Hospitals Are Closing Maternity Wards, Even Though We Have The Highest Maternal Death Rate Of Any High-Income Country
Even though there has been a decline in maternal deaths since the COVID-19 pandemic, the United States still has the highest maternal death rate of any high-income country.
For every 100,000 live births in the United States during 2022, there were approximately 22 maternal deaths. According to an analysis published by The Commonwealth Fund, this rate is significantly above other high-income nations.
While maternal death in the U.S. is lowest for Asian American women, it is highest for Black women, for which there are nearly 50 maternal deaths for every 100,000 live births. People of color face gaps in healthcare accessibility and quality, which is fueling this divide.
Now, the maternal mortality crisis may worsen even further in the wake of hospital obstetric units closing in both rural and urban communities.
A recent study conducted by the University of Minnesota’s School of Public Health has analyzed shifts in obstetric care offered in U.S. hospitals.
Utilizing data from the American Hospital Association Annual Survey and the Centers for Medicare & Medicaid services, as well as an advanced algorithm, the researchers were able to monitor changes in obstetric services at 4,964 acute-care hospitals. This encompassed 1,982 in rural areas and 2,982 in urban locations.
The study revealed that, from 2010 to 2022, the proportion of hospitals without obstetric services increased from 35% to 42%. By 2022, 52% of rural hospitals and 36% of urban hospitals no longer offer obstetric care.
In total, 537 hospitals stopped providing obstetric services, with 299 closures in urban areas and 238 in rural areas.
Finally, just 138 hospitals decided to introduce obstetric care during this period, predominantly in urban regions. There, 112 hospitals added services, compared to only 26 in rural areas.
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Katy Kozhimannil, the study’s lead author, discussed how maternal mortality is a devastating loss for countless families and has impacts that resonate across generations.
Kozhimannil claimed that shutting down obstetric units and restricting access to quality healthcare will only exacerbate the issue.
“Rural hospitals not only started with fewer obstetric services but also experience more severe losses over time, leaving rural residents with fewer options and longer distances to travel, often at times when patients are in urgent need of timely care,” she explained.
“Without targeted resources and policy interventions focused on equitable access to maternity care for all, including people of color and geographically isolated folks, this public health crisis will only get worse.”
The Commonwealth Fund’s analysis suggests the United States and Canada continue to lag far behind other nations, with the lowest supplies of midwives and ob-gyns.
The analysis also showed that nearly two out of three maternal deaths in the United States happen during the postpartum period.
Yet, women in the United States are the least likely to have home visits and guaranteed paid leave, as compared to women in the other studied countries, which included Australia, Canada, Chile, France, Germany, Japan, Korea, Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom.
To read the study’s complete findings, which have since been published in JAMA, visit the link here.
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