Women in Detroit are dying from pregnancy-related complications at about three times the US average, according to the Michigan Department of Community Health.

Twenty-six women died in Detroit over the period 2008-2011 as a result of pregnancy or childbirth, and Detroit has the highest rate of infant mortality among major US cities, with 13.5 infant deaths for every 1,000 live births.

According to Dr. Priya Agrawal, executive director of Merck for Mothers (an initiative launched to reduce maternal mortality), popular opinion in the US suggests maternal and infant death happens only in developing countries, but data proves otherwise, with US national rates increasing, even as maternal mortality rates worldwide decline.

“[Americans] don’t think women are dying [from pregnancy] in the US, let alone that the rate is going up,” Dr. Agrawal said.

The US is one of just eight countries where the number of maternal deaths increased between 2003 and 2013, according to a recent study published in The Lancet. That study found that in 2013, for every 100,000 births in the US, about 18.5 women died, even though it is more expensive to give birth in the US than anywhere else in the world.

Experts attribute the high maternal death rate in Detroit to a mix of chronic health conditions, which African-Americans suffer more often. African-Americans are up to four times more likely to die of pregnancy-related causes than white women, and almost 83 percent of Detroit’s population is black or African-American, according to US Census data.

Poverty also plays a critical role in the city’s high maternal and infant death rates. Detroit is the poorest major city in the country, with about 40 percent of the population living under the poverty line. Poorer individuals in the US often struggle to get the access to health care they need. And black women in the US are currently twice as likely not to receive prenatal care than white women.

Detroit also has a shortage of primary care physicians, some of whom do not accept Medicaid. Still, the recent expansion of Medicaid in the state – made possible through the Affordable Care Act (ACA) – will help provide necessary preventive health services that will help ensure that women can manage health conditions before and after pregnancy.

Media Resources: The Detroit News 7/10/2014, 1/30/2014; Child Trends 11/2014; US Census Bureau; Feminist Newswire 5/9/14; Think Progress 5/6/14