The United States is currently one of the wealthiest and most advanced countries in the world, yet, it is also one of just eight nations on Earth in which the number of pregnancy and childbirth related deaths is rising instead of falling. According to the Center for Disease Control and Prevention, 7.2 out of every 100,000 mothers passed away during live births in 1987. By 2011, that number had increased immensely, jumping to 17.8 deaths per 100,000 births.

According to experts in the field of labor and delivery, more than one factor is to blame for the number of American women dying during childbirth. Issues including hypertension, obesity-related complications, diabetes, a staggering increase in cesarean deliveries and lack of access to affordable and quality health care are all partially to blame.

Dr. William Callaghan, chief of maternal and infant health at the CDC has helped to shed some light on this troubling upward trend. According to Callaghan, "We’ve seen a big bump in cardiovascular disease and chronic disease contributing to maternal deaths. Underlying heart disease is common, diabetes is common. We now have a group of women bringing with them into pregnancy their entire health history.”

Marian MacDorman, a research professor at the University of Maryland, feels the severity of the situation. She has shared, "This is a really important issue. These are deaths of young women with families and often young children who need care.”

“It’s the thing that wakes us up in the middle of the night as we try to understand it,” adds Callaghan.

Recent research into this growing problem in the United States has unearthed some outrageous and extremely troubling reasons for the country's continued increase in maternal deaths. Read on for 15 possible causes.

15 Record Keeping Problems

Possibly in an effort to remove a portion of the blame from their shoulders, some health care professionals argue that the troubling increase in maternal deaths may be, at least in part, due to the improvement recent technology has lended to the ability for medical facilities to keep an accurate record of maternal mortality.

In other words, some experts in the field claim the troubling statistics may represent the fact that deaths during childbirth in the past may have gone unreported in some instances, while now, accuracy of records has caused the number of deaths to appear to have increased more than they actually have.

MacDorman begs to differ. She feels the 27 percent increase in deaths of mothers due to pregnancy or childbirth are an accurate representation of a disturbing upward trend that must be addressed She does not feel the spike in the mortality of new mothers is a reporting issue.

14 Obesity Epidemic

An increasing number of women in the United States are suffering from chronic health issues due to obesity. Among these problems are heart disease, high blood pressure and heart disease.

Elise Turner, an associate professor of nursing at Belhaven University in Mississippi and a nurse midwife with more than 35 years experience, has stated that the current obesity epidemic sweeping the United States is a "tremendous piece" of the overall problem.

According to Turner, "The body is already stressed by obesity and the other accompanying diseases, such as hypertension, diabetes and things that accompany that and then you put the demands of pregnancy on top of that and it's just very difficult."

Dr. Michael Brodman, chairman of the department of obstetrics, gynecology and reproductive science at the Mount Sinai Health System in New York agrees. Brodman has shared, "We didn't specifically have protocols for dealing with obese patients. We didn't treat them differently and in reality, you have to treat them differently."

13 Medical Egos 

After it came to light that the state of New York was plagued with one of the worst rates of maternal mortality in the country, Brodman met with approximately 50 other OB/GYNs to the get to the bottom of the problem. It was initially believed that the issue was the diverse population in New York, but was soon discovered that the main problem was the wide variety of methods used to care for pregnant women and new mothers depending on the state, the hospital or even the doctor.

Brodman shared of the group's discovery, "If you're in Sweden, everybody gets treated the same way. If you are in New York City, you get treated one way. If you're in Buffalo, you get treated another way and if you're in Missouri, you get treated another way...This is that sort of U.S. individualistic kind of thing, 'I know what I'm doing. This is how I'll do it.' In health care, at the end of the day, that doesn't work."

According to Brodman, in the United States, medical professionals sometimes let their egos get in the way of best practice. He continued, "'No one tells me to wear a helmet when I'm riding my motorcycle. I am allowed to do what I want,' that kind of mentality. Well, doctors have that, too, and in reality, it doesn't work in health care."

