The United States may be the most dangerous country in the developed world in which to give birth, as many hospitals routinely fail to perform basic safety practices, according to a new report.
USA Today combed through more than a half-million quality records from hospitals across the country and found at some facilities, less than 15% of mothers at risk for complications such as stroke received recommended treatments.
Maternal death rates in the U.S. are on the rise, even as rates drop in other developed countries. More than 700 women die in childbirth here each year, and more than 50,000 women face near-fatal complications. It is estimated that half of pregnancy- and childbirth-related deaths are preventable.
USA Today found issues with adherence to safety procedures at both small, rural facilities and large, urban medical centers. In one case, for example, a woman was discharged with her newborn despite dangerously high blood pressure. When she returned to the emergency department, with even higher blood pressure and a headache, she waited for hours to be seen; she had a stroke and later died as a result.
"Our medicine is run by cowboys today, where everyone is riding the range doing whatever they're wanting to do," Steven Clark, M.D., a childbirth safety expert and professor at Baylor College of Medicine, told USA Today.
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There was one bright spot, according to the article: California. Maternal death rates statewide decreased by half after California implemented new safety protocols experts say should be a "gold standard" across the country.
Hospitals elsewhere have been slow to implement safety changes, though, and there is limited push from regulators to do so, according to the article. The Joint Commission, for example, requires that hospitals track cesarean section rates but does not push them to monitor how often providers fail to meet safety standards that protect women from birth complications.
That may be changing, though. Rising maternal death rates have spurred legislators from both sides of the aisle to action. In late June, the Senate Appropriations Committee voted to approve a $50 million allocation for programs that aim to prevent death in childbirth.
Of that, $38 million would be allocated to the Maternal and Child Health Bureau to grow its evidence-based safety programs, and the remaining $12 million would go to the Centers for Disease Control and Prevention to research the issue further.
"In the 21st century, no mother should have to worry about dying in childbirth, especially in a country as advanced as the United States," said Sen. Heidi Heitkamp, D-N.D., one of the bill's co-sponsors.