Maternal and Infant Mortality Overview

Global Context

  • Lack of medical infrastructure in rural areas and sub-Saharan Africa.

  • Insufficient family planning resources and distribution networks.

  • Cultural acceptance of fertility limitation is low.

  • Women hold a low status within families and networks.

Comparison of Developed and Developing Nations

  • Developed nations (like the U.S.) have excessive intervention during childbirth.

  • Developing nations have inadequate intervention.

  • High age at first birth in developed nations, low in developing nations.

  • Maternal mortality: 2-5 times higher in women under 18 in poor countries compared to those over 20.

Known Risk Factors for Maternal Death

  • Very young or very old maternal age.

  • Rural residence.

  • Absence of prenatal care.

  • Closely spaced multiple pregnancies.

  • Cesarean section delivery.

  • Pre-existing health conditions (especially heart and kidney issues).

Common Causes of Maternal Death

  • Postpartum hemorrhage.

  • Hypertensive disorders (toxemia).

  • Aggravation of preexisting disorders.

Comparative Maternal Mortality (2020)

  • Maternal mortality ratio: deaths of women from pregnancy-related causes per 100,000 live births.

  • U.S. maternal mortality rate is significantly higher than other industrialized nations.

    • U.S.: 23.8

    • France: 8.7

    • Canada: 8.6

    • UK: 6.5

    • Australia: 4.8

    • Sweden: 4.3

    • Norway: 1.8

Racial Disparities in U.S. Maternal Mortality

  • Black women face a maternal mortality risk three times that of white women:

    • Black mothers: 55

    • White mothers: 19

Trends to Monitor

  • Lack of progress in maternal mortality reduction in Africa.

  • Rising maternal mortality risk in the U.S. despite modern medical technology.

Reasons for High U.S. Maternal Mortality Rate

  • Proximate causes: High preexisting health issues, low prenatal care accessibility, high rates of teen and unintended pregnancies.

  • Distal causes: Poverty, inequality, unequal access to healthcare and contraception, environmental racism.

Maternal Morbidity Worldwide

  • Issues include obstetric fistula, pelvic floor prolapse, severe anemia, calcium loss, and increased risk of autoimmune diseases.

Interventions Needed

  • Medically-trained attendants for all births.

  • Support for pregnancy (nutrition, prenatal care).

  • Basic public health infrastructure.

  • Secondary education access for youth, especially girls.

Connection Between Maternal and Infant Mortality

  • High maternal mortality correlated with high infant mortality.

  • Causes of death differ by country; rich countries focus on low birthweight and poor countries on obstructed labor.

Future Considerations

  1. Addressing inequality to lower maternal mortality in the U.S.

  2. Commitment to global reproductive justice.

  3. Consequences of inaction for future generations.