THURSDAY, Nov. 19, 2020 — The United States has the highest maternal mortality rate among high-income countries, with an overall shortage of maternity care providers, according to a report from The Commonwealth Fund published online Nov. 18.
Roosa Tikkanen, M.P.H., from The Commonwealth Fund in New York City, and colleagues compared maternal mortality rates for the United States and 10 high-income comparator countries and examined differences in maternal care workforces, access to postpartum care, and paid maternity leave.
The researchers found that among developed countries, the United States has the highest maternal mortality rate. Relative to midwives, obstetrician-gynecologists were overrepresented, and relative to births, there was an overall shortage of both obstetrician-gynecologists and midwives. Midwives outnumbered obstetrician-gynecologists by several-fold in most other countries, and in the health system, primary care played a central role. The United States was the only country not to guarantee access to provider home visits or paid parental leave in the postpartum period, although a large share of U.S. maternal deaths occurred postpartum.
“While the reasons behind the high U.S. maternal mortality rate are multifaceted, our findings suggest that an undersupply of maternity providers, especially midwives, and lack of access to comprehensive postpartum supports are contributing factors,” the authors write.
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