USA: call on Obama to establish maternal health office- New report

Amnesty International has today (12 March) called on President Obama to urgently establish an Office of Maternal Health to tackle soaring pregnancy-related complications and maternal deaths in the United States.

Releasing a new 101-page report, Deadly Delivery: The Maternal Health Care Crisis in the USA, Amnesty said the US government must take immediate steps to stop the deaths of two to three Women's rights's rightss rights's rights's rights's rights every day and reduce the risk of complications that affect one-third of all pregnant Women's rights's rightss rights's rights's rights's rights - 1.7 million Women's rights's rightss rights's rights's rights's rights a year.

Amnesty says that with a lifetime risk of maternal deaths that is greater than in 40 other countries - including virtually all other industrialised countries - the US has failed to reverse the two-decade upward trend in preventable maternal deaths, despite pledges to do so.  Most recently, the government failed to meet the goals set out in a 2010 “Healthy People” initiative, which called for a reduction in the number of maternal deaths to a third of current rates.

Amnesty International USA executive director Larry Cox said:

“This country's extraordinary record of medical advancement makes its haphazard approach to maternal care all the more scandalous and disgraceful.

“Good maternal care should not be considered a luxury available only to those who can access the best hospitals and the best doctors. Women's rights's rightss rights's rights's rights's rights should not die in the richest country on earth from preventable complications and emergencies.

"Mothers die not because the United States can't provide good care, but because it lacks the political will to make sure good care is available to all Women's rights's rightss rights's rights's rights's rights."

Amnesty’s report reveals that:

* severe pregnancy-related complications that nearly cause death - known as "near misses" - are rising at an alarming rate, increasing by 25% since 1998; currently nearly 34,000 Women's rights's rightss rights's rights's rights's rights annually experience a “near miss” during delivery;

* discrimination is costing lives. Opportunities to save Women's rights's rightss rights's rights's rights's rights's lives and reduce complications are being missed, largely because Women's rights's rightss rights's rights's rights's rights face barriers to care, especially Women's rights's rightss rights's rights's rights's rights of colour, those living in poverty, Native American and immigrant Women's rights's rightss rights's rights's rights's rights and those who speak little or no English;
* nearly 13 million Women's rights's rightss rights's rights's rights's rights of reproductive age (15-44), or one in five, have no health insurance. Women's rights's rightss rights's rights's rights's rights of colour account for just under one-third of all Women's rights's rightss rights's rights's rights's rights in the US (32%) but over half (51%) of uninsured Women's rights's rightss rights's rights's rights's rights;

* one in four Women's rights's rightss rights's rights's rights's rights do not receive adequate prenatal care, starting in the first trimester. This rises to about one in three for African American and Native American Women's rights's rightss rights's rights's rights's rights;

* burdensome bureaucratic procedures in Medicaid enrolment substantially delay access to vital prenatal care for pregnant Women's rights's rightss rights's rights's rights's rights seeking government-funded care.  Twenty-one states do not offer “presumptive eligibility” which allows pregnant Women's rights's rightss rights's rights's rights's rights to temporarily access medical care while their permanent application for Medicaid is pending. Women's rights's rightss rights's rights's rights's rights who do not receive any prenatal care are three to four times more likely to die than Women's rights's rightss rights's rights's rights's rights who do;

* a shortage of health care professionals is a serious obstacle to timely and adequate care, especially in rural areas and inner cities. In 2008, 64 million people were living in "shortage areas" for primary care (which includes maternal care), but federally-supported community health centres - a critical safety net - are available in only 20% of these areas;

* the lack of nationally standardised protocols addressing the leading causes of death - or the inconsistent use of them - could be leading to preventable deaths or injuries. Measures used widely in the United Kingdom to prevent blood clots after caesarian sections are not consistently taken in the US for example;

* Caesarean sections make up nearly one-third of all deliveries in the US - twice as high as recommended by the World Health Organisation. The risk of death following C-sections is more than three times higher than for vaginal births;

* the number of deaths is significantly understated because there are no federal requirements to report maternal deaths or complications and data collection at state level is insufficient;

* oversight and accountability is lacking: 29 states and the District of Columbia have no maternal death review process at all.

Amnesty stressed that maternal health is a human right for every woman in the US, regardless of race or income, yet the country lacks a systematic, robust government response to this need. Amnesty is urging President Obama to work with US Health and Human Services Secretary Kathleen Sebelius to establish - and seek Congressional funding for - a single office responsible for ensuring that all Women's rights's rightss rights's rights's rights's rights receive quality maternal health care.

Amnesty is also calling for vigorous enforcement of federal non-discrimination laws and an increase in support for Federally Qualified Health Centers by 2011 to increase the number of Women's rights's rightss rights's rights's rights's rights who can access affordable maternal health care. Amnesty’s analysis shows that health care reform before Congress does not address the crisis of maternal health care.

Rachel Ward, one of the authors of the Deadly Delivery report, said:

“Reform is primarily focused on health care coverage and reducing health care costs, and even optimistic estimates predict that any proposal on the table will still leave millions without access to affordable care.  

“Furthermore, it does not address discrimination, systemic failures and the lack of government accountability documented in Amnesty International’s report.

"The barriers preventing Women's rights's rightss rights's rights's rights's rights from getting the care that they need go far beyond simply lacking health insurance.  Health care reform does not address obstacles to maternal care, recommend nationally standardised protocols for preventing and treating the most common causes of death, eliminate health disparities or ensure that the government takes responsibility for reducing levels of maternal mortality."

Read the report

Note to editors
As part of its ongoing work on maternal mortality globally, later today Amnesty will release a short film calling on the UK government to prioritise maternal and child health as part of its international development commitments. The two-minute film - called Every Day Should Be Mother’s Day -features Keira Knightley, Annie Lennox, Jonathan Pryce, Beverley Knight, Colin Salmon, James Purefoy and Dervla Kirwan.

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