Thank you for bringing local awareness to the maternal mortality rates in West Africa (editorial by Nicholas Kristof). These rates illustrate a preventable, international health crisis that needs to be addressed immediately. I applaud the cosponsors of the recently introduced Newborn, Child and Mother Survival Act, an effort to restore United States leadership in improving maternal and infant health worldwide. However, the strongest show of leadership is example, and the United States ranks 41st in maternal mortality. No improvement has been made in our own country in this area since 1982. The Center for Disease Control estimates that more than half of all reported maternal deaths could have been prevented by early diagnosis and treatment. Interestingly, as our c-section and intervention rates rise, so does our maternal mortality rate. The maternal mortality rate for cesarean section is four times higher than for vaginal birth, and is still twice as high for routine repeat cesarean sections without any emergency diagnosis. It seems that the American women who are dying fall between the extremes of lack of access to medical care, or overuse of medical intervention. Our government has a moral and ethical responsibility to strike a happy medium between these extremes within our own obstetric model, and restore leadership by example. We can only hope to improve maternal mortality rates internationally by beginning right here at home.
---Thank you to the Herald Tribune for printing this letter on Saturday, May 23rd. Read the online edition here.