Born in the USA? Better not: Germany extends border controls with Switzerland for another twenty days

Born in the USA is the name of the album that made Bruce Springsteen a superstar almost forty years ago. Although the lyrics of the song of the same name are a bitter criticism of the shabby way the US treated Vietnam veterans, politicians today still like to play them at campaign events. After all, it sounds as beautiful as the triumphant hymn to a seemingly unbroken promise: everyone born in the USA, the land of the free, has automatically drawn the super ticket in the life lottery. Here you can become anything, here you can do anything.

We have known for a long time that this is not true. This is what poverty statistics, wealth distribution, access to education and higher education tell us. And more recently, birth itself.

For the first time in twenty years, infant mortality has risen in the United States. This is reported by the American health authority CDC (Centers for Disease Control and Prevention). According to preliminary statistics, there were 20,538 babies who did not reach their first birthday in 2022, an increase of three percent compared to 2021.

The authority recorded an even more extreme development in congenital syphilis: the number of babies born with the disease in the US has increased tenfold since 2012 to 3,761.

Blindness and other long-term consequences

Syphilis is a sexually transmitted disease. If a pregnant woman becomes infected, the baby in the womb can become infected. The disease can lead to miscarriages during pregnancy, blindness of the child after birth, bone damage or other long-term consequences. According to the CDC, how an infection affects the baby’s health depends on when the infection occurred and whether — and at what time — the mother received treatment.

Syphilis – which is treated with the antibiotic penicillin – was effectively considered largely eradicated in the US. The fact that it has become more common again in recent years, and more so among women, has been attributed in no small part to the escalating drug crisis and rising homelessness in the US. Many people do not even know they are infected because the disease easily goes unnoticed in its early stages.

It doesn’t have to be that this is such a threat to babies. Nine out of 10 cases of syphilis in newborns could have been prevented with timely testing and treatment during pregnancy, the CDC writes. In more than half of the cases, the mother tested positive for syphilis during pregnancy, but did not receive appropriate or timely treatment. And nearly 40 percent of cases occurred in women who received no prenatal care at all during pregnancy.

From a European perspective, this sounds completely absurd: a pregnancy without any precautions. But who gets what help in the American health care system is still a matter of money, education and often luck. Even as that number drops, at least eight percent of people in the U.S. still don’t have health insurance. Even if you live in the countryside, it is often a long way to the nearest town with a practice or clinic. And more and more they are closing.

The nongovernmental organization March of Dimes estimates that nearly 15 percent of pregnant Americans do not have access to adequate health care. This becomes even more important: more and more people suffer from chronic diseases such as high blood pressure, but also from addictions. The latter in turn makes people vulnerable to sexually transmitted diseases such as syphilis, due to the pressure to earn money for drugs through sex work.

Not a good place

Not only is the US not a good place to be born. They are also not a good place to give birth to a child. This affects some more than others: Maternal mortality – which is already many times higher in the US compared to other industrialized countries – is about three times as high among black Americans and indigenous peoples as among whites and Latinas. Similarly, for infant mortality, this ratio is approximately 2:1.

None of this happens by chance. The fact that more and more gynecological departments and clinics are closing is partly due to a declining birth rate in rural areas. However, the refusal of several Republican-controlled states to expand state-funded Medicaid health care to all adults below a certain income threshold also plays an important role. This means that clinics, which are already in financial trouble, miss out on reliable reimbursement of costs.

Whether tests and treatments for syphilis infections are part of the standard preventive screening program and therefore included in insurance coverage varies from state to state. And even if care for the pregnant woman herself is guaranteed, a partner who does not have access to syphilis treatment due to lack of money or insurance can re-infect her.

Forced to have children

But the problem is not just a failed health policy, it is also a reckless moral policy. Only 18 states require education to be “medically accurate,” and only 20 states require information about contraceptives that can protect against diseases like syphilis. Add to this the Supreme Court’s decision to abolish the fundamental right to abortion. The US religious right has been working towards this for decades.

Since then, numerous states have made abortions more difficult or banned, and dozens of abortion clinics have been forced to close. There is also a workforce shortage as gynecologists move to more liberal states for fear of breaking the law – and this workforce shortage exacerbates the problem of access to prenatal care.

Now on

In general, as experts have repeatedly warned and several studies have shown, both infant and maternal mortality could continue to rise in the future as a result of more difficult access to abortion: women are forced to have children they are unable to bear. concerns because of their living conditions that have a lower chance of survival due to health factors. If they experience complications themselves, in many places they and doctors are denied the opportunity to terminate the pregnancy.

How many children and mothers die is often used as a measure of a country’s prosperity. The world’s largest economic power is shockingly poor.

This article first appeared on Zeit Online. Watson may have changed the headings and subheadings. Here’s the original.