Amnesty International called
on President Obama today to quickly establish an Office of Maternal Health
to lead government action to reduce soaring pregnancy-related complications
and maternal deaths nationwide. The human rights organization said
the government must take immediate steps to stop the loss of two to three
women every day and reduce the risk of complications that now affect one-third
of all pregnant women - 1.7 million women a year.
With a lifetime risk of maternal deaths that
is greater than in 40 other countries, including virtually all of the industrialized
countries, the United States has failed to reverse the two-decade upward
trend in preventable maternal deaths, despite pledges to do so. Most
recently, the government has failed to meet the goals set forth in the
2010 Healthy People initiative, which called for reducing the number of
maternal deaths to one- third of current rates.
"This country's extraordinary record
of medical advancement makes its haphazard approach to maternal care all
the more scandalous and disgraceful," said Larry Cox, executive director
of Amnesty International USA. "Good maternal care should not be
considered a luxury available only to those who can access the best hospitals
and the best doctors. Women should not die in the richest
country on earth from preventable complications and emergencies."
Cox said: "Mothers die not because
the United States can't provide good care, but because it lacks the political
will to make sure good care is available to all women."
Amnesty International's new 101-page, national
report, Deadly Delivery: The Maternal Health Care Crisis in the USA,
reveals the following disturbing findings:
+ severe pregnancy-related complications
that nearly cause death -- known as "near misses" -- are rising
at an alarming rate, increasing by 25 percent since 1998; currently nearly
34,000 women annually experience a "near miss" during delivery;
+ discrimination is costing lives.
Opportunities to save women's lives and reduce complications are being
missed, in large part because women face barriers to care, especially women
of color, those living in poverty, Native American and immigrant women
and those who speak little or no English.
Maternal health is a human right for every
woman in the United States, regardless of race or income. Yet, the
United States lacks a systematic, robust government response to this critical
problem. Amnesty International is urging President Obama to work with Health
and Human Services Secretary Kathleen Sebelius to establish, and seek Congressional
funding, for a single office responsible for ensuring that all women receive
quality maternal health care. (Please visit: www.amnestyusa.org\deadlydelivery)
.
Additionally, Amnesty International calls
for vigorous enforcement of federal non-discrimination laws and an increase
in support for Federally Qualified Health Centers by 2011 to expand the
number of women who can access affordable maternal health care.
Amnesty International's analysis shows that
health care reform before Congress does not address the crisis of maternal
health care.
"Reform is primarily focused on health
care coverage and reducing health care costs, and even optimistic estimates
predict that any proposal on the table will still leave millions without
access to affordable care," said Rachel Ward, one of the authors of
the Deadly Delivery report. "Furthermore, it does not
address discrimination, systemic failures and the lack of government accountability
documented in Amnesty International's report."
Ward said: "The barriers preventing
women from getting the care that they need go far beyond simply lacking
health insurance. Health care reform does not address obstacles to
maternal care, recommend nationally standardized protocols for preventing
and treating the most common causes of death, eliminate health disparities
or ensure that the government takes responsibility for reducing levels
of maternal mortality."
Rapid and comprehensive federal leadership
is required, as the report found numerous systemic failures, including
the following:
- Obstacles
to care are widespread, even though the United States spends more on health
care than any other country and more on pregnancy and childbirth-related
hospital costs, $86 billion, than any other type of hospital care.
- Nearly
13 million women of reproductive age (15 to 44), or one in five, have no
health insurance. Women of color account for just under one-third
of all women in the United States (32 percent) but over half (51 percent)
of uninsured women.
- One
in four women do not receive adequate prenatal care, starting in the first
trimester. The number rises to about one in three for African American
and Native American women.
- Burdensome
bureaucratic procedures in Medicaid enrollment substantially delay access
to vital prenatal care for pregnant women seeking government-funded care.
Twenty-one states do not offer "presumptive eligibility" which
allows pregnant women to temporarily access medical care while their permanent
application for Medicaid is pending. Women who do not receive any prenatal
care are three to four times more likely to die than women who do.
- A
shortage of health care professionals is a serious obstacle to timely and
adequate care, especially in rural areas and inner cities. In 2008, 64
million people were living in "shortage areas" for primary care
(which includes maternal care), but federally-supported community health
centers -- a critical safety net -- are available in only 20 percent of
these areas.
- The
lack of nationally standardized protocols addressing the leading causes
of death -- or the inconsistent use of them -- may lead to preventable
deaths or injuries. Measures used widely in the United Kingdom to prevent
blood clots after caesarian sections are not consistently taken in the
United States, for example.
- Many
women are not given a say in decisions about their care and do not get
enough information about the signs of complications and the risks of interventions
such as inducing labor or cesarean sections. Cesarean sections make
up nearly one-third of all deliveries in the United States - twice as
high as recommended by the World Health Organization. The risk of
death following c-sections is more than three times higher than for vaginal
births.
- The
number of deaths is significantly understated because there are no federal
requirements to report maternal deaths or complications and data collection
at the state level is insufficient.
- Oversight
and accountability is lacking. 29 states and the District of Columbia
have no maternal death review process at all.
As a result, women are more likely to enter
into pregnancy in ill health, receive late or inadequate prenatal care,
are given inadequate or inappropriate care during childbirth and receive
insufficient post-natal care.
Amnesty International is a Nobel Peace Prize-winning
grassroots activist organization with more than 2.2 million supporters,
activists and volunteers in more than 150 countries campaigning for human
rights worldwide. The organization investigates and exposes abuses, educates
and mobilizes the public, and works to protect people wherever justice,
freedom, truth and dignity are denied.
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For more information or to take action, please
visit: www.amnestyusa.org\deadlydelivery
