https://researchopenworld.com/higher-maternal-death-rates-occur-in-rural-united-states-and-illinois/#

Nationally and internationally, maternal mortality is an important indicator of the quality of a nation’s healthcare [1]. Recent statistics reported by the Centers for Disease Control and Prevention (CDC) indicates an increase in the pregnancy-related maternal mortality ratio (MMR) to 17.0 deaths per 100,000 live births from 2011–2013 [2], while in Europe and maternal death rates are declining [3,4]. When analyzing the demographics of maternal deaths in the U.S., it appears pregnancies in rural environments are more at risk, with some maternal mortality rates in rural areas as high as 28.7 deaths per 100,000 live births [5]. A study by Kozhimannil and colleagues [6] demonstrated a rise in the maternal mortality and morbidity of both rural and urban areas, but rural mothers had a 9% greater chance of an adverse outcome compared to the urban mothers. The WHO has identified several factors that account for 75% of all maternal deaths: severe bleeding and infections after childbirth, pre-eclampsia and eclampsia, complications from delivery, and unsafe abortion [7]. The majority of these conditions could be prevented if recognized and treated by a skilled medical professional and if birth takes place in a sanitary place early enough (e.g. hospital), which can be difficult if the patient lives in an area with a shortage of skilled healthcare providers or a long distance from these professionals, as is often the case in rural settings. The purpose of this article is to examine the differences in maternal death rates between rural and urban Illinois stratified by urbanization level and race/ethnicity from 2007 to 2016.