In recent years, significant efforts have been directed toward reducing the global maternal mortality rate affecting many countries, especially developing nations. As a result of various interventions, the global mortality rate has dramatically reduced by approximately 38% in the last decades. Many countries significantly reduce their maternal deaths by more than half. The United States leads in maternal mortality among industrialized countries with at least 17.4 deaths per 100000 live births (Collier et al., 2019). The issue of maternal death presents a special concern in the United States because despite having the highest healthcare budget globally, it is one of the few countries with rising maternal mortality rates (Collier et al., 2019). Compared to other developed nations, many maternal deaths in the United States are preventable.
These statistics indicate that the current interventions have significantly failed to address the safety of pregnant women by exposing them to conditions that threaten their survival (Neggers, 2016). It is significant to address this healthcare challenge to create a conducive healthcare environment that guarantees women’s safety during pregnancy and after delivery. Women play an essential role in creating the future of a nation by giving rise to new generations through childbirth. Therefore, it is necessary to ensure that conditions threatening their lives during childbirth are effectively addressed to eliminate preventable maternal deaths.
Problem Statement
Common maternal mortality causes include embolism, hemorrhage, pre-eclampsia, infections, and cardiomyopathy. However, various factors in the United States contribute to the severity of the issue in the country, including poor access to healthcare, intimate partner violence (IPV), and race (Creanga et al., 2014). Many women in the United States experience difficulty accessing prenatal and postpartum care. Lack of adequate prenatal care makes it difficult for pregnant women to pay attention to specific symptoms of severe conditions making women unaware of potential maternal complications. Additionally, after delivery, few women visit their physicians for postpartum care. Averagely, many women in the United States seek postpartum care once within the first six weeks after delivery thus making them vulnerable to potentially severe complications (Goldenberg & McClure, 2011). One of the leading causes of post-delivery mortality is postpartum depression which can drive the mother to commit suicide.
Intimate partner violence (IPV) among pregnant women has been on the rise in the United States. The latest reports indicating at least 9% of pregnant women experience IPV (Joseph, 2017). Pregnant women experiencing IPV tend to experience excess stress leading to risky behaviors such as taking alcohol or substance abuse. These conditions can lead to fatal maternal outcomes such as preterm birth and low birth weight. Disparities in the healthcare sector caused by racial prejudice make women from minority communities more vulnerable to maternal mortality than white women (MacDorman et al., 2016). Racial prejudice has adverse effects on women of color by limiting their access to education and income, thus negatively influencing the quality of maternal care they receive.
Global Health Strategy
There have been various interventions by international and nations to end preventable maternal mortality. In 2015, the World Health Organization (W.H.O) developed the Strategic Framework for Policy and Program Planning to Achieve Maternal Mortality Ratio (MMR) global target of fewer than 70 deaths per 100000 live births by 2030 (World Health Organization, 2015). This strategy was developed from human rights principles of equality that aimed to ensure that all women access quality healthcare that responds to their medical needs. The program advocates for the availability of basic maternal complication services and readily accessible emergency treatment for pregnant women (World Health Organization, 2015). W.H. O’s strategy offers a broader approach to the issue of maternal mortality rate where all the stakeholders in healthcare are involved in designing the practical mechanisms that can be employed to address the issue.
The program’s implementation is based on several guiding principles that define its aims and approach to addressing the problem. For instance, one of these guiding principles includes empowering women on their value in society and their critical role in defining the future. Sensitizing the community on the position of women is aimed at eliminating gender-based violence, discrimination, and abuse of women’s rights that limit their ability to access quality healthcare (Moran et al., 2016). Another vital guiding principle is integrating maternal and newborn care in healthcare services to support the relationship between the mother and the baby.
The survival of the baby tends to depend on the mother’s survival. Therefore, it is necessary to ensure that healthcare providers prioritize giving care to the mother and the baby without separating them. This approach promotes the psychological well-being of pregnant women and enhances their readiness for the responsibilities of having a baby (Moran et al., 2016). Integration of the program into a country’s core objectives is another guiding principle that will facilitate the achievement of the set target (World Health Organization, 2015). Countries are advised to own the program and support it legally and financially to ensure that it is implemented at the community level and benefits all the concerned parties through effective public participation.
