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Want to live a longer life? Don’t be pregnant in America

zuzu

Sarah Blustein’s got the reasons why, especially if you’re a woman of color:

Good news! if you are an ordinary mortal living in the United States, your chances of staying alive are better than ever. According to new government numbers, the rate of Americans dying in 2004 (the most recent year to be calculated) hit a record low, while life expectancy — for blacks and whites, men and women — hit a record high. Men were closing their historic life-expectancy gap with women, and African Americans were closing their life-expectancy gap with whites. Even the babies were doing well: The infant mortality rate dropped, too.

Sadly, however, if you are a pregnant mortal living in the United States today, your chances of dying appear to be greater than ever. Yes, the total number of women who die in childbirth in America is low. But according to the Centers for Disease Control’s new “National Vital Statistics Report,” the number of women dying in or around childbirth has risen — putting the United States behind some unsurprising countries, like Switzerland and Sweden, and some surprising ones, like Serbia and Macedonia, Qatar and Kuwait, in its rate of maternal mortality. In rankings calculated on 2000 numbers, the World Health Organization (WHO) ranked the United States at No. 29 on the list, even though, according to the most recent statistics, there is only one country, Tuvalu, that spends more on health care as a percentage of gross domestic product than the United States.

Be sure to read the rest.

The US healthcare system is irrevocably broken. There’s no reason at all that the maternal mortality rate should be so high in a country with world-class healthcare facilities, except for the fact that we don’t have world-class access.

I knew people in my very first job, where few people made over $30,000, and only because they’d been hired away from union papers, where pregnancy and birth care wasn’t covered because the pregnant woman’s husband had been hired after she’d become pregnant and it was considered a pre-existing condition. And that was in 1990; it’s much worse since then.

Even I don’t have health insurance ATM, and I make somewhat more than the Frosts, with no kids. But I have student loans, and a mortgage, and unless you work for the kind of law firm that I turned my back on long ago, you’re not going to make a hell of a lot. I also have no dependents to consider taking a gamble on; the only person’s health I’m taking a chance on is my own. But I’ve priced health insurance in the private market, and thanked my lucky stars that I qualify for a couple of different group plans. If I could spare the cash. And I’m only getting it for myself.

Via Bean, who’s got some more information on a ruling which struck down an injunction against getting pregnant again as a condition for a homeless couple to regain custody of their children.

26 thoughts on Want to live a longer life? Don’t be pregnant in America

  1. Married, no kids, no insurance. Technically, we could afford insurance, but that would mean we couldn’t save any money. And, the only option we can afford has a $3,000 deductible so what’s the point of paying another $3,000 in premiums per year? I don’t know what we are going to do when we decide to have a baby. Sometimes, I feel like just saying a big “fuck you” to the insurance company and saving like mad to cover doctors visits.

    I was raised without insurance, and while it did affect my number of visits to the dentist, I survied. Since I make more money than my mom did, I think we could manage without insurance. And sometimes I’m scared to death there will be a big medical expense and we’ll go bankrupt. *sigh*

  2. The US healthcare system is irrevocably broken. There’s no reason at all that the maternal mortality rate should be so high in a country with world-class healthcare facilities, except for the fact that we don’t have world-class access.

    While it’s true we don’t all have access to proper health care, the article points out the two ways our healthcare system fails:

    1. Access to healthcare, but the care is inadequate:

    At least some of the problem may be in treatment….”It is absolutely clear,” Wagner told me, “that one of the biggest reasons for this excess [in childbirth-related deaths] is the excess Cesarean section.”

    2. Racist healthcare:

    But the equally significant explanation for American maternal mortality is probably under-treatment. Perhaps the most notable fact in the CDC’s new report is that African American women are nearly four times as likely as white women to die in child-birth. …this is a criminal disparity…Whether the causes are poor health, poor health care, poor insurance coverage, or — likely — all of the above, there is no excuse for the injustice that being black is a risk factor putting some pregnant women at death’s door.

  4. I think there is also a decline in ob/gyn MDs, because of the exorbitant cost of malpractice insurance. So the problem of access is happening on both sides of the aisle.

  5. Childbirth is also considered a disability, at least accd’ing to how the family medical leave act is written. That’s always struck me as totally offensive, given how much f***ing pressure we put on women to procreate. It’s like saying, hey ladies, please maim yourselves!

