Rise in infant mortality shows that the US needs to take better care of its moms | Mint

Rise in infant mortality shows that the US needs to take better care of its moms

Maternal deaths in the US more than doubled between 1999 and 2019, with American Indian, Alaska Native and African-American women faring much worse than other groups.
Maternal deaths in the US more than doubled between 1999 and 2019, with American Indian, Alaska Native and African-American women faring much worse than other groups.

Summary

  • The role of abortion bans in America's infant mortality rise is being studied. Policy to improve obstetric care must keep up with policy that undercuts it.

New provisional data from the US Centers for Disease Control and Prevention offer a horrible statistic: The infant death rate in the US rose by 3% in 2022 to 5.6 deaths per 1,000 live births, the first significant increase in about 20 years. It’s too soon to know if this is the start of a terrible trend or one bad year. Public health researchers will need time and more granular data to unravel factors behind the rise in infant deaths.

Still, the data reflects hard truths about the state of infant and maternal health care in the US—and it could worsen. We should consider even one year’s reversal in infant deaths, a rate already exceeding that of America’s economic peers, as a sign that more should be done to address the issue.

When Marie Thoma, who studies reproductive and maternal and infant health at the University of Maryland School of Public Health, saw the data, “my stomach just dropped," she says. The CDC pointed out a few specifics: The increase was most pronounced in babies born to Alaska Native and American Indian women, as well as Caucasian women and in births that were pre-term (less than 37 weeks’ gestation) and early pre-term (less than 34 weeks). Plus, more deaths were due to maternal complications and bacterial sepsis.

The question is whether this is a one-year blip or part of a more concerning shift. Public health experts stress that there’s not enough information yet to draw conclusions about why more babies died last year. But they also stress that we can’t talk about infant deaths without talking about the ongoing crisis in maternal health. Moms and babies are a package deal and failures on one reflect failures for the other.

And it’s fair to say that “the pressures on reproductive health are stacking up," says Laurie C. Zephyrin, senior vice-president for Advancing Health Equity at the Commonwealth Fund. Those pressures include increasingly limited access to abortion care services, rising rates of maternal mortality and morbidity, growing swathes of the country that lack maternal care, and lack of insurance coverage.

Maternal deaths in the US more than doubled between 1999 and 2019, with American Indian, Alaska Native and African-American women faring much worse than other groups. The numbers further deteriorated during the early pandemic, and while provisional CDC data suggest an improvement in 2022 and 2023, they still remain significantly higher than before Covid hit. These unconscionable statistics have forced some policy changes that could benefit moms (and babies). Already, 38 states and Washington DC have extended the time that women are covered by Medicaid after birth from six weeks to a full year, and seven more states plan to do so, according to KFF. Given about 40% of births in the US are covered by Medicaid, the hope is that lengthier insurance coverage, which first became available in April 2022, can help move the needle on maternal mortality and morbidity. But then, some 10 million people and counting, including some 1.8 million children (including infants), have been dropped from Medicaid as pandemic-era coverage unwinds. There’s a reasonable fear that infant and maternal mortality rates could worsen if people aren’t getting appropriate care, whether that’s before, during or after a pregnancy.

It’s tempting to draw a line from newly implemented abortion bans to infant deaths. After all, three of the four states with the most significant increases in the death rate (Georgia, Missouri and Texas) had the most restrictive laws either leading into or immediately following the mid-2022 dissolution of Dobbs. And while one recent study suggests bans could lead to a rise in infant deaths, it’s too soon to tell if that will be broadly true. Among the fears is that women will be forced to carry out pregnancies that aren’t viable due to severe genetic or other birth defects. An analysis by CNN found that such deaths rose by 21% in Texas after abortion rules tightened.

States with bans already had the worst infant and maternal mortality rates, and giving birth there could get riskier: a Commonwealth Fund analysis found that states with abortion restrictions have a higher proportion of so-called ‘maternity care deserts,’ or counties lacking obstetric providers and hospitals offering such care, a disparity that could widen as some obstetricians and gynaecologists opt to leave states with strict bans.

Researchers will now pick apart what happened in 2022 to understand how to prevent infant mortality in the US from worsening. But there are already many emerging forces working against maternal and infant health in America. The key question is whether policy to improve obstetric care can keep up with policy that undercuts it. ©Bloomberg

Catch all the Business News, Market News, Breaking News Events and Latest News Updates on Live Mint. Download The Mint News App to get Daily Market Updates.
more

MINT SPECIALS

Switch to the Mint app for fast and personalized news - Get App