Emily Oster on Maternal Healthcare - by Lisa Rab
If you’ve been reading this newsletter for awhile, you know that I started from the premise that it’s far more dangerous to give birth now than it was for our parents. I came to this idea after six years of reporting on maternal health, and from reading Dr. Neel Shah, who wrote on the Harvard Health Blog in 2018, “Compared with their own mothers, American women today are 50% more likely to die in childbirth.”
But any good journalist will tell you it’s important to question your assumptions. So I’ve started asking maternal health experts to share their views on this question.
Emily Oster, bestselling author of Expecting Better and founder of ParentData, was the first person to respond. She’s an economics professor at Brown University who analyzes data on pregnancy and parenthood. Here’s her thoughtful, emailed response.
Question: Do you think maternal healthcare has gotten better or worse in the past 40 years?
Emily Oster: In the global sense, yes. Maternal mortality rates, especially in poor countries, have fallen dramatically over this time period. (This Lancet piece is good context). Better hospital access and better technology in some cases have really made a difference. In the U.S. in particular, the maternal mortality rate hasn't had a significant decline. There is some argument and confusion about how we count maternal mortality, but even putting this aside the U.S. has a worse situation than most of our peer countries.
Obviously the mortality piece is only a small part of this, although it is reflective of a broader set of complications. This makes it tempting to say that things have not improved over time, or have gotten worse in the U.S. in particular.
Pushing back on that, though, there are clearly some large advancements in health care. IVF has made pregnancy possible for a lot of women for whom that was not the case in the past. There have been large improvements in infant survival, which isn't exactly maternal healthcare but is closely related.
I do not see a definitive answer here for the U.S., although I'd be inclined to say "yes" [maternal healthcare has gotten better], simply because the technological improvements that allow many more people to have a family seem important.
More expert opinions to come! Share this post with the parents in your life.
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