The United States is one of the only developed countries in which the maternal mortality rate (MMR) is not decreasing. In fact, it is higher now than it was fifteen years ago. Access to healthcare is the linchpin for safe pregnancies. A decrease in access to healthcare and a lack of access to contraceptives increase the problems that lead to maternal mortality.
A rise in the maternal mortality rate is indicative of larger issues centered around women’s rights to health care. The birth control mandate of the Affordable Care Act (ACA) requires private employers to provide women with access to birth control. President Trump’s administration’s recent roll back of the provision gives evidence to a failure in the health care system to adequately provide basic health services to women.
The ACA’s main goals were to eliminate discriminatory disparities in the health care system. Section 1557 prohibits discrimination by any federal health care program on the basis of race, sex, national origin, age, or disability. Additionally, it sought to extend health care to those who cannot afford it by expanding Medicaid. In spite of the ACA, there is still systemic discrimination against women, especially against women in minority groups. Women living below the poverty line or women of color are more likely to lack insurance, placing them at a higher risk for poor maternal health.
Access to family planning or regular primary care, which makes birth control and other basic health care needs available, are more difficult to obtain for women in minority groups because they are less likely to have a primary care provider. This raises the risk of unintended pregnancies and subsequently the risk of complications during pregnancy. The attack on the birth control mandate and other provisions of the ACA will raise costs by making women pay for birth control out of pocket. This will force many women living at the poverty line to forego birth control, which will only worsen the already increasing maternal mortality rate statistics.
The Convention on the Elimination of all forms of Discrimination against Women (CEDAW) delineates the fundamental human rights of women. Article 3 requires that countries take all appropriate measures to ensure women can exercise and enjoy fundamental human rights. Health care is a basic human right, and President Trump’s administration’s attack on the very provisions protecting women’s rights to health care is a serious detriment to their enjoyment of human rights. Furthermore, Article 12 requires countries to take all appropriate measures to eliminate discrimination against women in health care, such as ensuring the right to health care services like family planning.
The United States has signed CEDAW, but it has not ratified it. This means that the United States generally agrees with the provisions, but it is not legally bound by them. However, President Trump’s administration’s recent attacks on the ACA disproportionately affect women, and makes it difficult to infer that the administration agrees with CEDAW. If the United States is truly in agreement with CEDAW, it will ratify it and become legally bound to it. There are valuable lessons to be learned from other developed countries that have ratified the convention. It is no coincidence that Canada, Sweden, Finland, and the United Kingdom have all ratified CEDAW, and also have better maternal mortality rates than the United States. The lesson the United States can learn is that protecting women’s rights to health care make women safer.
For the United States to truly implement policies that benefit women, there should be a push for more equal representation in the government. Women should have controlling interest in policy decisions that affect them; however, only 19.6 percent of representatives in congress are women. Article 7 subsection b of CEDAW requires that countries ensure women’s right to participate in the formulation and implementation of government policies. It is imperative that the United States foster inclusivity in its policies to best represent the actual interests of women.
In order to uphold its obligations to protect women’s rights, the United States must ratify CEDAW, and take all appropriate measures to ensure equitable healthcare for all women. The United States must also continue to build upon the foundation laid out by the ACA. If the United States government continues to undermine and dismantle women’s reproductive rights and rights to healthcare, the maternal mortality rate will only continue to increase.