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Deaths from pregnancy-related causes have increased by 26.6 per cent across most of the US in 15 years. The problem is particularly bad in Texas, where the maternal mortality rate nearly doubled in the space of a year, from 2011 to 2012.

These numbers come from a study of health data led by Marian MacDorman at the University of Maryland. The average maternal mortality rate in the US was 23.8 per 100,000 live births in 2014, although the researchers excluded Texas and California from this calculation. In comparison, it was only 9 and 6 deaths per 100,000 live births in the UK and Australia, respectively, in 2015.

In fact, according to a , the US is one of only eight countries in the world where the rate of pregnancy-related deaths has gone up in the last few decades, instead of down. The other countries where this has happened are Afghanistan, Belize, El Salvador, Guinea-Bissau, Greece and the Seychelles.  But it’s Texas’s shocking rise that has caught the most attention. MacDorman’s team hasn’t pinned the state’s doubling in maternal mortality to a specific cause, but the team did note that the it has seen “some changes in the provision of women’s health services” since 2011.

Clinic closures

These changes include cuts to funding for women’s health and family planning. A new law restricting abortions in Texas – which has now been struck down by the US Supreme Court – also prompted a number of abortion clinics across the state to close. This may have made it harder for women whose health was at risk from pregnancy to get a termination.

There are a few probable factors behind the rise, says at the American Public ��ҹ����1000���� Association in Washington DC. There are more women in the US giving birth at an older age, having caesarean sections, or becoming pregnant while dealing with complications such as obesity or hypertension – all of which can raise the risks associated with pregnancy or childbirth.

We also have better methods of surveying public health than we did a few decades ago, which may explain the increase in reported pregnancy-related deaths.

But the likeliest culprit is limited access to care, be it through the closure of clinics, the limited availability of health care in rural areas, or a lack of health insurance. “When you see a decrease in services related to reproductive health, you’re certainly going to see adverse outcomes,” says Davis Moss. “The reality is that, until we decide that women’s health is a priority in our lives, we’re going to see outcomes like this.”

Journal reference: Obstetrics & Gynaecology, DOI: 10.1097/AOG.0000000000001556

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