Talk:Maternal mortality in the United States

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Potential sources

 * Howell, Elizabeth A., Natalia N. Egorova, Amy Balbierz, Jennifer Zeitlin, and Paul L. Hebert. 2016. "Reports of Major Impact: Site of delivery contribution to black-white severe maternal morbidity disparity." American Journal Of Obstetrics And Gynecology 215, 143-152. ScienceDirect, EBSCOhost(accessed April 16, 2018).
 * Headley, Adrienne J.. “Generations of Loss: Contemporary Perspectives on Black Infant Mortality.” Journal of the National Medical Association 96.7 (2004): 987–994.
 * Mary O. Hearst, J. Michael Oakes, Pamela Jo Johnson; The Effect of Racial Residential Segregation on Black Infant Mortality, American Journal of Epidemiology, Volume 168, Issue 11 (1 December 2008): 1247–1254. https://doi.org/10.1093/aje/kwn291
 * Rodriguez, Cheryl. "Mothering While Black: Feminist Thought on Maternal Loss, Mourning and Agency in the African Diaspora." Transforming Anthropology 24, no. 1 (2016): 61-69. doi:10.1111/traa.12059
 * Rousseau, Nicole. “Social Rhetoric and the Construction of Black Motherhood.” Journal of Black Studies 44, no. 5 (July 2013): 451-471. http://www.jstor.org/stable/24573096 — Preceding unsigned comment added by Hufflm (talk • contribs) 05:31, 23 April 2018 (UTC)
 * note, i formatted the above. Please be aware that any content that is WP:Biomedical information (which includes things like epidemiology) needs to be sourced per WP:MEDRS. Please make sure you have done the student training and especially the training for editing about health. Jytdog (talk) 15:00, 27 April 2018 (UTC)

U.S. Maternal Mortality Trends
I removed this sentence from the lead as it is misleading.


 * Analysis of these studies has shown that a large part of the effect is due to a change in statistical reporting, rather than an increase in the number of deaths.

In her 2016 editorial in Obstetrics & Gynecology, Nancy C.Chescheir summarized the MacDorman et al's 2016 article. She wrote that MacDorman et al found that the statistics on maternal mortality ratios were much worse than what Obstetrics & Gynecology had reported in the January 2015 issue based on data from the Centers for Disease Control and Prevention. MacDorman et al reported a baseline rate of 18.8 maternal deaths per 100,000 births was higher than previously thought. In 2014 there was a 26.6% increase representing 23.8 maternal deaths per 100,000 births. MacDorman et al concluded that, "In conclusion, the maternal mortality rate for 48 states and Washington D.C. from 2000–2014 was higher than previously reported, is increasing, and places the U.S. far behind other industrialized nations."

In 2003 the national U.S. standard death certificate added a "tick box" question regarding the pregnancy status of the deceased. Many states delayed adopting the new death certificate. This "muddied" data and obstructed analysis of trends in maternal mortality rates. It also meant that for many years, the United States could not report a national maternal mortality rate to the OECD or other repositories that collect data internationally. MacDorman et al described this as an "international embarrassment".

Lead Confusion
Your lead is a little confusing because it does not follow chronological order. My suggestion would be:

"23.8 maternal deaths per 100,000 births were reported in 2014. Although the CDC reported 18.8 maternal deaths per 100,000 births in 2016, a 23.6% decrease as compared to 2014, the amount of women losing their lives due to maternal mortality remained higher than expected." Tkk20 (talk) 01:14, 31 August 2018 (UTC)

WorkPlan
Over the next 4 weeks I will be working on improving this article as a part of the WikiEd curriculum. As a brief overview I will begin by focusing on the references and organization during the first week. I will focus on reading through the references and determine which ones are appropriate and use those in the future. I also plan to utilize potential references and get ideas based off of what has already been discussed within the Talk page, though not much to date.

At a brief glance, the first paragraph needs revising. It is a bit choppy and brings in Texas very abruptly. I would like to smoothly incorporate that part. I also noticed some acronyms that need to be explained.

