Maternal Healthcare Crisis as a Justification for Healthcare Reform

Today, I had an article pointed out to me published on the website of an organization called Change.org. It was under the heading of Human Rights. The article,  A Maternal Mortality FAIL in the U.S., was written by a Harvard professor, Alicia Ely Yamin.

The article states that Ms. Yamin ” is currently a Joseph H. Flom Fellow on Global Health and Human Rights at Harvard Law School’s Human Rights Program, and an Adjunct Lecturer at the Harvard School of Public Health.”

To support her thesis Ms. Yamin claims that “the likelihood of a woman dying in childbirth in the U.S. is five times greater than in Greece.”

To further support her contention, she also claims that “African-American women are nearly four times more likely to die of pregnancy-related complications than white women. These rates and disparities have not improved in more than 20 years.”

Then she goes on to iterate Amnesty International’s assertion that “this is not just a public health scandal; it reflects widespread violations of women’s human rights, including the right to life, the right to freedom from discrimination, and the right to the highest attainable standard of health. Patterns of marginalization and exclusion in this society are exacerbated by a discriminatory and dysfunctional health system.”

After a little more haranguing, she finally gets to her point, “Join Amnesty International USA in calling on President Obama to establish an Office of Maternal Health to lead government efforts to reduce the appalling U.S. death rate for women having babies.”

If you click on this highlighted link, it will take you to an Amnesty International site where you can sign and submit a form letter. So, have at it, but … before you do …, think … and do a little of your own research.

A little “googling” will, fairly quickly, reveal some sites that present some data on maternal mortality. Maternal mortality (most recent) by country presents data gathered by UNICEF between 1985 and 1999 which was published in 2002. WHO/UNICEF/UNFPA/The World Bank Estimates of Maternal Mortality 2005 is self explanatory and more recent.

Data is data and, unfortunately, can frequently be cherry picked to try to prove one’s point … if one is so inclined.

For instance, let’s look at Ms. Yamin’s claim that the maternal mortality rate in the U.S. is five times that of Greece’s. She needs to check her math. A look at the 2005 data reveals that the U.S. rate is 3.67 times that of Greece, down from 8 times that of Greece in 2002.

A little “cherry-picking” of data will quickly reveal that while Greece’s maternal mortality rate between 2002 and 2005 has increased by 300%, the U.S. maternal mortality rate has only increased by 37.5%. Does this mean that Greece’s maternal healthcare system has collapsed along with their socialist economy?

And what does this prove? The incidence of maternal mortality is so minuscule in the countries cited that slight changes can produce exaggerated and preposterous claims. Between 2002 and 2005, maternal mortality in both the U.S. and Greece varied by two to three deaths per 100,000 births.

Frankly, comparing Greece’s rather homogeneous population of 11 million with the rather diverse U.S. population of 300 million is a bit of a stretch. Review of the data reveals that the U.S. maternal morbidity rate is actually on par with other industrialized nations which, quite frankly, is rather remarkable considering its diversity in many ways. And, I think the U.S. Constitution was designed to guarantee individual freedom with the right to make choices, good or bad, and not an inherent “right to the highest attainable standard of health” as conceived by and forced upon the population by a central government.

In 2002, U.S. maternal mortality per 100,000 births was 8 … the same as Germany and Japan. In the short span of three years the numbers changed to 11, 4 and 6 for the U.S., Germany and Japan, respectively. Does this mean that, in three short years, the U.S. has degenerated into a chaotic state of crisis brimming with anti-feminine discrimination, while Germany and Japan have become absolute models of virtue and feminine equality?

Of further interest, while, from 2002 to 2007, the birth rate in the U.S. increased from 13.9 to 14.3 per 1000 population; from 2003 to 2009, the birthrate in Greece declined from 9.79 to 9.45/1000. During the same period Germany declined from 8.6 to 8.18 and Japan declined from 9.61 to 7.64.

Could there actually be causes other than Ms. Yamin’s claimed U.S. “violations” of women’s inherent ”
right to the highest attainable standard of health” and “widespread violations of women’s human rights“?

For instance, illegitimacy, … excuse me … births out of wedlock, in the U.S. currently is 26% for Caucasians, 50% for Latinos and 70% for African Americans. The overall illegitimacy rate for the U.S. in 2007 was 39.7% compared to a reported 20% in 2004. I think that has something to do with “freedom of choice” along with  a lack of “responsibility”. Should the government control that too? And what does Amnesty International have to say about that?

In 2004, when the overall illegitimacy rate in the U.S. was around 20%, in Japan, it was about 1%. A current rate, although the year was unspecified, for Greece is 9%. The most recent data I could find on Germany was about 23% in the year 2000.

So, Greece, with a low illegitimacy rate, falling birth rate,universal healthcare and relatively homogeneous population has seen its maternal mortality rate triple. Germany, with a moderately high illegitimacy rate, falling birth rate, universal healthcare and, again, a relatively homogeneous population has seen its maternal mortality decline by half. Japan, on the other hand, also with universal healthcare, an extremely low illegitimacy rate, markedly falling birth rate and very homogenous population has only decreased their maternal mortality rate by 25%.

What does all of this prove? Nothing … the same as Ms. Yamin’s irrational, albeit Amnesty International inspired, rant against the U.S. But, it might bring to question some of Ms. Yamin’s more irrational contentions.

Now, correct me if I’m wrong, but … don’t women, as a rule, avail themselves of the healthcare system a lot more than men. Don’t get me wrong, I’m not criticizing women for following recommended guidelines regarding their health, but it hardly makes a case for the healthcare system discriminating against the very people who use it most frequently. It could also be the reason that the healthcare costs for women are more than for men. Anyone with a ounce of sense knows that it cost more to drive your car 20,000 miles than it does if you only drive it 10,000 miles. That doesn’t mean you didn’t need to drive it more, but you should expect it to cost more.

And, why would a system with an overwhelming number of women as a part of it discriminate against its most frequent users, women? If anything, the greatest conflict within the system is trying to balance the desires and needs of the changing lifestyles of the women that work in the system with the desires and needs of the changing lifestyles of the women that use it. Physicians, both male and female, in private practice frequently find themselves trying to work out this quandary of staff versus patients while frequently neglecting their own lives and families.

I do think that the more educated a woman is, the more likely she is to make educated and informed decisions about her health. It would be nice if young women would wait to make important life changing decisions about their personal health and welfare until they are older and more capable of making more informed decisions. It might have a tremendous impact on the data. I haven’t seen the demographic breakdown regarding the ages involved in maternal mortality, but I was taught that a teenage pregnancy was “high risk” by definition. I wonder if that has anything to do with the data.

Shoddy, sophomoric propaganda, … even from a Harvard professor …, is still … shoddy, sophomoric propaganda. And picking Greece, a failing socialist economy with rising maternal mortality, for comparison was just plain dumb.

My Director of Medical Education would have filed this article under the heading of “worthless crap” … more suitable for brainwashing a class of first graders than being brainlessly assimilated by adults. But she does know her usual audience, right?

Amnesty International … it figures. Ms. Yamin, Harvard University … SHAME!!!