Originally posted by Breaking the Chains magazine.
A new report out from the National Center for Health Statistics finds that U.S. maternal deaths have increased by an alarming 40% since 2020. The latest federal data suggests that 84% of these deaths were preventable. The maternal death rate is highest among Black women — from 2018 to 2021, Black maternal mortality nearly doubled.
What is the cause of skyrocketing maternal mortality rates? The U.S capitalist system and the racism and sexism built into the core of that system. While the spike in maternal mortality is being attributed to the COVID-19 pandemic, the pandemic simply exacerbated an already existing crisis. The United States’ abysmal maternal death rates can be attributed to many factors but chief among them are: no universal health care, no paid maternity leave and medical racism and sexism, all problems that are endemic to a system that puts private profits over people’s needs.
The most dangerous high-income country to give birth
Maternal deaths in the United States have escalated to the highest rates in nearly 60 years, pushing maternal mortality rates to an average of 33 deaths per 100,000 live births and 69.9 deaths for Black women. The COVID-19 pandemic exacerbated the crises of maternal deaths and revealed the failure of the American capitalist health care system in saving women’s lives, especially Black women. Black women are 2.6 times more likely than white women to die each year due to health complications related to pregnancy. Despite Black women only comprising 14% of the total U.S. population, they make up 30% of maternal deaths.
The high death rates among Black women further reveal the political, social and economic disadvantages that are systemically imposed on working women targeted by racist oppression. This leaves Black women at the bottom of the barrel for receiving access to affordable health care, childcare, housing and quality education.
Inadequate access to health insurance is one of the primary obstacles to accessing vital health care services. The U.S. is the only high-income country that does not provide universal health care to millions of poor and working women. A little over 1 in 10 women are uninsured, while only 18% of women ages 19 to 64 are covered by Medicaid. Even when women are covered under Medicaid, some states strip the right to coverage for women 60 days after giving birth.
Privatized health care system that treats childbearers as wombs, not people in need of care
Health department researchers found that 84% of pregnancy-related deaths were preventable. A troubling 53% of maternal deaths occurred well after women left the hospital, between seven days and a year after delivery. The primary causes of later-maternal deaths are mental health and substance abuse. For Black women, cardiovascular disease is the leading cause of death. The majority of later-maternal deaths could be prevented by improved access to health care, including mental health care.
Another factor in the high rates of later-maternal deaths is the fact that the U.S has no paid maternity leave. This “federal policy failure leaves more than 100 million people — 80% of U.S. workers — without paid time off after the birth or adoption of a child,” according to the National Partnership for Women and Families. Among the 25% lowest-paid workers, most of whom are women and people of oppressed nationalities, only 9% had access to paid family leave in 2020.
Research shows that fewer than eight weeks of paid leave is linked to a reduction in women’s overall health status and increased depression. For women who are able to take paid leave, their chances of being re-hospitalized are reduced by 51%. These statistics make clear that the government’s unwillingness to legislate paid leave at the federal level is causing women to die.
Women who live in rural areas have also been left behind by the American profit-driven health care system. Hospitals across the country have closed down their obstetric units in several rural and impoverished areas because “childbirth doesn’t pay, at least not in low-income communities.” The closure of rural hospitals have a disproportionate impact on Native American women who also experience very high rates of pregnancy-related deaths.
The Dobbs v. Jackson decision impacts maternal health
Since the overturning of Roe v. Wade, states that have banned or restricted abortion access also have higher rates of maternal mortality and infant death. The 2021 American Rescue Plan introduced expanded Medicaid coverage — up to one year postpartum — but less than one-third of the states with abortion bans have opted into this new federal coverage. The same states that have banned or attempted to ban abortion refuse to offer their residents necessary health care coverage to address the physical and mental health complications mothers face that contribute to maternal deaths. It is unsurprising that the reckless decisions by state lawmakers to attack the reproductive health care system only further widen the disparities women and disproportionately Black women face.
The role of racism in the U.S. health care system balloons the crisis of maternal mortality rates by driving up the racial and health disparities, revealing the effects of what Claudia Jones called “triple oppression.” Under capitalism, the high rates of maternal deaths are inextricably linked to the deeply rooted nature of racism that plagues the U.S. health care system. Many reports reveal that Black women who experienced health complications during pregnancy and after birth were frequently disregarded by their medical providers. Reports further depict racist mistreatment that occurs on the hospital floor throughout the duration of a Black woman’s pregnancy including medical providers shouting, scolding and refusing requests for help.
The U.S. capitalist system has always disregarded the lives of working-class Black women and women of other oppressed nationalities. This is the same system that medically experimented on female slaves without anesthesia and forced compulsory sterilizations and hysterectomies, all while building a two-tiered, profit-driven health care system. Black and Native women’s reproduction have been policed, controlled and regulated since the founding of the United States.
We need a new system that prioritizes reproductive health and welfare of millions of working women
The fact that 84% of pregnancy-related deaths are preventable is an indictment of the racist and sexist capitalist health care system and its blatant attacks on women’s lives. Hospitals and OB-GYN departments close down in the communities that face the highest levels of poverty and racial oppression because they are not profitable. The COVID-19 pandemic and the Dobbs decision further reveal to millions of working class women that the capitalist system chooses to prioritize lining the pockets of private hospital CEOs while attacking essential public health care services.
The rights to survive a pregnancy and birth as well as to have an abortion, adequate health care, paid family leave and essential services for family planning are all part of the struggle for reproductive justice. It is clear that a system that prioritizes profit cannot be the same system that will provide quality, dignified care for working, poor and oppressed people. We need a broad movement for reproductive justice that defends the rights of all working, poor and oppressed women — a movement that catalyzes a revolutionary transformation of the system to guarantee that our basic human rights and needs are met.