Overall, I would like to expand on preventable causes, restructure the timeline and some sentences, improve the section headings/groups, find more images that deal with childbirth and pregnancy. The historical images section seems out of place. I could possibly add a maternal mortality in history section and include images there, and/or include practices to combat maternal mortality in history. I would like to include an image that corresponds to some of the factors that cause higher rates of mortality, possibly include a map showing the differences between states. The comparison between countries and states needs to be cleaned up and expanded, as well as the cause and prevention sections. The cause and prevention are the most important to this topic so I intend to focus on these sections primarily. I will include a section on the trends and its comparison to the rest of the world. I will also look for research on health disparity regarding MM and how to combat. Since there are no specific signs and symptoms I will have to do more research on the topic to figure out what groups/headings/sections would be appropriate and important to include in the article.

Towards the end I will focus more on retracting things, for example: decreasing the focus on measurement and data collections, as that does not seem to be of high importance. As important words or topics arise, I will hyperlink them accordingly. I will have to find a good balance between the medical side and the public health aspect as this topic is a mix between the two. I plan to have mothers I know who are not within the medical field to review the page to ensure everything makes sense from their point of view. I would also like to have other family members and friends who do not have children read through the article as well to ensure there isn't medical jargon that is confusing. Neiceylyn (talk) 13:49, 20 November 2018 (UTC)
 * Thank you for being interested enough in this topic to tackle this article! I guess your priorities should definitely be first on preventable causes, because there are more and more women in the US without access to basic healthcare, nevermind prenatal care. That said, of course you help the whole world when you don't restrict yourself to the US. Please consider splitting this article into its various components - there is no reason it all has to be bundled into one page. So e.g. as long as you have access to reliable sources, you can make pages for each *leading cause* of maternal death, such as Maternal Mortality (Sepsis), which can include postpartum infections, etc. Since this is the Unesco Millenium Development Goal 5 you can also use their breakdown methods, but since this is such a neglected part of Wikipedia you can also just be bold and do whatever interests you most and others can chime in later. Good luck and thanks again. Jane (talk) 14:15, 20 November 2018 (UTC)


 * Do also take a look at Maternal healthcare in Texas. I'm not sure that a seperate article about only one state is really justified. WikiProject Medicine can also be very helpful as there are several topic experts active there. Roger (Dodger67) (talk) 14:26, 20 November 2018 (UTC)
 * Funny - I was going to suggest articles for CA and MA, since those states have, like TX, have established specific programs and seem to be doing well - the differences state-to-state are larger than between the US & any other developed nation. I suspect this is largely due to measurement differences, but without access to data we will never know. Jane (talk) 15:30, 20 November 2018 (UTC)

Edit
Removed: Texas According to a 2017 BBC report, Texas has the highest MMR in the United States and the lowest number of people covered by health insurance.

Neiceylyn (talk) 19:00, 7 December 2018 (UTC)

Removed:

Measurement and data collection A widely cited 2016 study by Centers for Disease Control and Prevention (CDC) statistician Marian F. MacDorman and others, reported a baseline rate of 18.8 maternal deaths per 100,000 births, which was higher than previously thought. In 2014 there was a 26.6% increase representing 23.8 maternal deaths per 100,000 births.:427 MacDorman et al. concluded that, "the maternal mortality rate for 48 states and Washington D.C. from 2000–2014 was higher than previously reported, is increasing, and places the U.S. far behind other industrialized nations." Neiceylyn (talk) 05:26, 10 December 2018 (UTC)