12 Lack Of Accessibility To Good Care

Another factor that is likely contributing to the steady rise of maternal deaths in the United States is the amount of women in the country lacking access to quality care. One example of this took place in the Lone Star state. From the year 2000 until the year 2015, the state of Texas made changes to many of their reproductive health services that weren't for the better. The state closed several clinics that previously offered abortions and did away with other services. The family planning budget for the state was cut by two-thirds in 2011.

During the same time period, Texas saw a major increase in maternal mortality. Although experts claim the lack of access to good care was not the only reason for the spike in deaths of moms-to-be and new mothers, the Texas Tribune reported it may have been a major contributing factor.

MacDorman also weighed in on the deaths in Texas. She stated, “I’ve done my best to try to investigate this as a data error and I can’t find any changes to account for it. It’s very concerning what’s happening in Texas.”

11 Increase In C-Sections

Currently, approximately one in three expecting American women will deliver via C-section. Twenty years ago, the number was one in five. From 1996 to 2007, C-section rates among American women went up 53 percent. Currently, 32 percent of all babies in the United States are delivered via C-section.

Brodman feels the increase in C-sections in recent years may have a lot to do with the fear many medical professionals harbor of being sued. Changes in malpractice laws and a younger generation of OB/GYNs that are more aware of the risk lawsuits ruining their professional careers may have exacerbated these fears, but he still has hope for the future.

He has stated, "People are not sitting on the labor floor thinking, 'If I make the wrong decision, I'm going to get sued,' so all of that hysteria and paranoia, I think, is abated, which is a good thing," he added.

According to Dr. Michael Lu, an associate administrator with the Maternal and Child Health Bureau at the Health Resources and Services Administration, "Cesarean has its place, and it has saved the lives of mothers and babies, but [also] has its complications and these can increase the risk of maternal death."

10 African-American Women Are More At-Risk

According to the CDC, African-American women are three times more likely to pass away due to complications from pregnancy or childbirth than white women in the United States.

Why? A spokesperson for the CDC has stated, "We know that black women dying from pregnancy-related causes are younger, less educated, more likely to be unmarried, more likely to start prenatal care in the second (or) third trimester of pregnancy or not at all, when compared to white women, but except for that, we don't know a lot."

Poverty and lack of insurance coverage are non-medical factors that should be considered when attempting to determine why the rate of maternal death is so much higher among African-American women. While they are not necessarily more likely to suffer from potentially life threatening conditions such as hemorrhage or preeclampsia during pregnancy, when these conditions present themselves, African-American women are more likely to die from them.

9 More Women Are Having Children Later In Life

The CDC has determined that while only 15 percent of babies born in the United States arrive to mothers in the 35 years and older age bracket, approximately 29 percent of all pregnancy-related deaths occur in women who are 35 years of age or older.

A CDC spokesperson sheds light on why: "Because women are delaying childbearing, a larger proportion of them are likely entering pregnancy with a burden of chronic disease conditions. Many studies have shown that an increasing number of pregnant women in the United States have chronic health conditions such as hypertension, diabetes, chronic heart disease and all these conditions can put a pregnant woman at higher risk of pregnancy complications."

Lu has stated, "It’s not clear whether it’s age, or that older women have more chronic conditions when they enter pregnancy. The demographic of childbearing is changing. Women are getting older and they are entering pregnancy with more conditions like obesity, diabetes, and heart disease."

8 Lack Of Sufficient Mental Heath Care For New Mothers

Up to one in five women suffers from some form of anxiety or depression during or after pregnancy, while postpartum psychosis is found in around one of every 1,000 new mothers.

Lynne McIntyre, manager of the maternal health program at Mary's Center for Maternal and Child Care in Washington, D.C., and a survivor of postpartum depression, has said on the subject, "I have had African-American friends tell me, so it was firsthand, they were on the receiving end of messages including, 'That's a white woman's disease. We don't get that.'" McIntyre was suicidal after her son was born, but pulled through the darkness. She now works to save other women from this silent yet deadly disease.

Dr. Judy Greene, director of women's mental health at Bellevue Hospital Center in New York, "There's a fear that if one opens up...that child protective services would become involved, and it's not uncommon for women to fear the extreme that their children will be taken away from them." The fears of being shamed or seen as unfit mothers often cause women to suffer in silence, in many cases until it is too late.

