Researchers poured through twenty years of records and compared pregnancy related deaths to the number of annual pregnancies. They used the standard definition of maternal mortality—deaths from complications during or just after a pregnancy such as bleeding, infection, eclampsia, etc. They looked at geographic distribution, regional variation, and racial make-up.
In every corner of the country, for every ethnic group, outcomes worsened. By 2019, deaths per 100,000 pregnancies (the benchmark measure) had increased from 12.7 to 32.2. For Black and American Indian women, the picture was much worse. Their mortality skyrocketed to 55.4 and 49.2, respectively.
And this study counted deaths from medical causes only. It didn’t include pregnant women who died from firearms and auto accidents. According to an earlier analysis, homicide takes the lives of more pregnant women than any other cause. Add in those deaths, and mortality for U.S. pregnant women soars even further.
Only in America. What the hell is wrong with us?
Maybe we’ve reached the point where we should give this condition a clinical name. DWP. Dying while pregnant.
Make no mistake. American outcomes were nothing to brag about before the study began in 1999. Even then, our rates were the worst in the developed world. And since then, we’ve only lagged further and further behind.
Since the study’s 2019 conclusion, maternal mortality has risen even further. Will we as a nation have the courage to acknowledge and address the root causes of these unnecessary deaths? Or will we continue to ignore our racial, economic, gender, and geographic disparities, choosing instead to label them just an unfortunate coincidence?
Next month, thousands of future doctors and nurses will begin their training in institutions around the country. Hopefully, this new generation of professionals can address our maternal mortality crisis. But it won’t be easy.
Answers won’t be found in any laboratory. No technological breakthroughs will provide magic solutions. Progress will only come through taking a hard look at why pregnant women are dying, and what can be done to prevent it. It will require honest questioning as to why mortality is worsening even further for minorities and the economically disadvantaged. It will require a concerted effort from all of us.
But such progress won’t occur if every time an issue is raised it’s shouted down with cries of “you can’t talk about that, that’s critical race theory! That’s wokeism! That’s cultural Marxism! That’s socialism!”
No, it’s not any of those things. It’s about young women dying. And that needs to change.
And progress will be further hindered in states that prioritize embryos over the lives of mothers. Regardless of how you may feel about abortion, radical laws are being proposed throughout the country that greatly endanger women. Last year in Missouri, for example, the legislature debated whether to outlaw surgery for ectopic pregnancies (an embryo that implants in the fallopian tube instead of the uterus), even though such pregnancies are 100% non-viable. Apparently, the near-certainty of a mother’s tubal rupture, internal bleeding, sepsis, and death, wasn’t particularly important.
Make no mistake, how we deal with America’s DWP crisis may be the most important factor in determining the future health and well-being of our daughters and granddaughters. Right now, maternal mortality is headed dangerously in the wrong direction, and must be corrected. I’m optimistic that those future nurses and doctors will be up to the challenge.
The real question for the rest of us is, will we?