Peer Review
I think the lead is solid. I like that it highlights the increase in maternal mortality deaths in the US recently, and shows how much different we are than the rest of the developed world. I think that is likely the most pertinent piece of information for people who would be searching for this. I think defining what maternal mortality is, but I’m a little confused. There is one sentence that states “some sources will define material mortality as the death of a woman up to 42 days after her pregnancy has ended, instead of one year.” This sentence is not sourced and is at odds with the other definition. I just think some clarity is needed. I also like that you have listed the most common medical conditions responsible for maternal mortality, I think that is excellent knowledge. However, I saw that it was hyperlinked in your sandbox. Not sure if you could bold and hyperlink the terms, but I think if so it could be useful. The images are good, and I like the location. They give a quick visual representation of the information right when I was wanting one on my read through. In the “Disparities” section, I noticed that there was a lack of citations. There are some statistics in there that are unsupported, as well as some unsupported statements throughout the rest of the ‘Disparities’ section. All in all, I think it’s a good article with good information, just missing a little citation. I like the organization and think it reads well. Bts200 (talk) 00:23, 11 December 2018 (UTC)

Age of mothers?
Did I miss seeing this in the article? Is age in the U.S. data? International data? David notMD (talk) 00:45, 14 December 2018 (UTC)
 * Age as a factor of maternal mortality, like younger versus older? Or are you asking what is the age of the mothers in the data that they are collecting?

Older age is mentioned as a risk factor, and within that same article thats references they specifically mentioned the mothers in the data as "childbearing age", which they defined as 18-44. I am not sure if I added that second part within this article, but I can. Neiceylyn (talk) 02:23, 14 December 2018 (UTC)
 * Yes, specifically, is there data that compares younger and older mothers? David notMD (talk) 21:10, 14 December 2018 (UTC)

Merge discussion
At the article for maternal death the section Maternal_death has grown to be huge, when instead it should be one paragraph with a link for the reader to access this article.

This is a content fork to correct by merging that content from there to here. I do not expect to be able to address this myself, but if anyone has a go at performing the merge, then I would comment on the outcome if anyone pinged me. Thanks.  Blue Rasberry  (talk)  02:45, 21 January 2020 (UTC)
 * I've done this rather simply, so feel free to edit in situ in case you think that there is a need for internal merging or refinement. Klbrain (talk) 15:32, 23 December 2020 (UTC)
 * Thanks for this, good job. I cleaned up the maternal mortality article and moved a bit more here. Both articles could use a rewrite but I think the task is more straightforward now.  Blue Rasberry   (talk)  19:15, 23 December 2020 (UTC)

Edit Proposals
Hello! I think this is a great article, and I would like to consider adding to the "Race" subsection to include more information about Black maternal mortality in the United States and the associated health disparities. Recently, there has been more research into this topic and potential solution that I think would be worth mentioning, such as historical racism in gynecology and comorbidity in Black mothers. Check out my user page for more information and some of the sources I plan to use! Thanks! Akandru (talk) 03:37, 11 September 2020 (UTC)

More In-Depth Proposals
Hi again! I wanted to give a more in-depth look at how I am proposing to revise this article (more detailed information and sources can be found on my user page). I would like to add a new section under "Medical causes" called "Medical segregation" to include information on segregation of Black people from higher-quality hospitals. I would also like to include more information about abortion access under the "Access to healthcare" section, particularly because of the contribution of unsafe abortions to maternal mortality. I also plan to edit the "Race" section a bit more to highlight medical racism, and the "Income" section to emphasize the link between lower income and higher pregnancy related deaths.

Furthermore, I plan to create a new article with this current one as its parent. This new article would be about Black maternal mortality in the US, and would include sections on History (including trends to the present), access to peri- and post-natal care, intersection of race and SES, medical racism, and reproductive and sexual health and rights (including access to abortion). Much more detailed information can be found in my user sandbox. I welcome any feedback! Thanks! Akandru (talk) 04:08, 30 September 2020 (UTC)!

Peer review
Overall a well written addition to the existing article on Maternal mortality in the United States. I think the lead has been left unchanged and already encompasses the changes made. The content is presented a neutral manner with good sources that appear to be from well-respected experts with little to no added bias or non-neutrality. I think that the sources are current and that they improve upon the article by adding in up-to-date information that seems to be an upgrade in the article.

