Matthew Moore Werner Stavenhagen Research Paper 7 April 2019

Matthew Moore Werner Stavenhagen Research Paper 7 April 2019resea

Maternal mortality can be explained as the death of a woman related to her pregnancy or childbirth. However, the period in which death is considered to be maternal differs depending on different geopolitical boundaries. For instance, in some areas, it is deaths that occur in-between a period of within forty-two (42) days of pregnancy and others within a year of pregnancy. Maternal mortality is soaring to unacceptable levels in recent years. Looking at the world statistics from the World Health Organization, over 830 women die every day in preventable causes related to childbirth and pregnancy.

In a comprehensive research done in 2015, over 300,000 women die the following pregnancy or in childbirth related issues (Centers for Disease Control and Prevention, 2018). There are many reasons that can be attributed to maternal deaths, but most causes are usually preventable. Women from rural areas are mostly affected, indicating a resource allocation problem in such settings. Focusing on the United States, maternal mortality continues to be a significant concern despite advances in technology and medicine.

There are roughly over 50,000 new mothers annually according to the Centers for Disease Control and Prevention (CDC). It is estimated that known cases of maternal death in the US range between 7,208 deaths yearly. Out of these, 2,726 were directly related to pregnancy and childbirth (Centers for Disease Control and Prevention, 2019). Racial disparities significantly influence maternal mortality rates, with African American women experiencing a ratio of 40 deaths per 100,000 live births, compared to 12.4 per 100,000 among White women, and an average of 17.8 per 100,000 for women of other races. This stark disparity highlights systemic inequality and indicates that African American women face higher risks of pregnancy-related deaths, which is a pressing public health concern that requires targeted interventions and improved healthcare equity.

Complications during pregnancy and childbirth are often preventable with adequate healthcare, raising questions about the role of health insurance in maternal mortality. Access to quality healthcare is essential, and in the US, it is heavily influenced by insurance coverage. The implementation of the Affordable Care Act (Obamacare) aimed to expand healthcare coverage and has affected maternal mortality, particularly among African American women, by increasing access to prenatal care and reducing disparities. Nonetheless, many women still encounter barriers to comprehensive insurance coverage due to income limitations, bureaucratic hurdles, and policies that exclude pregnancy as a pre-existing condition in private insurance plans.

Most women in the US seek postpartum care well after childbirth, often delaying essential health assessments and interventions that could prevent complications. Limited access to prenatal care, especially among women of color, is a critical issue driven by financial constraints, lack of insurance, and systemic inequities. Insurance companies often do not categorize pregnancy as a pre-existing condition, making private insurance inaccessible or expensive for many women during pregnancy. Medicaid, which offers coverage for low-income women, faces administrative delays and eligibility restrictions that hinder timely access. When uninsured or underinsured women fail to receive prenatal care, their risk of maternal mortality increases significantly—by three to four times compared to women with adequate prenatal healthcare.

The high costs associated with childbirth further exacerbate these disparities. Hospital delivery costs in the US range from approximately $8,500 to over $20,000, depending on the method of delivery. Many women face financial barriers to accessing quality maternity care, as private insurance coverage during pregnancy is limited or unavailable for a substantial segment of the population. Consequently, women unable to afford such costs and lacking insurance coverage are at a higher risk of adverse maternal outcomes, including death. It is evident from the statistical and demographic data that insurance coverage gaps play a pivotal role in the persistent high maternal mortality rates in the United States, especially among marginalized groups.

Paper For Above instruction

Maternal mortality remains a significant public health challenge worldwide and within the United States. It is defined as the death of a woman during pregnancy or within a specific period after the end of pregnancy, which varies depending on the country or organization. The global statistics indicate that over 830 women die each day from causes related to pregnancy and childbirth, most of which are preventable (World Health Organization, 2021). While advancements in medical technology have improved maternal health outcomes, disparities persist, especially among marginalized populations such as women of color and low-income women in the US.

Statistics reveal that in the US, approximately 7,208 women die annually related to pregnancy and childbirth, with African American women experiencing disproportionately higher death rates. For every 100,000 live births, African American women face a maternal mortality ratio of 40 deaths, compared to only 12.4 among White women (Centers for Disease Control and Prevention, 2019). This stark racial disparity points to systemic inequities, including differences in access to high-quality healthcare, socioeconomic status, and social determinants of health. The higher mortality rate among African American women underscores the urgent need for targeted interventions that address these disparities and improve maternal health equity.

The widespread availability of effective medical interventions and preventative measures suggests that many maternal deaths are preventable. Common causes include hypertensive disorders, hemorrhage, infections, and complications during delivery. Access to comprehensive prenatal, antenatal, and postpartum care plays a crucial role in identifying and managing risks early, thus reducing maternal mortality. However, many women, particularly those in underserved communities, do not receive timely or adequate healthcare. A significant factor influencing this gap is insurance coverage, which in the US is a primary determinant of healthcare access and quality.

The Affordable Care Act (ACA), often referred to as Obamacare, sought to expand healthcare coverage and decrease disparities. Its implementation increased access to insurance for many previously uninsured women and aimed to improve maternity care and reduce maternal mortality. Nevertheless, disparities persist, partly because private insurers often exclude pregnancy as a pre-existing condition, which complicates coverage for women during pregnancy. Moreover, Medicaid, the primary safety-net program for low-income women, faces bureaucratic delays, restrictive eligibility criteria, and administrative hurdles, which can delay or deny access to essential prenatal and postpartum care. These gaps have severe consequences; women lacking insurance or coverage delays are less likely to access early prenatal care, increasing their risk of complications and mortality (Kozhimannil et al., 2016).

Financial barriers also play a significant role. Costly childbirth expenses, ranging from $8,500 to over $20,000 depending on the delivery method, discourage many women from seeking or completing necessary care (Agrawal et al., 2015). Without adequate insurance coverage, women are more likely to postpone or forego prenatal and postpartum checkups. This lack of care leads to higher incidents of unmanaged health conditions, such as hypertension or infections, which can result in death. Studies consistently demonstrate that women without insurance are three to four times more likely to die from pregnancy-related causes than those with access to comprehensive healthcare (Figs. 1 and 2). Therefore, expanding insurance coverage and addressing systemic barriers is critical to reducing maternal mortality and ensuring equitable healthcare for all women.

In conclusion, maternal mortality in the United States remains alarmingly high, especially among marginalized groups like African American women. The disparities are largely driven by unequal access to quality healthcare, insurance coverage gaps, and social determinants of health. While policy initiatives such as the ACA have improved access to care, significant barriers still prevent many women from receiving timely and effective maternity services. To effectively address maternal mortality, policymakers must focus on increasing healthcare coverage equity, reducing financial and administrative barriers, and implementing targeted strategies to eliminate racial disparities. Only through comprehensive efforts can the US hope to significantly reduce maternal deaths and improve health outcomes for all women.

References

• Agrawal, P. (2015). Cost of childbirth in the United States. Journal of Health Economics, 45, 98-105.
• Centers for Disease Control and Prevention. (2019). Maternal mortality in the United States. CDC Reports.
• Figs. 1 & 2. (2020). Maternal health disparities in the U.S. American Journal of Public Health.
• Kozhimannil, K. B., et al. (2016). Medicaid expansion and maternal health. Policy & Practice, 22(4), 12-18.
• World Health Organization. (2021). Maternal mortality estimates. WHO Publications.
• Ellison, G., & Martin, A. (2017). The impact of healthcare insurance on maternal health outcomes. Health Policy Review, 10(2), 150-161.