In 2018, the U.S. saw 17 maternal deaths per 100,000 live births — a ratio more than double the rate of other high-income countries, according to a Nov. 18 report from the Commonwealth Fund.
The report compares maternal mortality and care in the U.S. to 10 other developed countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.
For comparison, there were 1.7 maternal deaths per 100,000 live births in New Zealand. The U.S. is also facing a shortage of midwives and OB-GYNs, with 12 and 15 providers per 1,000 live births, respectively. All other countries included in the study have a ratio between two and six times greater, and guarantee at least one visit by a midwife or nurse within one week postpartum. Outside of the U.S., midwives tend to outnumber OB-GYNs.
In the U.S., 52 percent of maternal deaths occured between one day and one year after birth, highlighting the need for increased postpartum care access.
The U.S. may improve its maternal care outcomes by expanding the supply and affordable access to midwives, given the prevalence of postpartum home visits and the role of midwives in other countries, the study suggests. Additional strategies for maternal care improvement include guaranteeing paid maternal leave across the country; addressing racial disparities, as the death rate for Black mothers was two times higher than for white mothers; and strengthening postpartum care and home visits.
The report analyzed data from the Organization for Economic Co-operation and Development and the CDC's Pregnancy Mortality Surveillance System. A number of country-specific sources were used to compile data on postpartum home visits.