The information added is presented concisely, yet thoroughly with few run on or hard-to-read sentences. The section added on Intimate partner violence was well-written and a vital addition to the overall article to further information available to us as health professionals and our future patients. I think some sentences may have some medical jargon but that may be unavoidable. I would consider adding in embedded links to articles already present. Specifically, in the IPV section. Otherwise, well done other than a few tweaks in the information you added. — Preceding unsigned comment added by Hamsalim07 (talk • contribs) 17:15, 24 March 2021 (UTC)

Revising Article
Hello! I will be revising the Wikipedia article on black materiality mortality in the United States. This article needs revision due to outdated content and poor organization. I will delete certain sections and rearrange and odd other content to others. Check my sandbox for more information on this. — Preceding unsigned comment added by Ferviani (talk • contribs) 30 September 2021 (UTC)

Table updated via Visual Editor paste
See: User:Timeshifter/Sandbox182 for instructions. Visual Editor paste makes it easy to update table. --Timeshifter (talk) 06:20, 17 September 2022 (UTC)

New Edits
The data regarding the major causes of maternal mortality were outdated. I determined that this was an important update because readers should have access to correct and current data. The CDC released maternal mortality data from 2017-2019 which was not included on this page. The leading causes listed on the Wikipedia page were previously from a study released in 2010 and did not list mental health conditions(it only listed Post-Partum Depression which is too limited in scope) among the top causes. According to the CDC data with which I updated the page, mental health conditions are the leading cause of maternal mortalities in the United States. It is important to highlight this leading factor in order to increase awareness of the mental health issues that birthing people encounter.

Additionally, the page stated that 20-40% of maternal mortality in the US is preventable, but according to the data from the CDC over 80% of maternal mortality is preventable. I consider this the most important update because seeing how great the percentage of preventable deaths is may help spur individuals into action. Knowing that so many birthing people were dying of preventable causes is what inspired my interest in maternal health.

The section about monitoring maternal health didn’t cite Maternal Mortality Review Committees (MMRCs) among the monitoring organizations. The CDC lists MMRCs as the gold standard in terms of publishing data that allows for understanding of the causes of maternal mortality and suggestions for the most effective interventions. This data is particularly powerful because it is collected at local and state levels which allow for localized interventions. This is important information for anyone wanting to learn about the most effective strategies for preventing maternal mortality. Nlaguardia (talk) 23:04, 30 October 2022 (UTC)

Prevention section addition
Hi, I'm here with a request for editors to assess a possible addition to this article. I work for an organization that focuses on improving health outcomes in diverse communities and noticed that there is some valuable research not represented in this article.

Specifically, within the Prevention section, I'd like to suggest adding research findings from the | University of Colorado about the effects on maternal health and mortality with home visits from nurses after giving birth.


 * Quote: "Prenatal and infant/toddler home visitation by nurses is a promising means of reducing all-cause mortality among mothers and preventable-cause mortality in their first-born children living in highly disadvantaged settings."

Potentially an addition like the following would be fair:
 * "According to a study conducted at the University of Colorado, new mothers living in “highly disadvantaged” settings who had consistent home-nurse visitations after birth had a reduction in all preventable deaths."

Since I have a conflict of interest, which can be seen on my user page, I will defer to non-COI editors to evaluate this. If there are any other resources I can provide, please let me know. Thank you!

Bvar on Wiki (talk) 14:48, 22 May 2023 (UTC)
 * Pictogram voting comment.svg Note: It may be better to word this differently. I would suggest "Consistent home-nurse visitations have been found to reduce mortality both in infants and their mothers." Actualcpscm (talk) 09:18, 26 May 2023 (UTC)
 * Thank you for the guidance on this. I’d be happy to use your suggested language, as it does work with the source I provided. Is this something you would be comfortable incorporating in the article? As I mentioned above, I do have a conflict of interest, so I’m hoping another editor might be willing to make the update.
 * Again, thank you for taking the time to review and offer feedback. I appreciate it. Bvar on Wiki (talk) 16:39, 2 June 2023 (UTC)
 * ✅ Actualcpscm (talk) 10:20, 3 June 2023 (UTC)
 * Thanks so much! Bvar on Wiki (talk) 20:23, 5 June 2023 (UTC)

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