The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

And Protection against Maternal Mortality

Bryce J. Christensen and Robert W. Patterson

Maternal death in childbirth is relatively rare in twenty-first-century America. Yet American mothers still die in childbirth in the United States (recent reports indicating that the maternal mortality rate in childbirth in the U.S. has actually risen sharply from 11 per 100,00 in 1995 to 24 per 100,000 births in 2008), and mothers in other countries die in childbirth much more often. In fact, when an international team of American, Swiss, and British researchers recently set out to study the problem, they estimated that, globally, “approximately one-third of a million women die each year from pregnancy-related conditions.”

To understand more fully the circumstances under which these tragic deaths occur, the researchers examined data for 287,035 inpatients giving birth in 2004 or 2005 in 373 health-care institutions in twenty-four countries in Africa, Asia and Latin America. In their analysis, the researchers emphasized the inverse relationship between maternal education and maternal mortality: well-educated women are significantly less likely to die in childbirth than poorly educated women. However, their research also highlighted other social circumstances that elevate the risk of maternal mortality in childbirth. For instance, statistical analysis reveals that women who are unmarried or cohabiting face a risk of childbirth death that runs 60 percent higher than do married peers (odds ratio, 1.60).

What is more, the data identify a markedly elevated mortality risk for women giving birth over the age of 35 (as is increasingly the case in the United States, where many women are postponing childbearing to pursue career and educational goals). Compared to younger mothers, women over the age of 35 run an almost 80 percent higher risk of childbirth death (odds ratio, 1.79).

In interpreting their findings, the researchers acknowledge that progress in reducing maternal mortality “depends on widespread improvements in the level and quality of antenatal and obstetric facilities in developing countries.” But these researchers appropriately warn against “an exclusive focus on medical and technological approaches” to the problem, cautioning against the error of “overlooking the critical contribution of societal conditions to health.” “More attention,” they write, “should be given to the wider social determinants of health, including education, . . . to reduce maternal mortality.”

Of course, as they seek to reduce maternal deaths in childbirth, public officials should remove obstacles to women’s education. However, this study makes clear the real peril in social developments that cause women to avoid marriage or postpone childbearing.

(“Maternal Mortality Ratio per 100,000 Live Births,” Millennium Goals Indicators, United Nations Statistics Division, ; Saffron Karlsen et al., “The Relationship Between Maternal Education and Mortality Among Women Giving Birth in Health Care Institutions: Analysis of the Cross Sectional WHO Global Survey on Maternal and Perinatal Health,” BMC Public Health 11 [July 29, 2011]: 606.)