Way more moms die having babies in the U.S. than in any other developed nation. Why?

The maternal death rate has dramatically decreased in recent decades worldwide. But in the U.S., it has risen more than 26%.

When people think of women dying during childbirth, they don't usually think of the United States. But according to a study published in 2016 in Obstetrics and Gynecology, the U.S. saw a 26.6% increase in pregnancy and childbirth-related deaths for women from 2000 to 2014. That's a sharp contrast to other developed nations — and even much of the developing world — where maternal death rates have plummeted.

The U.S. is the only developed country where maternal death rates have been rising. Photo via Jean-Sebastien Evrard/Getty Images.


The U.S. is one of only 13 countries where the maternal death rate is worse now than it was 25 years ago, according to journalist and professor Linda Villarosa, who has studied and written extensively about maternal mortality.

To put it bluntly: That's abysmal.

The U.S. is one of the world's wealthiest nations and spends the most on health care, which makes those statistics even worse.

As the only economically advanced nation not to guarantee health care to its citizens, perhaps it's not surprising that more moms die here than in other developed countries. Seems like a pretty simple equation really.

Image via Statista.

However, people in the U.S. spend an awful lot of money on health care to have that kind of outcome. In fact, Americans spend more per person than any other country — and not because they go to the doctor more. In the U.S., we use doctors less and are hospitalized less often than people in other countries yet we pay far more for our care. We pay more to birth babies here too — and yet the maternal outcomes are an embarrassment.

Maternal mortality rates in the U.S. are especially high for black women.

Part of why the maternal mortality rate is higher than expected is due to racial disparities. For example, black women in the U.S. are three to four times as likely to die from pregnancy-related complications than white women. And that's not purely an economic issue; even wealthy black women have higher rates of maternal mortality than white women.

Infographic via Maternal Health Task Force.

Why is that? According to Villarosa, "an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress, resulting in conditions — including hypertension and pre-eclampsia — that lead directly to higher rates of infant and maternal death" for black women. Combine that with studies showing implicit racial bias in health care — such as dismissing legitimate concerns and symptoms voiced by black mothers — and it appears that much of the maternal mortality problem comes down to the effects of racism.

The good news: Some states have dramatically reversed those numbers.

While the statistics are depressing, there is hope — even within our current system. Some states have tackled this issue by forming Maternal Mortality Review Committees (MMRCs), which review every maternal death to determine cause and assess whether it could have been prevented. Data from these committees have shown that more than half of maternal deaths are preventable.

Image via Eric Feferburg/Getty Images.

California shows how successful MMRCs can be at saving lives. California formed its MMRC in 2006 when maternal deaths in the state were on the rise. As they discovered the most common, preventable reasons moms were dying, they created interventions to specifically address them. Since then, California has reduced its maternal mortality rate by more than 55% — at 4.5 per 100,000 live births, it is now far lower than the national average.

There's no reason the U.S. maternal mortality rate should keep climbing. While we can't save every mother's life, we can and should do all we can to try.

Family

Whenever someone's words or behavior are called out as racist, a few predictable responses always follow. One is to see the word "racist" as a vicious personal attack. Two is to vehemently deny that whatever was said or done was racist. And three is to pull out the dictionary definition of racism to prove that the words or behavior weren't racist.

Honestly, as soon as refers to the dictionary when discussing racism, it's clear that person has never delved deeply into trying to understand racism. It's a big old red flag, every time.

I'm not an expert on race relations, but I've spent many years learning from people who are. And I've learned that the reality of racism is nuanced and complex, and resorting to a short dictionary definition completely ignores that fact. The dictionary can't include all of the ways racism manifests in individuals and society, and the limitations of dictionary definitions make it a poor tool for discussing the topic.

Since "racism" is such a loaded term for many people, let's look at such limitations through a different complex word. Let's take "anxiety." According to Merriam-Webster, "anxiety" is defined as "apprehensive uneasiness or nervousness, usually over an impending or anticipated ill."

Now imagine thinking that you understand everything that encompasses anxiety from reading that dictionary definition. Imagine thinking you could recognize the signs of anxiety in someone based on that definition alone. Ridiculous, right? The dictionary doesn't explain that some people's anxiety manifests as anger, even though it does. It doesn't say that anxiety sometimes manifests as withdrawal or aloofness. It doesn't say that you often won't see obvious signs of fear or nervousness in someone experiencing anxiety.

The dictionary doesn't offer anything close to the reality of what anxiety is or looks like. It would be silly to say that someone isn't experiencing anxiety because they're not clearly showing signs of nervousness like the dictionary definition implies. Just as the dictionary definition of anxiety is not comprehensive, neither is the dictionary definition of racism. Yet people keep using it to "prove" that something or someone isn't racist.

Fox News analyst Brit Hume just pulled that trick on Twitter to try to back up his claim that Donald Trump's "go back to" statements to four Congresswomen of color weren't technically racist.


The first Merriam-Webster entry for "racism" reads "a belief that race is the primary determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race."

Merriam-Webster

First of all, I'm not sure how this definition actually makes Trump's statements not racist. A belief is not always conscious, so even assuming that his racism is unconscious, a white man telling four women of color to "go back to" their countries of origin—despite three of them being born in the U.S. and the fourth being a naturalized citizen of the U.S.—is pretty objectively racist. No one knows exactly what is going on in the President's head, but such statements only being made to women of color would certainly be consistent with the behavior of someone with a belief in white people's inherent superiority.

But that simple definition isn't truly definitive, either. Shortly after Hume's tweet, Merriam-Webster pointed out a usage note for the word "racism," which clarifies that dictionaries do not provide the be-all-end-all definition of words.

Anti-racism advocates have tried time and time again to explain that racism is not as straightforward as someone saying, "I think I'm superior to people who don't share my skin color." Racism is almost never that blatant, and yet oodles of Americans refuse to call anything less than that kind of bold statement "racism." We have a long history showing exactly how white supremacy—the origin of racism in the U.S.—exerts itself in both strong and subtle ways, and thousands of hours and pages of education from experts describing how racism works on an individual and societal level. But people still insist on the simplistic narrative of "Racism=hating people of a different race."

I've seen many people, including Brit Hume, argue that the word racism has lost all meaning. Frankly, that's a copout. Racism—as both a conscious or unconscious belief of racial superiority and as a system of racial prejudice blended with power dynamics—has a broader meaning than one person hating another person for the color of their skin. But that doesn't make it meaningless.

I've also seen people complain that "everything is racist these days," but no, it's really not. We simply understand more about racism now, thanks to the field of race studies and to people of color offering their time and energy to explain it, so it's easier to identify in its various forms. In my experience, when someone's understanding of racism reaches a certain stage, they start recognizing it in places where ignorance or unconscious bias may have caused them to miss it in the past. That's not imagining racism where it doesn't exist or "calling everything racist these days"; that's simply seeing reality more clearly.

When you really dive deep into the historical, psychological, and sociological reality of racism in America, it becomes painfully obvious that racism is far more prevalent and enmeshed in our society than most people think. Until defensive, mostly-white folks stop automatically denying racism every time the word is used and stop throwing around dictionaries to avoid having to do that deep dive work, we're not going to make real headway on this issue.

Let's stop pretending that the definition and supposed overuse of the word "racism" is the problem, when the problem is racism, period.

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