THE CMG VOICE

The United States is a dangerous place to have a baby

We hope that you never have to experience tragedy during childbirth. The sad reality is that the United States is a dangerous place to have a baby, despite all of its wealth and access to top health care. Especially if you are Black.

When it comes to infant mortality, the United States is an outlier among the most wealthy countries in the world. Of the 35 countries in the Organization for Economic Cooperation and Development (OECD), the US’s infant mortality rate ranks 33rd. As bad as that is, what makes the US the outlier is the inequality in these infant deaths: while babies born to non-Hispanic white mothers fare similarly to those of other wealthy countries, those from racial minorities and lower incomes fare much worse. Similar inequality exists in maternal health for non-Hispanic white mothers and racial minorities and lower incomes.

The data follows research in the state of California, which has some of the country’s best medical systems and support for pregnant women, new mothers and infants. California represents perhaps the best-case example of all US states.

The data itself is rather startling. Starting with 100,000 births, when we compare infant mortality – that is, a baby that dies before its first birthday – the rates are as follows: 173 of the babies born to White families that earn in the top 10% will not survive; 350 of babies born to White families in the bottom 10%; 437 babies born to Black families in the top earning 10%; and an astounding 653 die that are born to the bottom earning 10% of Black mothers. That last number is comparable to infant mortality rates in Botswana, Papua New Guinea, and Myanmar.

Additionally, maternal mortality remains appallingly high for Black women compared to non-Hispanic White women.

To put it another way, childbirth is more dangerous for the wealthiest Black families than it is for the poorest White families.

Taking a deeper dive into the data demonstrates that wealthy White families are more likely to have preterm or underweight babies, yet have lower infant mortality. This tells us that our system is able to provide the support the most vulnerable babies need, but is out of reach to large segments of our population.  

Finally, the study was based in economics rather than medicine; it was published by the National Bureau of Economic Research.