[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.

[sshine]

> ... murder by a spouse ... is not what “maternal death rate” typically measures

That is a good example.

While perhaps unrelated to pregnancies, it is incidentally another difference between US and Norway.

[insickness]

You can't say that from these statistics if the statistic in Norway does not include murder by spouse.

[sshine]

That is correct.

I am making that claim without backing it up by references.

My point is that there are other correlated factors that explain death rates than pregnancy.

Another one might be that the death rate in the fertile age group could simply be higher, too, although I don't know if that is true.

[dtech]

It is not relevant for the study cited in the article

[wjnc]

The study cited uses OECD data. If the US does not adhere to the OECD guidelines for the data fields, for example by collecting a too broad measure and not correcting for it, studies are going to compare apples to pears. Not saying that the conclusion is false. But researchers should do their due diligence on the way international statistics are compiled.

[omnicognate]

> But researchers should do their due diligence on the way international statistics are compiled.

Do you have some evidence they didn't?

[AnthonyMouse]

If the US collects the data in a different way and then doesn't publish anything else, there is no other data available. All you can do is include a note that explains why the numbers aren't comparable.

[wjnc]

Sorry, the 'should' probably has an unintended negative connotation when talking about a specific study.

To delve a little deeper. They seem aware (under HOW WE CONDUCTED THIS STUDY [1]): "While the information collected by the OECD reflect the gold standard in international comparisons, it may mask differences in how countries collect their health data. Full details on how indicators were defined, as well as country-level differences in definitions, are available from the OECD."

They do not mention the specific CDC caveat mentioned above regarding the check box on US death certificates.

And then the pincher: The study points to CDC [2] where explicitly this effect is mentioned as a possible issue with the reporting via death certificates ("Efforts to improve data quality are ongoing, and these data will continue to be evaluated for possible errors.").

I'll leave the interpretation to you. They mention there is a gold standard and that some countries might not follow that gold standard. The conclusion is mainly based on US CDC data vs. OECD non-US data. They link to a CDC report mentioning this issue. Should they mention this fact in the study in the main body, or is this transparant enough?

Going back to the Noahpinion link with graph above in this discussion. For me the time series gives quite the hint that ICD-10 is not being followed appropriately and that false conclusions may arise. If this were my report, I'd take one or two paragraphs to explain why this issue doesn't affect my conclusions in the main body of text.

And then even a 'How to solve this (partially)'. As an actuary I know death is very unlikely in the childbearing age. Show a comparison table of deaths per 100k for women in the age of 20-40 between countries, including the 'US-Black' category. If that comparative line is a lot more flat (my expectation), I would really presume there is a data collection issue. The other interpretation would fail Occam's razor (that non-pregnancy death in US / US-Black categories are less likely than in other OECD-countries). First inkling: [OECD - 3], US ASMR in Women up to 20% higher than other countries.

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

[2] https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022...

[3] https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_MORTAN#

[limpbizkitfan]

Reporting differences don’t fix the fact that they also claim that 80% of these deaths are preventable.

The US healthcare system is always being designed around profit requirements and care constraints, and not vice versa. Nobody here (save for Medicare) really knows what the proper reimbursement is for care, and we waste needless amounts of time and money on quackery (naturopaths, supplements, chiropractic) instead. The reason why we open more “cancer centers” rather than adequate emergency or trauma care is because these hospital systems want to sell a Veblen good to wealthy people with cancer. There’s hope though, if we erase the weird private insurance industry we might start seeing prices and care reflect needs vs. means.

[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.