Biswaranjan Rout / AP

More U.S. mothers die in childbirth than in any other developed country, Vox reports. The maternal mortality rate in the U.S. — 26.4 deaths per 100,000 births — is three times higher than in the U.K., Germany, or Japan. It's eight times higher than the rate in the Netherlands and Sweden, two countries known for successful health care systems. And Texas has the highest maternal mortality rate in the developed world, with 36 mothers dying per 100,000 babies born.

Why it matters: The GOP health care plan proposes letting states opt out of the ACA's "essential health benefits" — a set of 10 categories of care that insurance plans are required to cover. One of the categories is maternity care.

Go deeper: A common cause of maternal death in the U.S. is placenta accreta, a condition in which a mother's placental tissue spreads throughout her body instead of containing itself to the uterus. This leads to severe internal bleeding, blood-clotting and, in many cases, death. A major risk factor for placenta accreta is a previous C-section delivery, which leaves residual scarring. Today, there are 60 times as many c-sections in the U.S. as there were in the 1950s.

But David Lagrew, an OB-GYN in California, told Vox that many of the C-sections performed in American hospitals are not medically necessary. Rather, they are convenient for the doctor or patient. Lagrew's organization, California Maternal Quality Care Collaborative, collects childbirth data from dozens of hospitals and analyzes which C-sections were necessary and which were not. He reports back to the hospitals to bring down their C-section rates.

This story has been updated to correct the description of how the Republican health care plan treats essential health benefits.

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Illustration: Aïda Amer/Axios

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What Matters 2020

The missed opportunities for 2020 and beyond

Photo illustration: Sarah Grillo/Axios. Photos: Jason Armond (Los Angeles Times), Noam Galai, Jabin Botsford (The Washington Post), Alex Wong/Getty Images

As the 2020 presidential campaign draws to a close, President Trump and Joe Biden have focused little on some of the most sweeping trends that will outlive the fights of the moment.

Why it matters: Both have engaged on some issues, like climate change and China, on their own terms, and Biden has addressed themes like economic inequality that work to his advantage. But others have gone largely unmentioned — a missed opportunity to address big shifts that are changing the country.

Pence chief of staff Marc Short tests positive for coronavirus

Marc Short with Katie Miller, Vice President Pence's communications director, in March. Photo: Doug Mills/The New York Times via Reuters

Marc Short, Vice President Mike Pence’s chief of staff, tested positive for the coronavirus Saturday and is quarantining, according to a White House statement.

Why it matters: Short is Pence's closest aide, and was one of the most powerful forces on the White House coronavirus task force.