[tyoma]

Kind of relevant: https://www.noahpinion.blog/p/how-many-of-our-facts-about-so...

> In 2021, Joseph et al. published a paper in Obstetrics & Gynecology demonstrating that the entire recorded increase in maternal mortality since 2003 was due to a change in the way data was gathered. In 2003, U.S. states began to include pregnancy checkboxes on death certificates. This led to a whole lot more women who died while pregnant being identified as such. The apparent steady increase in maternal mortality was due to the fact that states adopted this new checkbox at different times:

> In fact, when the authors looked at the common causes of death from pregnancy, they found that these had all declined since 2000, implying that U.S. maternal mortality has actually been falling. Meanwhile, a CDC report in 2020 had found the same thing as Joseph et al. (2021) — maternal mortality rose only in states that added the checkbox to death certificates.

[omnicognate]

The CNN article is about this [1] study, which is based on OECD 2023 maternal mortality data. OECD says here [2] about "Definition and Comparability":

> Maternal mortality is defined as the death of a woman while pregnant or during childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from unintentional or incidental causes. This includes direct deaths from obstetric complications of pregnancy, interventions, omissions or incorrect treatment. It also includes indirect deaths due to previously existing diseases, or diseases that developed during pregnancy, where these were aggravated by the effects of pregnancy.

Edit: [1] Also references [3], a 2022 CDC report saying over 80% of pregnancy-related deaths were determined to be preventable.

[1] https://www.commonwealthfund.org/publications/issue-briefs/2...

[2] https://www.oecd-ilibrary.org/sites/1ea5684a-en/index.html?i...

[3] https://www.cdc.gov/maternal-mortality/php/data-research/?CD...

[gorbachev]

That may be relevant to something, but not to why the difference is so drastic between Norway and US.

It is indicative of the US healthcare system, however, that up until 2003 it wasn't even known, statistically, that women were actually dieing of childbirth.

[tyoma]

It is very relevant. The US definition of maternal death is very expansive. The expanded definition counts any reason a woman who was recently pregnant and dies.

The prototypical example is murder by a spouse. While tragic and extremely important to collect for policy reasons, it is not what “maternal death rate” typically measures.

[vasco]

NVSS has reported monthly updates on this since the 60s, it's wrong to say it wasn't known statistically I think. Maternal mortality review committees have existed since the 1930s also which provide extra data. Maternal mortality is one of the most important vital metrics to track for any country so it indeed would be surprising not to have more data.

[RheingoldRiver]

Additional info here: https://foreignpolicy.com/2024/01/31/united-states-maternal-...

[refurb]

It’s amazing how often you find out the differences in metrics are due to how data is collected not due to actual differences.

I read a good paper(1) about newborn deaths rates in Cuba. It’s often touted that Cuba has amazingly low newborn death rates which obvious means communism has far better healthcare than capitalist systems.

Turns out it’s a reporting artifact. If you correct for it, they have the same death rate as other Central American countries with similar GDP per capita.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681443/

[throwawayqqq11]

Can you please explain the different data collection of norway to reach almost zero?

I just finished this comment before reading yours.

https://news.ycombinator.com/item?id=40607378

[ks1723]

In the same direction: https://ourworldindata.org/rise-us-maternal-mortality-rates-...

[ZeroGravitas]

World in Data's stats from before this 2003 statistical change happened:

https://ourworldindata.org/grapher/number-of-maternal-deaths...

[nonrandomstring]

How does moving the discussion to the legibility of the rate of change help us understand why large numbers of women are still dying from pre-industrial causes in the richest nation?

[throwawayqqq11]

Yea, US americans in here try really hard to reason their numbers away and ignore the comparand.

[pj_mukh]

Man! this plus the teenage suicide/mental health rate stats also possibly being an illusion (Obamacare changed data rules the same time mobile social media was taking off, obfuscating everything) has really thrown me for a loop. Not sure what to believe!

[roenxi]

A related effect is there is a real tendency in online debates to use countries that speak exotic foreign languages as examples. So there is no way of working out what the data actually represents, what the known strengths and weaknesses are or what they are trying to measure. Or what the legal framework is.

[complex1314]

Most statistical data in Norway is also available in English: https://www.ssb.no/en

[bloqs]

Apart from the bit where Norwegians speak better English than Brits and Americans

[complex1314]

And google translate can help with exotic languages, here's an in depth on methodology:

https://www-ssb-no.translate.goog/helse/artikler-og-publikas...

[calgoo]

Are saying that Norway speak an exotic foreign language, so we should ignore their results because some people feel that we cant trust their information? Does that mean that we should not compare the US system to these other nations? Who can we compare it to in that case, UK, Australia and New Zealand?

[pjc50]

> exotic foreign languages

> Norwegian

Come on, it's in the same writing system, runs through google translate, and there are plenty of English speaking Norwegians.

[rightbyte]

Norwegian and English is even in the same language group.

[oblio]

Yeah, Norway is conspiring to dethrone the mighty US through crooked statistics, we all know that Norwegians are infamous scoundrels! :-D

[jajko]

OK thats all fine, this kind of discrepancies/errors happen all the time in statistics. You for some reason completely avoid massive discrepancy between 0 and what US reports. The fact that its slowly falling from relative stratospheric heights gives no comfort to common US citizens, when clearly it can be done much, much better.

I think we all know most probably the main reason - US healthcare is a business with huge prices compared to anywhere else in the world including nations with higher salaries, not public service. So its all nice and top notch if you have millions in some form, not if you are remaining 95% of the country. General compassion to fellow citizens in need is not a strong point of US in general, is it.

People like me could move literally anywhere in the world if wanted. I moved to Switzerland from my crappy home country for example. But hell will freeze sooner than I would want to raise my kids or get old in US, no thank you for many reasons and this being one of biggest.

[dvt]

> OK thats all fine, this kind of discrepancies/errors happens all the time in statistics.

That's not what the article is tackling. Rather, it's quite literally about what types of deaths get categorized as "maternal mortality."