Week 22: Identify increases and decreases

Can the goddess of childbirth protect you from unnecessary pregnancy panic? |  The Metropolitan museum of Art

Can the goddess of childbirth protect you from unnecessary pregnancy panic? | The Metropolitan museum of Art

Now that you’re halfway through the pregnancy, you’re likely spending more time in an obstetrician’s waiting room, reacquainting yourself with daytime television. You hear an inexplicably cheerful group of women discussing a startling statistic: the U.S. maternal mortality rate has increased by 27% in fourteen years.

There are plenty of reasons to be concerned about that rising maternal mortality rate, especially considering that many other countries’ maternal mortality rates have decreased in the same time period. It’s startling that we collect so little data on deaths that may have been linked to pregnancy. It’s horrifying that maternal mortality disproportionately affects black women. It’s promising that states like California have made great strides in decreasing their maternal mortality rates.  

But none of these news stories should make you particularly concerned about dying in childbirth, because the overall rate of maternal mortality is quite low. 

An increase of 27% sounds enormous, enough to make you start asking your preferred hospital about what it is doing to prevent maternal deaths. But when increases and decreases are presented as percents, they can inflate our sense of risk.

When you see a scary-sounding percentage increase, ask yourself these questions:

What was the actual increase?

Reading about a 27% increase might make you think that 1 in 4 pregnant women is at risk of dying. But remember two weeks ago when we talked about denominators? They’re really helpful when we’re looking at increases and decreases. In 2000, 19 women per 100,000 were identified as dying from pregnancy-related causes. In 2014, that number rose to 24 per 100,000. That shift from 19 to 24 women in 100,000 translates into a 27% increase.

Could I express this percentage differently?

A 27% increase in maternal mortality seems huge until you consider the rate of maternal mortality in the U.S., which is, given that above figure of 24 per 100,000, just .024%. The overall risk of dying in childbirth in the U.S., while high compared to other countries, is still generally low.

Who should be most concerned about that increase?

This increase in maternal mortality suggests that there is something wrong with the medical care being provided to women in the U.S., an issue for doctors, medical researchers, and policymakers to explore and resolve. Doctors, public health officials, and other advocacy groups should be looking for solutions, but individual parents don’t need to be particularly concerned about dying in childbirth.

A better understanding of increases and decreases will come in handy when you’re needlessly panicking about the parenting crisis du jour, whether it’s Tide Pods, hoverboards, or couch naps.