For most of human history, pregnancy has come with a significant risk of death. Up until the early 1930s in America, nearly one woman died of related complications for every 100 live births. Thanks to advances in obstetric medicine and widened access to better care, the maternal-mortality rate declined by almost 99% over subsequent decades-one of the great public-health achievements of the 20th century. By 1987, fewer than eight women died for every 100,000 live births. Over the past quarter of a century, however, America's maternal-mortality rate has been creeping backup (see chart). By 2013 the rate had ticked up to 18.5 women for every 100,000 births (these numbers include women who die within 42 days of childbirth). This makes America an international outlier. Between 2003 and 2013 it was one of only eight countries, including Afghanistan and South Sudan, to see its maternal-death rate move in the wrong direction. American women are now more than three times as likely to die from pregnancy-related complications as their counterparts in Britain, the Czech Republic, Germany or Japan.
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