Obama challenged over soaring maternal mortality rates

By agency reporter
March 16, 2010

Amnesty International has called on US President Barack Obama to tackle soaring rates of maternal mortality and pregnancy-related complications that particularly affect minorities and those living in poverty.

The global human rights organisation’s report Deadly Delivery: The Maternal Health Care Crisis in the USA urges action to tackle a crisis which sees between two and three women die every day during pregnancy and childbirth in the US.

A total of 1.7 million women a year, one-third of all pregnant women in the country, suffer from pregnancy-related complications.

The report also revealed that severe pregnancy-related complications which nearly cause death - known as "near misses" - are rising at an alarming rate, having increased by 25 per cent since 1998.

Minorities, those living in poverty, Native American and immigrant women and those who speak little or no English are particularly affected.

"This country's extraordinary record of medical advancement makes its haphazard approach to maternal care all the more scandalous and disgraceful,” said Larry Cox, executive director of Amnesty International USA.

“Good maternal care should not be considered a luxury available only to those who can access the best hospitals and the best doctors. Women should not die in the richest country on earth from preventable complications and emergencies," said Larry Cox.

With a lifetime risk of maternal deaths that is greater than in 40 other countries, including virtually all industrialised nations, the US has failed to reverse the two-decade upward trend in preventable maternal deaths, despite pledges to do so.

"Mothers die not because the United States can't provide good care, but because it lacks the political will to make sure good care is available to all women," said Larry Cox.

Amnesty’s analysis also shows a health care reform proposal before the US Congress does not address the crisis of maternal health care.

"Reform is primarily focused on health care coverage and reducing health care costs, and even optimistic estimates predict that any proposal on the table will still leave millions without access to affordable care," said Rachel Ward, one of the authors of the Deadly Delivery report.

"Furthermore, it does not address discrimination, systemic failures and the lack of government accountability documented in Amnesty International’s report."

Rapid and comprehensive federal leadership is required, as the report found numerous systemic failures, including the following:

• Obstacles to care are widespread, even though the USA spends more on health care than any other country and more on pregnancy and childbirth-related hospital costs - $86 billion - than any other type of hospital care.

• Nearly 13 million women of reproductive age (15 to 44), or one in five, have no health insurance. Minorities account for just under one-third of all women in the US (32 per cent) but over half (51 per cent) of uninsured women.

• One in four women do not receive adequate prenatal care, starting in the first trimester. The number rises to about one in three for African American and Native American women

• Burdensome bureaucratic procedures in Medicaid enrollment substantially delay access to vital prenatal care for pregnant women seeking government-funded care.

• A shortage of health care professionals is a serious obstacle to timely and adequate care, especially in rural areas and inner cities. In 2008, 64 million people were living in "shortage areas" for primary care (which includes maternal care).

• Many women are not given a say in decisions about their care and the risks of interventions such as inducing labour or carrying out ceasarean sections. Ceasarean sections make up nearly one-third of all deliveries in the US – twice as high as recommended by the World Health Organisation.

• The number of maternal deaths is significantly understated because of a lack of effective data collection in the US.

Amnesty International also called on the US authorities for vigorous enforcement of federal non-discrimination laws and an increase in support for Federally Qualified Health Centers by 2011 to expand the number of women able to access affordable maternal health care.

The report and work on this issue is part of Amnesty’s 'Demand Dignity' campaign which aims to end the human rights violations that drive and deepen global poverty.

The campaign aims to mobilise people all over the world to demand that governments, corporations and others who have power, listen to the voices of those living in poverty and recognise and protect their rights. For more information visit http://www.amnesty.org/en/demand-dignity

For the full report Deadly Delivery: The Maternal Health Care Crisis in the USA, go to: www.amnestyusa.org\deadlydelivery

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