内容摘要：Pressed against the fringes of the small northern city of Cuauhtemoc, the Mennonite settlement here spans about 40 kilometers (25 miles). With 23,000 residents, it’s one of Cuauhtemoc’s primary economic engines, but it’s an isolated place where families keep to themselves. Some have turned to social media and anti-vaccine websites for research. Others use little technology but visit family in the United States, where they also hear misinformation — which then spreads through word of mouth.

Pressed against the fringes of the small northern city of Cuauhtemoc, the Mennonite settlement here spans about 40 kilometers (25 miles). With 23,000 residents, it’s one of Cuauhtemoc’s primary economic engines, but it’s an isolated place where families keep to themselves. Some have turned to social media and anti-vaccine websites for research. Others use little technology but visit family in the United States, where they also hear misinformation — which then spreads through word of mouth.

, which suggested the rate is about 10 in 100,000 live births. Some say the true rate may be somewhere in between — meaning it’s still higher than other wealthy nations.Midwife Stephanie Wood examines Courtney Knight during a pregnancy checkup. Midwives at Commonsense Childbirth are striving to provide good, accessible care. (AP Photo/Laura Ungar)

Midwife Stephanie Wood examines Courtney Knight during a pregnancy checkup. Midwives at Commonsense Childbirth are striving to provide good, accessible care. (AP Photo/Laura Ungar)U.S. rates remain high despite proven ways to prevent maternal deaths and injuries, experts say — things like ensuring quality medical care at delivery; getting to know patients; addressing issues like addiction or poor nutrition; and providing care and support after the baby is born.One of the most important things is making sure everyone can get regular prenatal checkups, which requires having enough health care providers.

Consider Norway, which has the lowest maternal mortality rate in the world: zero. Through its universal health care system, people get free prenatal appointments at health centers near their homes. And like Sweden, Germany, France and the U.K., it has a robust supply of midwives.For every 1,000 live births, Norway has 13 OB-GYNs and 54 midwives, the

found, compared with 12 OB-GYNs and four midwives in the U.S. The

deems more than a third of American counties maternity care deserts and recommends integrating and expanding midwifery in all states.That approach has been the biggest flaw of the government’s response, said Dr. Carlos del Rio, past president of the Infectious Diseases Society of America.

“Imagine if the captain of the Titanic had told you that you need to be careful about lifeboats and think about other opportunities,” del Rio said.Trials were conducted on thousands of children before the vaccine was approved for use in the 1960s. The federal government has since used medical records to continue to monitor for side effects from use in millions of people since.

Health secretaries have typically delivered a clear message urging the public to get vaccinated during outbreaks, said Dr. Anne Schuchat, a former deputy director at the CDC who retired after 33 years at the agency in 2021.President Donald Trump and his first-term health secretary, Alex Azar, urged people to get shots during news conferences in 2019, when measles ripped through Brooklyn and infected more than 1,200 nationwide.