The United States has the worst maternal mortality rate in the developed world. As other wealthy countries have seen maternal mortality plummet to nearly zero, we are the only developed nation whose maternal mortality has risen in the past two decades. In some states, the situation is even more dire. Georgia’s maternal mortality rate rivals that of Iran, Iraq, and 100 other countries. An American woman giving birth today is now 50% more likely to die than her mother was a generation ago. Maternal mortality in Finland is virtually unheard of; a tonsilectomy is more dangerous.
Meanwhile, Republican lawmakers act to reduce access to contraceptives and slash maternal health funding. And anti-choice protesters picket outside of abortion clinics claiming that they’re there to save women’s lives, even as they ignore the 700-900 women who die giving birth each year, the 50,000 women who suffer disabling birth injuries, and the 25% of women who suffer lasting trauma from giving birth. They ignore that it is anywhere from 14 to 111 times more dangerous to give birth than to have an abortion, depending on which state you live in and the color of your skin.
Pro-choice activists have rightly drawn attention to maternal mortality in recent years. But as knowledge of the issue spreads, so too does a lie that kills women:
Giving birth is inherently dangerous, and high maternal mortality is inevitable.
Wrapped up in this lie is often a second, which is that women die because they are unhealthy or make bad lifestyle choices. The data shows otherwise.
The Maternal Mortality Lie That Keeps Killing Women
Depending which study you believe, between 60 and 85% of maternal deaths are preventable. The actual number may even be higher, especially if we were to make preventative care more accessible and affordable before women get pregnant. No matter how you parse the data, one thing is certain: a whole lot of women are dying because we have chosen not to do enough to fix maternal mortality.
In Europe, where maternal mortality is so rare most doctors never encounter it, they don’t make a different species of women. They have older mothers there, too. And overweight mothers. And poor mothers. And mothers with imperfect lifestyles. What they don’t have in Europe is a healthcare system that prioritizes profits over people, and that continually pushes high-cost, high-risk interventions at the expense of human lives.
Dig deeply into maternal mortality review committee reports and you’ll find a treasure trove of alarming data showing that racism permeates medical culture and kills women; that many women die while begging for help from doctors who ignore them; and that an epidemic of unnecessary interventions and dangerous c-sections are killing women who don’t have to die.
The problem doesn’t end with maternal deaths, either. Many women barely escape giving birth with their lives. Or they leave birth traumatized, with stories of assaults, sexual abuse, and forced and unnecessary medical interventions to which they never consented.
The leading causes of maternal death include infection, hemorrhage, and cardiovascular health problems such as untreated blood clots.
In a modern healthcare system, there is no reason for women to bleed to death, to suffer infections, to have cardiovascular health issues they don’t know about.
As long as media reports, doctors, and pundits continue to assert that these deaths are inevitable, that birth is necessarily dangerous for everyone, or that women die because of unpredictable sudden emergencies or unhealthy lifestyles, the collective will to do anything will remain weak.
Research shows that maternal mortality is concentrated in certain locations and at certain facilities. Reports of maternal deaths often relay stories of women who begged for help, only to be ignored by doctors. This suggests that the epidemic may trace back to the bad practices of specific doctors and hospitals. As long as we treat maternal mortality as inevitable, these facilities and clinicians get a free pass. They get to keep killing women, and then blaming dead women who can no longer defend themselves.
The truth behind the lie that maternal mortality is inevitable is this:
In a technologically advanced society, high maternal mortality is a choice. We have chosen to let women continue to die because we don’t want to confront the myriad systemic failures behind these deaths.
It's true that, without medical care, giving birth can be very dangerous. But that’s not the world we live in today. We know how to save women. There are hospitals everywhere. Antibiotics and blood transfusions and preventative care exist. We’ve just chosen not to ensure that women have full access to quality care.
The Link Between Anti-Choice Politics and Maternal Deaths
Yesterday I spoke to a woman who had all of the classic symptoms of HELLP. HELLP can be catastrophic for both the mother and the baby. Delaying treatment can be fatal for both. She contacted her OB, as every website advises to do. He ignored her calls. When she finally got in touch with him, he dismissed symptoms of this potentially lethal condition and said he would see her at her next appointment.
This outrageous-sounding behavior is more common than many of us want to believe. Numerous studies have shown that doctors are more likely to dismiss women’s symptoms, even when those symptoms point to a life-threatening condition.
This phenomenon also extends well beyond the walls of maternity wards. Distrust of women is the same reason anti-choice activists think they—not a woman and her doctor—should decide when a woman should have to have a baby. It’s the same reason they think a fair penalty for being raped is the risk of dying to give your rapist’s baby.
We as a society just don’t believe women. Our favorite national pastime has always been judging the motives, behaviors, and choices of women. When they get mad about it, we call them hysterical. When they complain about poor medical treatment, we ignore them. When their doctors serve up substandard care, we tell women they need to be more assertive or knowledgeable, or “know the warning signs” of maternal death.
Until we start believing women, until we listen to them when they are in pain, until we stop blaming women and start blaming a collapsing healthcare system, women will keep dying.
The first step is to reject the lie that maternal mortality is inevitable.