Death by childbirth in the USA

Childbirth - the gory bits - was the subject of almost every late night conversation over a bottle of wine during my 30s. We talked about our feelings, the pain, what went wrong, what went right, hospital births, home births....we also moaned a lot and wished it had all gone differently. Not once did we celebrate the fact that we and our babies had all survived childbirth, or considered that Ireland has the lowest maternal death rate in the world (UNICEF 2005).

I was thinking about this when I read that maternal death rates have doubled in the USA in the past 20 years. At least two women die in childbirth every day. To say I was shocked is an understatement. In 1987 there were 6.6 maternal deaths per 100,000 births. By 2006 that had increased to 13.3 deaths. In Ireland it is 2 deaths per 100,000 births. The report, by Amnesty International, also shows that 13 million women aged 15 to 44 years old - or one in five - do not have health insurance. Having a baby in the USA without health insurance is very expensive - and if your child is premature or has health problems, say hello to bankruptcy. So it's hardly surprising that some of the highest rates of women dying in childbirth are in deprived African American communities.

"In the U.S., we spend more than any country on health care, yet American women are at greater risk of dying from pregnancy-related causes than in 40 other countries," says Nan Strauss, the report's co-author, who spent two years investigating the issue of maternal mortality worldwide.

Some commentators are also speculating that high rates of caesarian sections in the USA may also be a contributory factor, but I am not sure how relevant this is. I wonder how many of the African American women who died had caesarians? I imagine that most of them would not be able to afford a section. And I'm not trying to pick on one particular group, it's just that they have a particularly high death rate - more than 32 deaths per 100,000 births.

I so hope that President Obama takes note of this report, and that improvements in maternal care form part of his final healthcare package. Americans see their country as the world's leading nation, and most of us admire their optimism, their work ethic and the opportunities that they give to anyone who is prepared to work hard. But why can they also not care for those who need it, and why has care for mothers got worse as technology has improved and incomes risen? Set a good example for the world, start with pregnant women, and make the future better for all their unborn babies.

On Wednesday, the world will be celebrating all things Irish. Now I know that childbirth in Ireland isn't always ideal, but it is at least pretty safe. So wouldn't it be great if other countries aspired to our maternal mortality rates, as well as the 'craic'.

Happy Mother's Day!