Via Radical Catholic Mom, according to the National Center for Health Statistics, maternal death rates in the US rose from 12 per 100,000 in 2003 to 13 per 100,000 in 2004. And while revised death certificate questions in California, Montana, and Idaho may account for some of the up-tick in terms of cause of death reporting (that is, deaths that would not have been attributed to childbirth formerly now are), experts believe the actual number is rising, perhaps because of the continued increase in C-section deliveries.

“There’s an inherent risk to C-sections,” said Dr. Elliott Main, who co-chairs a panel reviewing obstetrics care in California. “As you do thousands and thousands of them, there’s going to be a price.”

Excessive bleeding is one of the leading causes of pregnancy-related death, and women with several previous C-sections are at especially high risk, according to a review of maternal deaths in New York. Blood vessel blockages and infections are among the other leading causes.

Maternal obesity may also be a factor, as overweight women are more prone to complications such as diabetes, and are more likely to have excess tissues and large babies that make vaginal deliveries problematic. Older mothers are also more likely to have pregnancy complications, and more women are having babies in their late 30s and 40s.

Sadly, 40% of maternal deaths could have been prevented through proper monitoring. Black women in particular are more prone to high blood pressure during pregnancy, and are also more likely to have inadequate prenatal care. The rate of maternal death for black women is three times higher than that of white women.

And while these deaths matter in and of themselves, they also point to a larger public health issue. The CDC’s 2001 manual on reducing pregnancy-related deaths opens with the following reflection:

Pregnancy-related deaths are the tip-of-the-iceberg with regard to complications of pregnancy. For every woman who dies of a pregnancy-related cause, several thousand suffer morbidity related to pregnancy—before, during, or after delivery. Each year six million women become pregnant, almost four million give birth, and over one million experience pregnancy-related complications. This means that pregnancy-related complications are a significant burden on women, their families, and society in economic, social, and personal term.

The CDC proposes a three-tiered plan to reduce maternal mortality:

• Primary prevention strategies: Improving sex education and family planning services to prevent unintended and high-risk pregnancies; improving nutrition programs, preconception care, and diagnosis and treatment of STDs.
• Secondary prevention strategies: Improving pregnancy outcomes through early detection and treatment of complications.
• Tertiary prevention strategies: Treating complications in an optimal fashion to reduce fatality rates.

Tangent: I’ve been thinking about how much of the above is in our own hands. What can we women do for ourselves to improve our pregnancy - and general health - outcomes? How can we better serve ourselves in terms of family planning, preconception care, and health and lifestyle choices? How can we be better role models for our children in terms of staying informed about and protecting our own health?

I hope I don’t sound preachy. Let’s face it - in large part, general health is a roll of the dice, a combination of genetics and luck. But some common poor health outcomes are the result of lifestyle choices. And I write this as a woman who for years smoked a pack a day and was never ten feet from a Doritos bag. I cleaned up my act pretty well in my 30s and have been blessed with two healthy children after two uncomplicated pregnancies. My family has good health coverage. I think I’m pretty well informed about general health issues. But with all these advantages, I’m still far from where I want to be in terms of being my own health monitor.

Posted by MommaSteph.