Democratic Rep. Robin Kelly claimed on Twitter that the rate of maternal mortality in the U.S. has been rising.

Congresswoman @HerreraBeutler is 100% correct. We need better data in order to address America’s dangerous and growing rate of #maternalmortality. I’m proud to co-sponsor this critical bill to help save mothers’ lives. #MOMMAact #act2savemoms https://t.co/KdIBWOkE9s

— Robin Kelly (@RepRobinKelly) September 28, 2018

“Congresswoman @HerreraBeutler is 100% correct. We need better data in order to address America’s dangerous and growing rate of #maternalmortality,” said Kelly in a tweet.

Verdict: True

The rate of maternal mortality in the U.S. has steadily increased in recent decades. Some of the growth is likely due to better reporting of maternal deaths, while other explanations include inconsistent health care practices and the rise of chronic conditions like diabetes and hypertension.

Fact Check:

The rate of maternal mortality is measured as the number of women who die from pregnancy-related complications, during or soon after child birth, out of every 100,000 live births.

While numbers vary depending on which source is consulted, estimates generally show an increase in maternal mortality in the U.S. over the last few decades. One study published in the medical journal The Lancet found that the rate increased from 16.9 deaths per 100,000 live births in 1990 to 26.4 in 2015. The study estimated that 1,063 women died from complications due to child birth in 2015.

Other studies report similar findings.

The Centers for Disease Control and Prevention (CDC) estimates that the rate increased from 7.2 in 1987 to 18 in 2014.

A report by the World Health Organization (WHO) shows that the rate grew from 12 deaths per 100,000 live births in 1990 to 14 in 2015. (WHO produced a study one year earlier that showed a more substantial increase – 12 in 1990 and 28 in 2013.)

Estimates vary, in part, because of differences in how researchers define a “pregnancy-related death.” The CDC counts women who die up to one year after birth, for example, while WHO only counts women who die up to 42 days later.

Experts believe a number of factors have likely contributed to the rise in maternal mortality. An increasing number of women have chronic conditions like hypertension and diabetes that can lead to pregnancy-related complications.

Dr. Priya Agrawal, the executive director of vaccines and women’s health at Merck, also cites a lack of consistent standards in the field of obstetrics. “Hospitals across the USA lack a standard approach to managing obstetric emergencies and the complications of pregnancy and childbirth are often identified too late,” she wrote in a 2015 bulletin for WHO.

Another factor may be an administrative change to death certificates. In 2003, a question asking whether the deceased person was pregnant or had recently been pregnant was added to the standard U.S. death certificate. The new question decreased the chances that maternal deaths slipped through the cracks, ultimately resulting in an increase in the total number of maternal deaths reported.

It could be the case that there is no real increase in maternal deaths, only better data collection, according to one CDC expert. Other experts say it’s a combination of factors. A 2016 study sought to control for the change in death certificates over time and found that the rate of maternal mortality still increased 26.6 percent across 48 states and Washington, D.C., from 2000 to 2014.

The cause of death for these women varies considerably, with the most frequent cause being cardiovascular disease, according to CDC statistics from 2011 to 2014.

Black women are significantly more likely to die from pregnancy-related complications than woman of other races. From 2011 to 2014, the CDC reports that there were 40 deaths per 100,000 live births for black women, versus 12.4 for white women and 17.8 for women of other races. A 2007 study found that although black women are not actually more prone to certain pregnancy complications, they are more likely to die from these complications.

While the rate of maternal mortality has increased in the U.S., it has dropped across the globe, including in most industrialized countries.

Globally, the maternity mortality rate dropped from 385 deaths per 100,000 live births in 1990 to 216 in 2015, according to WHO. Nearly 99 percent of maternal deaths come from developing regions of the world, with India and Nigeria accounting for a third of all deaths in 2015.

In March of 2017, Republican Rep. Jaime Herrera Beutler introduced the Preventing Maternal Deaths Act in order to combat the increasing rate of maternal mortality in the U.S. The bill calls for committees to be established in every state that would monitor, review and disseminate information regarding maternal deaths. The bill has 175 cosponsors, including Kelly.

“For all the families, single fathers, parents and children who have lost a wife, daughter and mother, I remain committed to passing this bill into law so we can prevent future families from suffering the profound loss of a mother,” said Herrera Beutler in a recent press release.

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