  6. I was surprised that the article made no mention of the increasing age of mothers. I’ll likely be 40 when/if I have a child, and surely that is going to affect the various health issues involved. That’s got to be some degree of a factor.

    That said, the insistence on C-sections does creep me out. I wonder, as an older woman giving birth, how do you know if it’s really medically necessary that you give birth by C-section? I dread having to deal with that.

  7. Kristen – hell yes!

    When I had a pregnancy scare back about a decade ago while we were uninsured, we looked into insurance. First off, no insurance period would cover an existing pregnancy. Second off, in order to get insurance that would cover a pregnancy, you could not get pregnant for at least nine full months after you started coverage. Not give birth – get pregnant. Thirdly, having pregnancy coverage more than doubled the premium amounths over allowing a specific pregnancy exclusion.

  8. I have sympathy for people who are unemployed and cannot get health insurance.

    HOWEVER, it is damn irresponsible to *choose* not to purchase health insurance – especially if you could possibly become pregnant.

    I know it’s expensive and I know that it sucks to have to spend such a large part of one’s paycheck on health insurance. That’s why people are fighting to change the system.

    But if you can afford a mortgage – chances are very great that you can afford health insurance. Will it take sacrifice? YES. But we *all* have to pay for it. It’s expensive for everyone. Why should some people be able to “opt out” and still get their medical expenses paid for by the rest of us who are paying an arm and a leg to keep ourselves covered (as shitty as the coverage may be).

    I’m sick of hearing sob stories from people who just don’t want to pay for health insurance because it’s too expensive – especially if they might bring a child into the world without health insurance. If you can’t afford a health insurance premium – you can’t afford to raise a child.

  10. Because nobody’s life circumstances ever change in between becoming pregnant and having a child, according to Q.
    And then, you know, there’s just common humanity, and pragmatism and such.

  11. What about all those people who can’t afford a mortgage?

    What about all those people who can afford insurance, but it’s shitty insurance and they max out quickly after one bad accident or cancer instance and still owe a few hundred thousand dollars?

    What about the women who know they can’t afford to have a baby, but get denied EC at the only pharmacy in town and then can’t afford to take a couple of days off to go to the nearest Planned Parenthood a couple of counties away and would have to go twice because of 24-hour notification laws in their state?

    Why should anyone have to pay an arm and a leg for shitty health insurance when every other first world country has figured out how to make it work?

  12. @car:

    Re: your first 3 paragraphs – I wasn’t talking about extenuating circumstances like that. I was talking about employed people who own homes “claiming” that they “can’t afford” health insurance.

    Re: your final statement – duh, I agree.

    @ledasmom:

    Changed circumstances are not what I was referring to. I was annoyed by people who *choose* not to have health insurance.

  13. Q are you talking about people that can afford Prada not getting insurance, people who don’t get insurance because they want to eat more than just ramen noodles and water, or somewhere in the middle? I think I’m trying to figure out the cutoff for people who are just wealthy enough to pay for their insurance. Where would you cut it off at? People who make X should be buying their insurance, what is x?

  14. There’s no reason at all that the maternal mortality rate should be so high in a country with world-class healthcare facilities, except for the fact that we don’t have world-class access.”

    Actually the study shows that a major cause of maternal mortality is the high rate of C-sections. Surgery is dangerous, and if the pregnancy is uncomplicated, a C-section is more dangerous than a vaginal delivery,

    Not lack of access. Too much access.

  15. I was talking about employed people who own homes “claiming” that they “can’t afford” health insurance.

    Have you priced insurance recently? Because the payment I was quoted for a group rate, never mind privately-purchased individual policies, was more than half the cost of my mortgage. For just me.

    Incidentally, with no-money-down mortgages, it’s not like it necessarily requires a ton of money to “own” a home. But add in an insurance payment or COBRA payment when a job change or loss leads to loss of benefits, and you’re radically changing the equation.

    BTW, if you’re bitching about the Frosts, know this: their house may be assessed at $260K, and houses in their neighborhood might be selling for more than that after gut renovation, but their purchase price was $55K, though they have a second mortgage to pay for accommodations for the two kids badly injured in an accident. Before the accident, insurance costs were the major contributing factor to the shutdown of Halsey Frost’s business, and they simply couldn’t afford the $1200 a month for private insurance they were quoted. Since the accident, they can’t get insurance at any cost.

