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Giving Birth in America Film Series

The U.S. is facing a maternal health crisis. Hear the stories of mothers and providers behind the statistics.

NEW FILM

Giving Birth in America: Arkansas

Our newest film spotlights Arkansas, the state with the highest maternal mortality rate across the U.S. Watch it now.

The number of women who die giving birth in America each year has nearly doubled in the last two decades. 

The United States is the only high-resource country with a consistently rising maternal mortality rate.

Black women are 3 times more likely to die from pregnancy-related complications than white women in the U.S.

Black women are 3 times more likely to die from pregnancy-related complications than white women in the U.S.

More than 80% of all maternal deaths in the U.S. can be prevented.

More than 80% of all maternal deaths in the U.S. can be prevented.

Learn about the U.S. maternal health crisis

The Giving Birth in America film series features stories from seven states.

WATCH THE FILMS

Learn more about the factors driving the U.S. maternal health crisis.

FAQ
Provider Shortages
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Provider Shortages

More than a third of all counties in the United States do not have an obstetric care provider.

Nearly 99 million people live in areas with shortages of primary health care providers, mostly in rural or under-resourced urban communities. Shortages of obstetricians, midwives, hospitals, and birth centers mean that some people, especially in rural areas, have to travel an hour or more to get basic prenatal and delivery care. For women with complications who need to see a specialist, the trip can be prohibitive, leading some women to go without the level of care they need for the best chance at a healthy birth.

Lack of Insurance
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Lack of Insurance

There are 11 million uninsured women ages 19-64 in the U.S.

The countries with the best maternal health outcomes also have universal health coverage. America’s health care system is the most expensive in the world, yet many people go without the care they need. People of color are more likely to remain without coverage; Hispanic and Black women have significantly higher uninsured rates (22% and 12%, respectively), compared with white women (7%). Women with consistent access to health care throughout the perinatal period are more likely to access preventative care and be able to manage or address risks or complications early to maximize the chances of a healthy pregnancy and birth.

Chronic Conditions
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Chronic Conditions

Some of the most common chronic health conditions—high blood pressure, diabetes, and obesity—contribute to higher risks in pregnancy and birth.

Following the Affordable Care Act, 13 states, mostly concentrated in the South, decided not to expand Medicaid. As a result, approximately 4 million poor, uninsured adults fall into a “coverage gap”; i.e., they earn too much to qualify for Medicaid but not enough to purchase insurance on the Marketplace.When women are unable to access affordable health care throughout their lifetimes, they are more likely to enter into pregnancy with unmanaged chronic conditions that can lead to poor maternal health outcomes.

Underuse of Evidence-Based Practices
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Underuse of Evidence-Based Practices

In the U.S., evidence-based, low-risk models of care are underutilized while higher-risk interventions are used too often.

The United States’ national cesarean section rate is nearly one third (32.1%). While c-sections can be lifesaving, the WHO has found that cesarean section rates higher than 10% do not offer benefits to mothers or babies. In addition to c-sections, overused procedures include: inducing labor early, requiring women to stay in bed, and restricting food and drink. Because all medical procedures come with risks as well as benefits, procedures should not be used for the convenience of maternity care providers or facilities and should always be performed with the mother’s consent.

Many hospitals and provider practices are committing to improving maternal health care by revising practice guidelines to prevent unnecessary procedures and support women in laboring longer. Additionally, low-risk, evidence-based approaches such as the midwifery model and doula support result in lower rates of interventions, such as induction of labor and epidural use, and lead to higher rates of vaginal delivery.

Racial and Socioeconomic Disparities
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Racial and Socioeconomic Disparities

Chronic stress and systemic and interpersonal racism contribute to a higher risk of complications and death for women of color.

Racial disparities in maternal mortality in the U.S. have been documented for over 100 years—as long as maternal mortality data has been available. Today, significant racial disparities persist: Black and Indigenous women are 2 to 3 times more likely to die from a complication of pregnancy or childbirth than white women. Maternal mortality rates are twice as high for women living in counties with high poverty rates, compared with women living in counties with low rates of poverty.

Lack of Comprehensive, Coordinated Care
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Lack of Comprehensive, Coordinated Care

Lack of access to needed support services and a fragmented system contributes to poor outcomes and disparities.

Many pregnant people, especially those enrolled in Medicaid, see different care providers at each prenatal visit and meet the physician or midwife attending their birth for the first time when they arrive at the hospital in labor. Information often falls through the cracks when a person is not able to build a trusting relationship with their care provider. In addition, many women don’t know about available perinatal support services or have difficulty navigating a complex health system. A comprehensive and integrated team-based approach to care can have a powerful beneficial impact, especially for those at the greatest risk of poor health outcomes, and make a difference in achieving a safe and healthy birth.

Disrespectful Treatment
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Disrespectful Treatment

Too often, women report being ignored, belittled, or pressured by their care providers.

In the U.S., women have reported a range of disrespectful, coercive, and abusive behaviors in care related to pregnancy and childbirth. Women report that they have been ignored, shouted at, or threatened (including with coerced or withheld treatment or with calling child protective services), had their physical privacy violated, and more rarely, experienced physical abuse. A disturbing number of cases have been documented where women with a life-threatening complication knew something was wrong, but their requests for help went unheeded.

The midwifery model, doula support, and other patient-centered models of care emphasize the value of respectful, equitable treatment, and engage birthing people as active participants in their care.

Inadequate Postpartum Support
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Inadequate Postpartum Support

More than half of maternal deaths occur during the postpartum period, when new complications to physical or mental health can develop or existing ones may become exacerbated.

Yet this stage of pregnancy is often neglected in maternal health policy, leaving many moms and new parents without the support they need and deserve. Policies like guaranteed paid maternity leave, Medicaid coverage through at least the full year following childbirth, and Medicaid coverage for postpartum doula support are immediately needed to support U.S. families during this critical period.

Lack of Mental Health Support
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Lack of Mental Health Support

One in five pregnant or postpartum people in the United States experience maternal mental health complications.

Despite this, many families experience significant barriers to accessing needed support, including stigma, distance to care, cost, inadequate insurance coverage, and lack of integration of mental health screening into routine maternity care visits.

Feeling outraged?

The Giving Birth in America: Arkansas Screening and Advocacy Guide provides ways to take action on this crisis.

EXPLORE THE GUIDE

Solutions exist. Take action for maternal health.