Improvements in medicine and public health around the world have helped to reduce the mortality rate for mothers giving birth. From 2000-2015, the maternal death rate fell by more than a third. The reduction has been consistent over time and covering most underdeveloped countries.

That’s why it is so striking that, in the United States, maternal mortality from pregnancy or childbirth complications has risen almost the same percentage. Among the developed countries, only Mexico has a higher maternal mortality rate. The explanation is multi-factorial: increased maternal age, increase in chronic illness during pregnancy, and substance abuse in many communities are some of the reasons.

In the face of this startling statistic, many efforts are being made to reduce or reverse the trend. On both the national and local level many organizations are dealing with the underlying reasons for maternal mortality: The Council on Patient Safety in Women’s Health Care, the Alliance of Innovation in Maternal health, and “Merck for Mothers” are three of the groups focused on reversing the maternal mortality rate in the U.S.

They are sponsoring technical assistance to local hospitals to address some of the major problems, such as obstetric hemorrhage, severe hypertension, and venous thromboembolism. The Merck for Mothers program funds local groups that use community health workers to improve health care system navigation for low-income pregnant women.

The problems have been most persistent in African-American women, who have a four-fold risk of maternal mortality. So some programs are focused on improving health education and outreach in that particular community.

The goal of these efforts is to bring the American mortality to levels comparable to those in Western Europe. At least, the hope is that the U.S. can no longer be next to last among all developed countries. We have the most expensive health care costs in the developed world, and it seems anachronistic that the quality of that health care is in such dire shape.