# Maternal mortality rates in the US have gone up, but in CA they've gone down significantly **URL:** \ **Category:** Great Debates\ **Created:** [June 29, 2017, 1:54pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135 "2017-06-29T13:54:04Z")\ **Posts on this page:** 15\ **Page:** 1
**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\ **Post date:** [June 29, 2017, 1:54pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/1 "2017-06-29T13:54:04Z")
Article here: [California decided it was tired of women bleeding to death in childbirth - Vox](https://www.vox.com/science-and-health/2017/6/29/15830970/women-health-care-maternal-mortality-rate) In short, maternal mortality (women dying in childbirth) has been increasing in America for the past 10-15 years. But California has successfully reversed this trend, and has a maternal mortality rate of 1/3rd of the rest of the country (and 1/5th of Texas, which has the highest rate in the country). Maternal mortality rates in the US are significantly higher than the rest of the developed world. I’m sure liberals agree with me that this is a good program that California has instituted, but what about conservative Dopers? If government could do this for the whole country, would it be worth the cost – or what cost would make it worth it? Are you troubled by the fact that Texas, and the country at large, have so much higher maternal mortality rates than other 1st world countries, and if so, why do you think this is? ---
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [June 29, 2017, 2:17pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/2 "2017-06-29T14:17:34Z")
That was a hugely biased article but I think it is great that universities and hospitals team up to improve patient outcomes. It is not clear from the article what government does or what expenses would be associated with it. ---
**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\ **Post date:** [June 29, 2017, 2:30pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/3 "2017-06-29T14:30:08Z")
> [@puddleglum](#): > > That was a hugely biased article but I think it is great that universities and hospitals team up to improve patient outcomes. It is not clear from the article what government does or what expenses would be associated with it. If I understand it correctly, the CMQCC (the organization responsible for the better care) is funded by the California Healthcare Foundation, California Department of Public Health, and the Centers for Disease Control and Prevention. So some level of public funding. What level of public funding would you be comfortable with to improve outcomes in this way? ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [June 30, 2017, 3:59pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/4 "2017-06-30T15:59:17Z")
> [@iiandyiiii](#): > > Are you troubled by the fact that Texas, and the country at large, have so much higher maternal mortality rates than other 1st world countries, and if so, why do you think this is? At least part of it is better reporting - > [@](#): > > A second study reported in the same issue indicates that pregnancy-associated deaths due to violence are three times more likely than deaths associated with the leading pregnancy-related causes of maternal mortality. > > Although much of the reported increase in maternal mortality rates from 2000 to 2014 “was the result of improved ascertainment of maternal deaths,” the authors write, combined data for 48 states and the District of Columbia showed a 26.6% increase… > > The updated statistics come from a new analytical model that compensates for deficits in the collection of maternal mortality statistics, particularly with the addition in 2003 of a pregnancy question to the US standard death certificate. Although the question — which includes checkboxes to indicate whether female decedents were not pregnant at the time of death, pregnant at the time of death, not pregnant at the time of death but pregnant within 42 days of death, not pregnant at the time of death but pregnant from 43 days to 1 year before death, or of unknown pregnancy status — was designed to improve the accuracy of maternal mortality estimates, the question has been inconsistently adopted by individual states. [Cite](http://www.medscape.com/viewarticle/867225). Regards, Shodan ---
**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\ **Post date:** [June 30, 2017, 4:40pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/5 "2017-06-30T16:40:36Z")
> [@Shodan](#): > > At least part of it is better reporting - > > [Cite](http://www.medscape.com/viewarticle/867225). > > Regards, > Shodan How about the remainder, which if my math is correct, is still significantly higher than most other developed countries? ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [June 30, 2017, 5:28pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/6 "2017-06-30T17:28:34Z")
The article you linked to talked about medical issues relating to maternal death. The article I linked to mentioned that deaths by violence were three times more common than medically related maternal deaths. Reducing violent crime doesn’t strike me as a medical issue - maybe we should spend the research money on building more prisons for those who kill their girlfriends. Regards, Shodan ---
