Despite spending dramatically more on health care than any other county in the world, the US does not lead the world in health outcomes. Most sadly, the rate of maternal mortality in this country is triple that of other western democracies. As documented in my book, Prescription for Bankruptcy, countries such as Canada, Germany and France in 2015 had maternal mortality rates ranging from 6 to 9/100,000 births while in the US over 26 women died per 100,000 births. The maternal death rate is particularly bad for African-American women. We could do better if we applied well-known principles. As outlined in a position paper in the New England Journal of Medicine dated 11/1/18, there are several published bundles of best practices that would drop the maternal death rate dramatically if adopted by all hospitals. Since many of the pregnancy-related deaths occur after delivery, good follow-up care is essential. Unfortunately the US is one of the few Western democracies that does not mandate paid maternity leave, and as a result, only one postpartum visit is usually scheduled, and half of these visits are skipped. Could we do better? Yes. Will we? Time will tell. Read my book. Put pressure on our elected officials.
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