The rate of death among women delivering babies has doubled in the last 10 years:

Each day in the U.S., two women die of problems related to pregnancy or childbirth. The numbers have been rising, for reasons that are not entirely clear. After plunging in the 1900s, maternal mortality rates in California tripled between 1996 and 2006, from 5.6 deaths per 100,000 births to 16.9. Nationally, the rate, defined as deaths from obstetrical causes within one year of giving birth, rose from 7.6 per 100,000 to 13.3 per 100,000.

For each death, experts estimate, there are about 50 instances of complications related to pregnancy or childbirth that are life-threatening or cause permanent damage. According to a study published last year, such “near misses” — including kidney failure, respiratory distress syndrome, shock and the need for blood transfusions and ventilation —rose 25% from the late 1990s to 2005.

Childbirth-linked deaths are still rare in the U.S., numbering about 90 women a year for California. But health experts believe that at least one-third are preventable. Furthermore, they add, it is a problem typically associated with poor nations, not a rich, industrial country like the U.S. It is one of the primary indicators of public health that improves dramatically as countries develop and strengthen access to, and quality of, medical care.

Though the U.S. spends more per birth than any other nation, maternal mortality is higher here than in 40 other industrialized countries, including Croatia, Hungary and Macedonia, and is double that of Canada and much of Western Europe. That the United States is backsliding in this most basic of healthcare measures has triggered attention and alarm in medical circles. In January, the Joint Commission, an independent organization that accredits and certifies healthcare organizations and programs, issued a “sentinel event alert” warning of the rising maternal mortality rates.

In March, the human rights organization Amnesty International released its own report, “Deadly Delivery,” calling for sweeping changes in maternal healthcare in the U.S.

The California Department of Public Health has commissioned a statewide review of medical charts in maternal death cases to identify reasons for the rise and seek ways to improve. “Mothers shouldn’t die in childbirth,” said Dr. Elliott Main, chief of obstetrics at Sutter Health and director of the ongoing California review. The trend, he said, may signal a much larger problem with U.S. maternal healthcare.

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