**Author:** ![Richard\_Parker](https://avatars.discourse-cdn.com/v4/letter/r/35a633/32.png) [@Richard\_Parker](https://boards.straightdope.com/u/Richard_Parker)\ **Post date:** [June 30, 2017, 5:35pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/7 "2017-06-30T17:35:40Z")
> [@Shodan](#): > > … building more prisons for those who kill their girlfriends. Ironically, building more prisons is just a humanitarian gesture for prisoners who are confined in overcrowded, torturous conditions. We don’t do it because the same people who think more prisons lead to less crime also think terrible prison conditions lead to less crime, though both propositions have a big citation needed flag. ---
**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\ **Post date:** [June 30, 2017, 5:46pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/8 "2017-06-30T17:46:55Z")
> [@Shodan](#): > > The article you linked to talked about medical issues relating to maternal death. The article I linked to mentioned that deaths by violence were three times more common than medically related maternal deaths. Reducing violent crime doesn’t strike me as a medical issue - maybe we should spend the research money on building more prisons for those who kill their girlfriends. > > Regards, > Shodan But what about the medical issues? Or am I misunderstanding you? ---
**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\ **Post date:** [June 30, 2017, 5:59pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/9 "2017-06-30T17:59:23Z")
> [@iiandyiiii](#): > > But what about the medical issues? Or am I misunderstanding you? I’ll add that CA really did reduce the rate to a third – was that a fluke, or is there a chance that their efforts actually reduced medical related deaths? ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [June 30, 2017, 6:10pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/10 "2017-06-30T18:10:15Z")
> [@iiandyiiii](#): > > But what about the medical issues? Or am I misunderstanding you? If you have a problem, and one cause is three times worse than another, which is the one to concentrate on first? Regards, Shodan ---
**Author:** ![OldGuy](https://avatars.discourse-cdn.com/v4/letter/o/3bc359/32.png) [@OldGuy](https://boards.straightdope.com/u/OldGuy)\ **Post date:** [June 30, 2017, 6:26pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/11 "2017-06-30T18:26:05Z")
> [@Shodan](#): > > The article you linked to talked about medical issues relating to maternal death. The article I linked to mentioned that deaths by violence were three times more common than medically related maternal deaths. Reducing violent crime doesn’t strike me as a medical issue - maybe we should spend the research money on building more prisons for those who kill their girlfriends. > > Regards, > Shodan Or perhaps stricter gun laws? ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [June 30, 2017, 6:59pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/12 "2017-06-30T18:59:35Z")
We could spend it in a lot of ways. I have no idea of what percentage of the mothers who died by violence died from gunshot wounds vs. beatings vs. vehicular vs. anything else. One of the articles mentioned opioid poisoning - maybe that working on that would help. Or maybe California had a bigger problem with retained placentae or too many C-sections than Texas does, and that’s why the research helped in CA. Or perhaps they have different demographics, or who knows what. Supposedly California is bucking the trend. That’s great. Maybe whatever they are doing will work in Texas. It would be great if it did. FTR I support motherhood. Also apple pie, _and_ the American Way. Regards, Shodan ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [June 30, 2017, 7:08pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/13 "2017-06-30T19:08:09Z")
It’s hard to tell from the article the biggest drivers of the rate disparity. It seems like engaging in evidence based medical procedures and reducing unnecessary Cesarean procedures were the focus. Both of those sound good to me but I think the connection to specific actions like funding levels is nebulous. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [June 30, 2017, 7:22pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/14 "2017-06-30T19:22:06Z")
That’s something I didn’t understand - does reducing C-sections reduce maternal mortality? IANAD but some Googling seems to indicate that > [@](#): > > In April 2008, the UK’s Birth Trauma Association also analyzed data > taken from the latest CEMACH report, and found that planned cesarean > delivery had the lowest maternal mortality rate compared with all other > births: [Cite](http://www.bmj.com/rapid-response/2011/11/02/new-research-finds-lowest-maternal-mortality-rate-elective-cesarean-delive). Regards, Shodan ---
**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\ **Post date:** [June 30, 2017, 7:53pm UTC](https://boards.straightdope.com/t/maternal-mortality-rates-in-the-us-have-gone-up-but-in-ca-theyve-gone-down-significantly/790135/15 "2017-06-30T19:53:14Z")
> [@Shodan](#): > > If you have a problem, and one cause is three times worse than another, which is the one to concentrate on first? > > Regards, > Shodan I don’t think they’re related to each other, and therefore they can be addressed in parallel.