That was a rollercoaster. They make a good argument for why official stats are too high, and why the CDC's method is likely bad. Their alternative method shows that maternal death rate is likely around 10.4 per 100K (similar to other Western-style nations).<p>But then end with this nugget, using their alternative method:<p>> while Black women had the highest, 23.8 per 100,000 live births in 2018-2021<p>So more than double the national average.
"Maternal mortality in the United States: are the high and rising rates due to changes in obstetrical factors, maternal medical conditions, or maternal mortality surveillance?", Joseph et al 2024 <a href="https://www.ajog.org/article/S0002-9378(24)00005-X/fulltext" rel="nofollow">https://www.ajog.org/article/S0002-9378(24)00005-X/fulltext</a><p>"38% of direct obstetrical deaths and 87% of indirect obstetrical deaths in 2018–2021 were identified because of a positive pregnancy checkbox. The pregnancy checkbox was associated with increases in less specific and incidental causes of death. For example, maternal deaths with malignant neoplasms listed as a multiple cause of death increased 46-fold from 0.03 in 1999–2002 to 1.42 per 100,000 live births in 2018–2021. Under the alternative formulation, the maternal mortality rate was 10.2 in 1999–2002 and 10.4 per 100,000 live births in 2018–2021; deaths from direct obstetrical causes decreased from 7.05 to 5.82 per 100,000 live births. Deaths due to preeclampsia, eclampsia, postpartum hemorrhage, puerperal sepsis, venous complications, and embolism decreased, whereas deaths due to adherent placenta, renal and unspecified causes, cardiomyopathy, and preexisting hypertension increased.<p>...The high and rising rates of maternal mortality in the United States are a consequence of changes in maternal mortality surveillance, with reliance on the pregnancy checkbox leading to an increase in misclassified maternal deaths."<p>It has been interesting watching these stats circulate for years with no mention of how obviously maternal deaths did not skyrocket over a few years totally coincidentally and unrelated to big reporting changes. There's a large appetite for such statistics, particularly ones which show the EU to be better than the USA.
TLDR, maternal morbidity in US sources often widens the net to include things like drug overdoses. Whereas other sources do not, and that can explain the discrepancy between US and other nation maternal mortality rates.<p>Read this article the other day and has some breakdowns to show how many of those maternal deaths are for things not directly related to pregnancy issues (like embolism or eclampsia).<p><a href="https://reviewtoaction.org/sites/default/files/2022-08/2014-16-MMRCReport_North%20Carolina.pdf" rel="nofollow">https://reviewtoaction.org/sites/default/files/2022-08/2014-...</a>