7 The Focus Is On The Baby

One surprising statistic is the fact that as maternal mortality rates in the United States continue to rise, infant mortality in the country is the lowest it has ever been. It seems the American medical system is currently putting all of the focus on the safety of unborn babies and infants, while neglecting the health and well-being of the mothers.

Barbara Levy, vice president for health policy/advocacy at the American Congress of Obstetricians and Gynecologists (ACOG) and a member of the Council on Patient Safety in Women's Health Care has admitted, "We worry a lot about vulnerable little babies. We don't pay enough attention to those things that can be catastrophic for women."

It was reported that in 2016, most states devoted approximately 6 percent of block grants under the Title V federal-state program to care for mothers, while 78 percent of the funds went to programs for infants and children with special needs. Additionally, Medicaid, which covers approximately 45 percent of all births, covers mothers for only 60 days postpartum, while infants have coverage for a full year after their arrivals.

6 Medical Professionals Don't Know Enough About Treating New Mothers

Young doctors specializing in the field of maternal-fetal medicine are often focused mainly on infant care. In fact, beginning in 2012, those with a desire to work in the field were not required to spend any time learning about caring for birthing mothers. Around the nation, more than 20 hospitals have care centers focused on providing care for babies that are at a high risk of developing complications. Currently, New York-Presbyterian/Columbia is the only hospital in the United States to have a similar program focused on high-risk new mothers and mothers-to-be.

Women are often discharged from the hospital with information about how to feed and care for their infant, and what to do if their baby has any medical problems, but receive very little information on how to determine if they themselves are in need of medical attention.

Elizabeth Howell, professor of obstetrics and gynecology at the Icahn School of Medicine at Mount Sinai Hospital in New York City has shared, "It was only when I had my own child that I realized, 'Oh my goodness. That was completely insufficient information. The way that we've been trained, we do not give women enough information for them to manage their health postpartum. The focus had always been on babies and not on mothers."

5 Inability Of Medical Professionals To Recognize Dangerous Symptoms

Lauren Bloomstein, an experienced NICU nurse, passed away due to preeclampsia soon after her daughter, Hailey, was born. Afterwards, it came to light that medical professionals missed many crucial signs that something was very wrong until it was much too late. About 90 minutes after giving birth, Lauren still hadn't eaten anything and was complaining of stomach pain. When her husband, orthopedist Larry Bloomstein, questioned her doctor about what may be wrong, he recalls, "He was like, 'I see this a lot. We do a lot of belly surgery. This is definitely reflux.'"

Soon, Lauren's pain was excruciating. At the time a nurse recorded,"Patient [is] unable to stay still." Also alarming, her blood pressure was dangerously high. Larry would later find out that her blood pressure readings had been abnormally high since she had arrived at the hospital, but while baby-to-be Hailey's vital signs were continuously monitored during labor, Lauren's blood pressure wasn't checked once over a nearly eight hour period. Later, Lauren's doctor, Vaclavik stated in court, it "might have been recommended to be monitored more closely, in retrospect."

Many symptoms of preeclampsia including swelling, gastric discomfort, vomiting, anxiety and headache can be mistaken for routine symptoms women experience while pregnant or after delivery, adding to the possibility of a misdiagnosis. According to Eleni Tsigas, executive director of the Preeclampsia Foundation, "We don't have a yes-no test for it. A lot of physicians don't necessarily see a lot of it."

4 Suffering In Silence 

Many dealing with the loss of a loved one due to complications with pregnancy or childbirth are left numb and unable to process what has happened. A time that should be filled with joy and celebration becomes a bittersweet experience for all left behind to care for a motherless child. One reason maternal deaths continue to rise may be the silence that often follows the tragic occurrence of the passing on of a new mother.

During the grieving process, loved ones aren't emotionally equipped to deal with questioning whether or not the death could have been prevented. After Lauren's death, Larry took time off of work and eventually quit his job altogether. He sold the house he and Lauren planned to raise Hailey in together, and became something of a recluse. He shared of the time, "It's strange for people to see a father alone. You're walking around this world and all these people are around you, and they're going on with their lives and I just felt very, very isolated and very alone with that."

