(Meredith) — An in-depth investigation by USA Today reporters finds the U.S. to be the most dangerous developed nation to give birth.

The vast majority of births go just fine, but every year, about 700 mothers die from childbirth in the U.S. and more than 50,000 suffer serious injury. And the number of mothers dying from childbirth is actually rising.

Between 1990 and 2015, the number of maternal deaths per 100,00 births has gone up from less than 18 to more than 26. Other nations like Germany, England, and Canada have less than 10 deaths per 100,00 births — and most of their numbers are dropping. The investigation cites information from this study published in The Lancet medical journal.

In the U.S., maternal death rates vary widely from state to state. Louisiana, Georgia, and Indiana all have more than 40 deaths per 100,000 births. California, the safest place to give birth in the U.S., only has 4 deaths per 100,000 births. The investigation attempts to find out why mothers in California survive when mothers in Louisiana don’t.

The investigation concludes that the best way to prevent deaths caused by childbirth is to strictly follow safety practices known for years. The biggest causes of these preventable deaths are things like excessive bleeding and hypertension. Health experts agree that hospitals should measure the amount of blood a patient loses during childbirth, and to monitor and react to blood pressure changes quickly. These safety measures are implemented widely in California, but hospitals elsewhere have been slow to adopt the practices.

Dr. Steven Clark, a childbirth safety expert at Baylor College of Medicine, said,”Our medicine is run by cowboys today, where everyone is riding the range doing whatever they’re wanting to do. …It’s a failure at all levels, at national organization levels and at the local hospital leadership levels as well.”

The understanding and adoption of these important safety measures has increased in recent years. The Alliance for Innovation on Maternal Health has a program for childbirth safety, and in the past year, the number of hospitals participating in their program has doubled. There are now 985 hospitals participating in the AIM program, which is about 40 percent of birthing hospitals in the U.S.

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