The rise in maternal mortality in the United States has been hitting the headlines, especially as it relates to Louisiana leading the way. Senator Bill Cassidy is getting flak, rightfully so, for trying to minimize the problem focusing on taking the African-American mothers out of the equation. Their deaths are an important part of this, but they are only a part, but deserve due diligence as to why just like every other race, income group, ethnic group, etc. We should look to things like – lack of healthcare access, fewer rural hospitals, food deserts and poverty as several of the causes. Yet, this is not a new problem, as I wrote this post seven years ago.
Recently, a very powerful article was written by Danielle Paquette in The Washington Post entitled “Why pregnant women in Mississippi keep dying.” A link to the article follows: http://www.washingtonpost.com/blogs/wonkblog/wp/2015/04/24/why-pregnant-women-in-mississippi-keep-dying/. While the article focuses its title on Mississippi, that is a metaphor for a national problem. The US is now the only developed nation where the rate of pregnant mother deaths is increasing. In 1987 only 7.2 pregnant women were dying per 100,000 births. That rate has more than doubled in 2013 to 18.5 deaths per 100,000 births. Our maternal death rate in childbirth is 3x the rate in Saudi Arabia and 2x the rate in the UK.
In Mississippi, it is far worse with 54.7 black mothers dying in childbirth out of 100,000 births and 29.3 white mothers dying per 100,000. There a number of reasons cited, but one of the key reasons is that Mississippi has not expanded Medicaid and have over 107,000 people who do not have access to healthcare coverage. Note, other reasons are cited, but not having health care coverage limits access to preventive visits that expectant mothers with care get.
As many know, I have been a broken record for the need to continue and improve the Affordable Care Act, which is working pretty well by a number of studies and has dampened cost increases with the Congressional Budget Office lowering health care projections three times due in part to the ACA. In fact, just yesterday at Congress’ request, the CBO and Joint Committee on Taxation noted that repealing the ACA would increase the deficit by $353 Billion (or $137 Billion when a new dynamic scoring approach is used). This seems to run counter to rhetoric of how harmful the law is. Here is a link to the article: http://www.msn.com/en-us/news/politics/obamacare-repeal-would-boost-10-year-deficit-by-dollar353b-cbo/ar-AAbQa2S?ocid=DELLDHP
But, we need to finish the job and completely implement the ACA in about twenty states, such as North Carolina, that have not expanded Medicaid to cover a key tranche of people under the ACA. It is not surprising, these predominantly southern states are seeing the worst child and mother health results. Several reputable health-related foundations (The Commonwealth Fund, Kaiser Family Foundation) and economic think tanks (RAND and Economic Policy Institute) have noted that not expanding Medicaid is actually harmful to people and this is more evidence of that assertion.
Please read these articles and, if you concur these are problems worth doing something about, reach out to your state legislators and US representatives and senators. Ask them to support the continuation of the ACA as the majority of Americans wish to happen. Ask the states who have not expanded Medicaid to do so as they are hurting people, rural hospitals and their own economies in not so doing. These issues are that important as people are the pawns in these political chess games and they bear the brunt of these decisions with their health and lives.