Unlike many others who understandably don't spend too much time reliving the painful experience of losing a loved one, after some time, Larry decided to delve into the cause of Lauren's death and investigate whether or not it could have been prevented.

3 Medical Error Is Usually To Blame When A New Mother Dies

Other people in Lauren's and Larry's circle had been asking questions about her care since the night she died. Larry's friends in the medical field pushed him to look further into what went wrong in the hours following Hailey's delivery. It was painful for Larry to consider that Lauren's  death could have been  prevented, but his friends weren't backing down. He has shared, "And my friends were like, 'We can't accept that ... With our technology, every single time a woman dies [in childbirth], it's a medical error.'"

When a new mother passes away in the United Kingdom, the tragedy is always considered a system failure. Each and every death of a woman due to complications from pregnancy or childbirth is reviewed by a national committee. Medical records and assessments from caregivers are scrutinized. This process has been credited for the amazing decrease of deaths due to preeclampsia in the U.K. in recent years.

In the United States, maternal death investigations vary from state to state. Currently, only 26 states have an established process for looking into pregnancy and childbirth related deaths. Usually, reviews of cases can take years, and anything the committees in place do find doesn't get much attention.

2 Medical Professionals Are Not Following Protocol

In 2012, Larry filed a complaint against Monmouth Medical Center, where Lauren gave birth and later passed away. The New Jersey Department of Health looked further into the matter, interviewing Lauren's caregivers and looking over the policies and practices at Monmouth. Afterwards, they determined, "There is no record in the medical record that the Registered Nurse notified [the ob/gyn] of the elevated blood pressures of patient prior to delivery."

Investigators also determined that, "There is no evidence in the medical record of further evaluation and surveillance of patient from [the ob/gyn] prior to delivery...There was no evidence in the medical record that the elevated blood pressures were addressed by [the ob/gyn] until after the Code Stroke was called."

The conclusion of the report was, "The facility is not in compliance. The facility failed to ensure that recommended obstetrics guidelines are adhered to by staff."

Despite these findings, the only changes the hospital made to its protocols as a result were unimpressive: "Staff nurses were educated regarding the necessity of reviewing, when available, or obtaining the patient's [sic] prenatal records. Education identified that they must make a comparison of the prenatal blood pressure against the initial admission blood pressure." Additionally: "Repeat vital signs will be obtained every 4 hours at a minimum."

Larry was disappointed to learn that the DOH's determination was a private ruling, and would never be public knowledge. The findings beg the question: how many new mothers pass away because medical staff fail to follow protocol?

1 "It's Never Just One Thing"

An analysis of maternal mortality data from four different states was recently conducted by the CDC Foundation, and the findings are quite revealing. Over 20 "critical factors" that contribute to pregnancy and childbirth-related deaths were identified. Among them were lack of standardized policies, failure to consult with specialists, inadequate clinical skills and poor coordination of care. On average, a maternal death is due to 3.7 critical factors.

Larry Bloomstein, who has filed a medical malpractice lawsuit against Monmouth Medical Center, Lauren's obstetrician Vaclavik and five nurses, has remarried since Lauren's death, and is moving on the best he can, but the pain of her loss will always remain. Larry has shared, "By far the hardest thing for me to accept is [what happened] from Lauren's perspective...The amount of pain she must have experienced in that exact moment when she finally had this little girl ... I can accept the amount of pain I have been dealt. But [her pain] is the one thing I just can't accept. I can't understand, I can't fathom it."

Perhaps Robyn D'Oria, Executive Director of the Central Jersey Family Health Consortium best described up how tragic the loss of a new mother is to all involved. D'Oria wisely mused, "When you take that one death and what that does, not only to the husband, but to the family and to the community, the impact that it has in the hospital, on the staff, on everybody that's cared for her, on all the people who knew them, it has ripple effects for generations to come."

Sources: NPR.org, Time.com, CNN.com, NYTLive.NYTimes.com