Childbirth Deaths Are Falling Worldwide, but Not in the U.S.

Last week saw the release of a game-changing report on the state of maternal mortality (that is, women dying from complications related to pregnancy). According to the report, published in the medical journal The Lancet (and financed by the Gates Foundation) in the last 20 years, rates of death for pregnant women have, in large part, fallen around the globe.

As The New York Times reports, "the study cited a number of reasons for the improvement: lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of' 'skilled attendants' -- people with some medical training -- to help women give birth. Improvements in large countries like India and China helped to drive down the overall death rates."

That's the good news. The bad news: Maternal mortality has risen in other parts of the globe, including right here in the United States. And the ugly? Longtime advocates for maternal-health programs wanted to prevent the publication of the report, fearing it would undermine their efforts to gain increased financing for their work.

The Times does not specify who these maternal-health advocacy groups are. While it's understandable the groups might be (cough) wary of any "Mission Accomplished" banners being unfurled just yet, their inclination to hide or delay the release of relevant information -- especially news of progress and effective treatment -- seems pessimistic at best, dishonest at worst.

Instead of fearing that news of a decline in death rates would mean less money for programs, I'd reason that conclusive evidence of progress is a powerful endorsement for continued (and increased!) support. Too often, advocates present donors with only the bleak landscapes, presumably as part of a strategy to show them how great the need is. I'm not disputing the efficacy or necessity of doing this, but I do think a more balanced approach would be appreciated and encouraged. Maybe I'm too optimistic in my belief that the public doesn't just need to hear bad news to be convinced of the urgency of a situation: people can appreciate the complexity of a problem, too (See: Afghanistan, US presence in).

More disconcerting is the notion that advocates would try to block information from becoming public. Impulses like this do a great deal to undermine public confidence, and do much to reinforce a Chicken Little-ish impression of groups working to raise awareness about problems around the world. The sky cannot be falling all of the time.

I'll stop giving the advocacy groups a hard time now and focus on some other wildly unfortunate information: Maternal mortality rates in the United States have risen in the last 20 years. Between 1990 and 2008, the number of deaths (per 100,000 live births) rose from 12 to 17. Women in the United States face a higher risk of pregnancy-related complications than those in 40 other countries. According to Amnesty International, two to three American women die from pregnancy complications every day for reasons ranging from discrimination to financial and language barriers to lack of information about maternal care and family planning options.

Even more appalling: Black women are four times as likely to die from pregnancy-related complications as white women. This is a national issue, something that the White House could (and should) take up with relish.

What's more: rates in many parts of southern and eastern Africa rose during the same period, due in large part to increased rates of HIV-positive pregnancies. In this way, the study conclusively links HIV treatment and maternal health, something that will (hopefully) be a boon for programs working to tackle both issues.

In the end, the report might prompt more questions than it answers: How did Egypt cut its maternal mortality rate to a fifth of what it was in 1990? What are the Bolivians and Italians doing that we aren't (More spaghetti? More salteñas?) When it comes to issues of global health and treatment, we need more signposts, more guides, more communication and more coordination. Childbirth, (fingers double crossed!) isn't something that's going away anytime soon. After all, everybody has a mother -- and if nothing else, we owe it to her.