This program is designed to achieve five primary objectives to lower the global mortality rate. Firstly, the program addresses the inequalities that limit access to quality reproduction and sexual and maternal healthcare (World Health Organization, 2015). This objective intends to protect vulnerable groups such as people of color who experience challenges when accessing quality healthcare, thus leading to complications during pregnancy. Secondly, the program proposes Universal Health Coverage (UHC) for women in need of maternal care to protect them from the high cost of accessing healthcare services that tend to discourage many pregnant women from seeking maternal care. Additionally, UHC is essential in eliminating discrimination that women from ethnic minorities tend to experience when seeking medical services.
Thirdly, the program aims to address all factors contributing to maternal mortality, reproduction, and other related complications. Each country must analyze the major factors contributing to the high maternal mortality rate and address them. For instance, in the United States, it is essential to promote easier access to quality prenatal and postpartum care, address racial inequalities and address IPV (Main et al., 2018). Fourthly, the program intends to strengthen healthcare systems to respond effectively to women’s needs. Strengthening healthcare facilities will ensure availability and readiness to provide maternal services to expectant women (Petersen et al., 2019). Lastly, the program aims to promote accountability in the healthcare sector to ensure equity in the provision of quality healthcare services. Accountability enables the relevant stakeholders to accurately measure the progress of a country’s efforts in addressing the issue of maternal care.
Conclusion
In conclusion, the maternal mortality rate continues to be a global health concern despite the various interventions that have been initiated. Although some maternal deaths are unpreventable, many expectant women continue to die of preventable causes due to various factors. Some of these factors include lack of access to prenatal and postpartum care, insufficient funds to meet the cost of healthcare, racial inequality, and gender-based violence, which leads to poor mental conditions. Although some of the interventions are employed by global bodies such as W.H.O, these factors continue to be prevalent in the United States, making it difficult to flatten the curve of maternal mortality rate. The healthcare system in the United States has failed to meet the needs of pregnant women despite having the highest healthcare budget in the world. Therefore, there is an urgent need to reconsider the objectives Strategic Framework for Policy and Program Planning to Achieve Maternal Mortality Ratio (MMR) to effectively address the areas of concern. The healthcare system should be improved to eliminate inequality and sensitize the public on the importance of seeking prenatal and postpartum care for expectant women.
References
Collier, A. R. Y., & Molina, R. L. (2019). Maternal mortality in the United States: updates on trends, causes, and solutions. Neoreviews, 20(10), e561-e574.
Creanga, A. A., Berg, C. J., Ko, J. Y., Farr, S. L., Tong, V. T., Bruce, F. C., & Callaghan, W. M. (2014). Maternal mortality and morbidity in the United States: where are we now?Journal of women’s health, 23(1), 3-9.
Goldenberg, R. L., & McClure, E. M. (2011). Maternal mortality.American Journal of Obstetrics & Gynecology, 205(4), 293-295.
Joseph, K. S., Lisonkova, S., Muraca, G. M., Razaz, N., Sabr, Y., Mehrabadi, A., & Schisterman, E. F. (2017). Factors underlying the temporal increase in maternal mortality in the United States.Obstetrics and gynecology, 129(1), 91.
MacDorman, M. F., Declercq, E., Cabral, H., & Morton, C. (2016). Is the United States maternal mortality rate increasing? Disentangling trends from measurement issues short title: US maternal mortality trends. Obstetrics and gynecology, 128(3), 447.
Main, E. K., Markow, C., & Gould, J. (2018). Addressing maternal mortality and morbidity in California through public-private partnerships. Health Affairs, 37(9), 1484-1493.
Moran, A. C., Jolivet, R. R., Chou, D., Dalglish, S. L., Hill, K., Ramsey, K.,… & Say, L. (2016). A common monitoring framework for ending preventable maternal mortality, 2015–2030: phase I of a multi-step process. BMC pregnancy and childbirth, 16(1), 1-13.
Neggers, Y. H. (2016). Trends in maternal mortality in the United States.Reproductive Toxicology, 64, 72-76.
Petersen, E. E., Davis, N. L., Goodman, D., Cox, S., Mayes, N., Johnston, E. & Barfield, W. (2019). Vital signs: pregnancy-related deaths, United States, 2011–2015, and strategies for prevention, 13 states, 2013–2017.Morbidity and Mortality Weekly Report, 68(18), 423.
World Health Organization. (2015). Strategies towards ending preventable maternal mortality (EPMM).