Laws that make it more difficult for doctors to save pregnant patients’ lives dramatically increase the risk of maternal mortality. The included map clearly demonstrated the staggering correlation between abortion bans and high rates of maternal mortality, but the editorial failed to call attention to it.
Pregnancy can be a life-threatening condition. Modern medicine has made it dramatically less risky, but in at least 15 states, modern medicine can’t be practiced because of aggressive abortion bans. These laws are not supported by the majority of state residents and trivialize the lives of women.
Until we allow personal and potentially lifesaving medical decisions to be made by patients and the medical experts who guide them rather than by lawmakers with no scientific training, we should anticipate that the United States will continue to be the shame of the developed world.
Sara Imershein, Washington
The writer, a physician, is on the board of the NARAL Pro-Choice America Foundation.
The Aug. 20 editorial “Too many new moms are dying” reported that “over the past two decades, most countries have made great strides in maternal health, bettering outcomes for mothers and children. The most glaring exception to this trend is, disappointingly, the United States.”
This conclusion is premature. Between 2003 and 2017, U.S. states adopted a new procedure for recording maternal deaths — namely, a pregnancy status checkbox on the U.S. Standard Certificate of Death.
A 2020 study published by the Centers for Disease Control and Prevention “found that the use of the standard pregnancy status checkbox item to classify deaths as maternal has an impact on maternal mortality measures in the United States by increasing the number of deaths identified as maternal. Use of the checkbox resulted in the tripling of the number of deaths identified as maternal in the 47 states and the District of Columbia that were using the standard checkbox item in 2015 and 2016. … Calculating maternal mortality rates in 2015 and 2016 in a consistent manner for the entire United States without using the standard checkbox item yielded rates similar to the maternal mortality rates calculated from vital statistics before the standard checkbox item was introduced.”
At least some, and perhaps all, of the apparent increase in recent years of maternal mortality rates in the United States is an artifact of a change in death certificate recording.
Donald J. Boudreaux, Fairfax
The editorial on maternal mortality highlighted just one aspect of the appalling decline in the life expectancy of Americans. Though the United States leads the world on most economic measures, life expectancy here is now roughly six years below that of other industrial countries, and, in some of our states, is actually below that of China and many developing countries. This downward trend, with too many Americans dying much earlier than is necessary, diminishes us as a people and a society.
Poor health conditions and inadequate broad-based medical care are key culprits. The pervasive spread of opiates and a growing culture of violence are also major factors. Addressing these complex challenges will require fundamental shifts in state and national policy agendas to actively prioritize more equitable, life-affirming policies, particularly in ensuring that more adequate health care becomes accessible to all. Yes, the price of such policies would be costly, but considering the large concentrations of mega-wealth, it would be affordable. It would also be the right thing to do.
Brian G. Crowe, Rockville
