http://www.nytimes.com/2016/09/04/opinion/sunday/americas-shocking-maternal-deaths.html 2016-09-05 09:37:26 America’s Shocking Maternal Deaths In many countries, the number of deaths during pregnancy or after childbirth has fallen sharply. The United States is a glaring exception. === The rate at which women die during pregnancy or shortly after childbirth has In Texas, for instance, In California, the rate fell from 21.5 in 2003 to 15.1 in 2014, but in the remaining 48 states and the District of Columbia the rate increased from 18.8 in 2000 to 23.8 in 2014. The United States as a whole had the second-highest maternal mortality rate among 31 members of the Organization for Economic Cooperation and Development. Only Mexico had a higher rate. A big part of the problem is the inequality embedded in America’s health care system. The 2010 Affordable Care Act made health insurance more available, but millions of families still cannot afford the care they need. And lawmakers in many states and many Republicans in Congress have repeatedly shortchanged reproductive health programs because of ideological opposition to contraception and abortion. The maternal mortality rate’s surge in Texas defies easy explanation. Such increases typically happen during war, natural disasters and severe economic distress. State Republican lawmakers sharply The biggest killers during and after pregnancy in Texas are cardiac problems and overdoses involving prescription opioids and illegal drugs, according to a Texas lawmakers could address some of these problems by investing more in health clinics in minority communities and in mental health and addiction treatment. Expanding Texas can also learn from California, which has organized doctors, hospitals, insurance companies and public interest groups in a collaborative to focus on maternal mortality. The group has developed state-of-the-art treatments for causes of maternal mortality like hemorrhages and But even California could go further. Despite some improvement, its maternal mortality rate far surpasses that in nations like Germany and Britain, where the rate is 6.7 per 100,000. One reason for Britain’s low rate is a mandatory system of One of the United Nations’ Millennium Development Goals was to reduce global maternal mortality by three-fourths between 1990 and 2015. The world missed that target but still reduced the mortality rate by 45 percent. Set against that progress, America’s record is unconscionable.