The U.S. maternal mortality rate is the worst in the developed world. While other nations have seen dramatic drops in deaths related to pregnancy and childbirth, the maternal mortality rate in the U.S. has sharply risen since 2000—from 18.8 deaths per 100,000 births in 2000 to 23.8 deaths per 100,000 in 2014. In some states, such as Georgia, the rate is almost double that figure, at nearly 40 deaths per 100,000. The maternal mortality epidemic disproportionately affects women of color, who die at 3.5 times the rate of white women. In most developed nations, maternal death is virtually unheard of. In Norway, the rate is just 5 per 100,000.
This comes as legislators turn their attention to abortion, not living women. Abortion clinics in Georgia face an onerous morass of restrictions, even though a woman is far more likely to die giving birth.
The maternal mortality epidemic is ground zero for attitudes about women, racist cultural norms, and the many challenges of having a family in an increasingly family-hostile society. Most maternal deaths are preventable, yet almost nothing has been done to prevent them. We value mother so little that most states don’t keep data on maternal mortality--though a recently passed federal law promises to change that.
Despite this surge in preventable deaths, there’s been little interest in the epidemic until recently. The same lawmakers who are so eager to force women to give birth to babies they don’t want have shown no interest in stemming the tide of maternal deaths. Indeed, research suggests that limiting abortion access plays a role in poor maternal outcomes.
When legislators want to force women into pregnancies that may kill them, there’s clearly a problem. The maternal mortality epidemic is a feminist issue, despite receiving little attention from mainstream feminist organizations. But it’s also a pro-choice issue. That’s because many of the same attitudes that pervade in anti-choice circles play a role in maternal mortality.
Dismissing Women’s Pain, Ignoring Their Needs
The anti-choice movement has a long history of dismissing women’s pain and suffering. Anti-choice activists underestimate the impact of pregnancy from rape, insist that giving birth isn’t that much to ask, talk about how easy it is for single mothers to succeed, and insist that the non-existent mental health effects of abortion are more serious than the very real mental health effects of pregnancy and birth.
This same refusal to listen to women directly contributes to the maternal death epidemic. During Serena Williams’s birth, doctors refused to listen to her about her medical history of blood clots. She almost died, and had to tell her providers how to treat her symptoms. Another woman, Kira Johnson, died from preventable and treatable c-section complications. Medical providers ignored Johnson’s plea for helps, telling her husband that she wasn’t a priority. The couple waited 10 hours for tests and treatment as Johnson slowly bled to death.
Whether we’re asking them to justify their abortions or ignoring them as they die from preventable childbirth complications, our culture simply doesn’t believe women. We don’t take their pain seriously. Women remain somehow less than fully human. Doctors routinely dismiss women’s heart attack symptoms as mere anxiety. And an avalanche of research shows that doctors just don’t take women’s pain seriously.
Punishing Women
Pro-choice activists have long pointed to conservatives’ punitive attitudes about pregnancy. Anti-choice views are largely about punishing women for having sex and getting pregnant, not protecting babies. Otherwise anti-choice activists would support policies that end abortion, such as free birth control and comprehensive sex education.
A similarly punitive attitude pervades in labor and delivery suites across the country. Doctors and other providers punish women who don’t do what they say. It’s easy to find stories of women forced into episiotomies (a cut in the vagina that research suggests is almost always medically unnecessary) because their doctors are angry; women refused treatment at the hospital because they had an argument with the doctor; or women subjected to verbal or physical abuse because a doctor disagrees with their birth preferences.
In 2016, woman was awarded a $16 million verdict after verbal and physical abuse from doctors and nurses left her permanently injured. The hospital defended her treatment as the standard of care, and stories from women across the nation suggest that this sort of treatment is indeed typical.
Some feminist advocates say we need a #me too reckoning for childbirth.
Blaming Women for Their Own Suffering
For generations, misogynists have blamed women for their own suffering. Anti-choice activists say that abortion is a fair punishment for sex, or that women who make good decisions really don’t get raped, and certainly don’t get pregnant.
The same attitude has now made its way into attitudes about maternal mortality. A report by the Maternal Mortality Review Committees found that 57.4% of all maternal deaths are due to provider, facility, or system of care factors. Yet news stories about the maternal death epidemic continue to ignore the shoddy care women receive from care providers, and instead focus on patient factors such as obesity and smoking.
It’s a new version of the same old victim-blaming. A New York Times editorial recently castigated the media and doctors for blaming women for their own deaths. Yet the phenomenon continues.
Since 2001, nearly four times as many women have died in childbirth as died in the September 11th, 2001, terrorist attacks. But there’s no war on maternal mortality, no national outrage, no day of remembrance, no promise of a national reckoning.
We don’t value women, and we especially don’t value mothers. That’s why we continue to allow them to die giving birth—and why Republicans are fine with forcing them to remain pregnant, no matter the cost.