    In any event, even if they sold their house, the kids spent five months in the hospital and have required years of therapy to function; they would have burned right through that money with a quickness and then been homeless with kids with special needs.

    Yeah, great outcome there.

  16. Through my husband’s job, the insurance is MORE than our mortgage payment. When we were renters, it was almost double our rent.

    There’s a $50 copay, and a ridiculously low cap. It is a deliberate attempt by his school district NOT to provide insurance.

    My employer, fortunately, has good and affordable insurance.

  17. Regarding Q’s comments:

    1) Having a mortgage does not mean a person has unlimited money. Where I live, and I think a lot of places are like this, the mortgage I pay is pretty much the same for rent.

    2) Just looking at the overall income of a household cannot determine whether insurance is affordable. No one outside the home can know what other financial obligations a family may have. You may look at the car they make payments with dissapproval, but have you considered it’s necessary to have a reliable car to get to work? Or maybe it’s the cable/internet bill you tsk tsk over, or movie tickets they buy? It’s not for you to judge how people spend their money.

    3) A family or individual who chooses to save their money (if they have enough to do so) in a way that will earn at least nominal interest and, most importantly, give them access to that money for other needs (busted car, plumbing emergency, loss of job, etc) is not being irresponsible. It may be risky, but it is simply a different choice from what you make.

    Like I said in my first comment, my option for health insurance is to pay over $3K/year and still have a $3K deductible. So, you say it’s irresponsible, but I say having $3K in savings at the end of the year is better. Especially considering that all of the doctor’s visits my husband and I made this year would still have come out of our pocket.

    P.S. the comment regarding people who can’t afford insurance can’t afford to raise a child? Are you suggesting the poor shouldn’t be allowed to have children? Only rich folks should have that right? Having children, creating a family is a right of all people, not just those with X amount of income.

  18. Q,
    I think a lot of us actually have a better chance of getting cancer or other long-term, expensive healthcare issue than having a child.
    Moreover, a normal, healthy preganancy and childbirth can actually be hindered by the medical establishment. See my comment above re. C-sections.

  19. Q, I can afford health insurance and I have it, but I got it for myself, not for possible future children. If you’re going to lecture people to get insurance, tell them to do it for themselves, not for beings that don’t exist yet.

    Blix, It’s both. See the article Zuzu links to and my comment above @ 2.

  20. Since I live in a place where houses are, famously, cheaper than cars*, I find the whole idea that those who can afford a mortgage can afford to pay something like $800 + a month in individual health insurance to be utterly laughable.

    (note: this is true only technically. yes there are $5,000 houses around but they are usually in lousy shape, but the point stands)

  21. There is one more reason why pregnant mortals are dying in huge numbers unseen since the 1960s (and no one is reporting this one): barriers to abortion like never before.

    And I also agree with Redstar that procreation is a form of misogyny.

  23. I was talking about employed people who own homes “claiming” that they “can’t afford” health insurance.

    You’re looking at what’s happening to ARMs right now and have no idea how someone with a mortgage wouldn’t be able to afford health insurance?

    Sheesh.

  24. I was talking about employed people who own homes “claiming” that they “can’t afford” health insurance.

    I take it you’ve never visited the midwest or the south then, huh? Or many other areas of the United States. There are areas of the nation where the mortgages are quite low, but in those areas the pay scale is much lower, too. Health insurance still costs the same as it does in the metropolis.

    ‘Nother words, an apartment in Hipsterville could easily buy a year’s worth of mortgage for a large house in Bum Fuck. Yet residents of both burgs are probably struggling enough to meet their other obligations (food, transportation, utilities, childcare) that neither of them can pony up the $600-$800 (or more) for their families to have health insurance.

  25. And I also agree with Redstar that procreation is a form of misogyny.

    Come again?

    At the risk of a thread derailment, would you care to explain that, or was it just worded poorly? I can’t believe you meant that the way it sounded—that women who give birth are engaging in a form or practice of self-hate, and contributing to the oppression of themselves and other women. Did you mean to say that procreation is used as an excuse for misogyny?

  26. I was talking about employed people who own homes “claiming” that they “can’t afford” health insurance.

    Okay, other people have said as much already, but this is something that has really been pissing me off lately.

    Health insurance in America is so expensive, even the middle class can’t afford it. You’d think it wouldn’t take a huge leap of logic to realize this.

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