US lags other countries in maternity care
June 24, 2024
Maternal deaths per 100,000 live births
Source: Gunja, MZ et al Commonwealth Fund, June 2024 LINK
The Commonwealth Fund released its report on maternity care in the US and 13 other developed countries earlier this month. The maternal mortality numbers are no surprise, and exceptionally bad for Black US moms. The researchers report that almost two-thirds (65%) of maternal deaths were during the postpartum period, up to a year after delivery. They note that the US is different from these other countries in a few ways.
The US has the lowest supply of midwives and obstetricians. Further, in many better-performing countries midwives outnumber obstetricians, but in the US midwives make up only a third of providers of delivery care.
Number of providers (midwives and OB-GYNs) per 1,000 live births
Source: Gunja, MZ et al Commonwealth Fund, June 2024 LINK
Maternity care is often unavailable close to home. Nearly seven million women in the US live in counties with no obstetrical providers and no places to give birth.
The US has no mandated parental leave.
Number of federally mandated paid maternity, parental and home care leave
Source: Gunja, MZ et al Commonwealth Fund, June 2024 LINK
Out-of-pocket costs for maternity care are high in the US. Nearly eight million women of reproductive age are uninsured. Women with employer-sponsored health insurance with out-of-pocket costs had average cost-sharing of over $4,500 in 2015, part of a large gender gap in out-of-pocket costs.
Although the Commonwealth Fund does not emphasize this point, almost a quarter of postpartum deaths in the US are attributed in part to issues around mental health.
Implications for employers:
- Employers can offer an insurance plan with affordable premiums so that those having children can avoid high deductibles if they cannot afford them.
- Employers can offer robust mental health benefits and insist that their carriers have networks with adequate access.
- Employers can offer parental leave to decrease the financial and emotional stress on new parents.
- Other employer-sponsored programs, including virtual advocacy programs and digital monitoring programs for high blood pressure, gestational diabetes and premature labor can be helpful.
- Similarly, 24/7 professional assessment for anxiety and depression can help direct those needing mental health services.
There are currently drugs on the market for post partum depression but many hospitals will not dispense/cover them