U.S. maternal mortality rate is the highest it’s been in decades August 31, 2007 Jill More good news.
And this is why I choose home birth. Keep my body away from the doctors and their “failure to progress” golf schedules thank you very much.
Why don’t know they the reason for the increase? Do they not track any other information than “died in childbirth”? Can they not add up how many had GD or a caesarean or complications?
Golly, I wonder if the record numbers of Americans without health coverage has anything to do with this. If you can’t afford prenatal care, a problem is likely to go undiagnosed until it becomes acute, by which point it may be too late. And, to any circling trolls, spare me the “if they didn’t have insurance, they shouldn’t have been dumb enough to get pregnant” stuff. If you don’t fund universal health care, you don’t fund subsidised birth control for poor women, and you teach abstinence-only education, you’re going to end up with a lot of unplanned pregnancies. And nine months later, sometimes you’ll get a dead woman and/or baby because that woman was dumb enough to be born in the only wealthy First WOrld country that doesn’t consider access to health care a right. But dead women and babies are a small price to pay for a tax break.
And nine months later, sometimes you’ll get a dead woman and/or baby because that woman was dumb enough to be born in the only wealthy First WOrld country that doesn’t consider access to health care a right. Ah, the GOP’s “culture of life.”
from the linked article: A rise in the number of caesarean sections — which now account for 29% of all births Whoa!!! I just sat here staring at the monitor with my jaw dropped to the table at that one. I mean, I knew it was high, but dear lord, 29%????!!!!!! that is just f-ing insane!! Are we supposed to believe that nearly a THIRD of women supposedly are not able to give birth the usual way????
Raincitygirl, I think you nailed it, or at least a big part of it. I agree completely about the correlation between lack of health care and all the pre-natal stuff. I wonder too, how many of these women are victims of the “no sex education, no birth control, no access to other options” policies of the current administration (and the culture). But then, they’ll never have an abortion, so that must be a good thing, right? Obviously, the programs are succeeding. I do note the last paragraph of the article, which shows so much that is wrong with modern “reporting.” After the first few paragraphs, they essentially say that they have no idea if the actual numbers are up or not, since the way it’s all reported is changing. So, first blame the sluts, then the brown women, then the fat women, and THEN get around to acknowledging that maybe there isn’t even a story. Yeesh. I agree with Trudi – what, can’t they tell? Can’t they add? Can’t they eliminate the data from the states who changed their reporting methods and see if the trend matches when you just look at the states that didn’t change their methods?
Can someone tease out what they hell this means? “In addition, the report says the increase in maternal deaths “largely reflects” more states’ use of a separate item on the death certificate indicating pregnancy status of the woman. According to the report, the number of maternal deaths does not include all deaths of pregnant women, but only those deaths reported on the death certificate that were assigned to causes related to or aggravated by pregnancy or pregnancy management (NCHS report, 8/21).” It seems self-contradictory. The first sentence seems to be saying that the jump in numbers is the result of states are listing pregnancies on death certificates whether or not the pregnancy was a factor. The second seems to be saying that states adding that line shouldn’t matter to these stats, because ‘maternal death’ doesn’t mean ‘the death of a pregnant woman’ but ‘the pregnancy-related death of a woman.’ If women who died from random, non-pregnancy-related things while they happened to be pregnant weren’t counted then and aren’t counted now, it should only cause a reporting error for people tracking the non-maternal deaths of pregnant women.
There’s quite a bit of discussion about this in pregnancy/birth circles, which I’m following these days for the obvious reason. This might be a reporting glitch, though I can’t explain the weirdness pointed out by preying mantis. While the lack of health coverage is a biggie, I mostly blame the rise in cesarean section rates. Birth is mostly safe, but a cesarean is major abdominal surgery and has all the risks of any surgery, like anesthesia risks, hemorrhage, and infection. And don’t let anybody distract from the issue by blaming maternal choice: primary patient-elected cesareans are such a tiny fraction of the total number that they can’t be the cause. And even in that case the real issue is misinformation about birth in the medical establishment and the mainstream media. (Though, and this is something few think about, of women who do choose a cesarean without obvious medical indication, many are doing so due to PTSD associated with past sexual abuse, which makes vaginal birth frightening to them, and I wouldn’t deny them this option). Cesarean sections are increasing due to a complex interplay of the medical system, the legal system, and cultural attitudes that privilege the demands of the medical establishment over the needs of the birthing woman. Some women are being told at 8 weeks pregnant that their pelvises are just too small to birth a baby vaginally, and they don’t argue with their caregivers. Increases in inductions, which are both doctor-driven and patient-driven, are another big cause, since a large percentage of inductions fail and result in cesareans. Fetus/baby fetishism, which puts the life/health of the baby as much more important than the life/health of the mother, are another issue. Just think of the Angela Carder case and other cases in which doctors and lawyers have found it important to put the possibility of the life of the baby above the health or autonomy of the pregnant woman. There’s a stupid saying that the pregnant women on some sites I visit have often heard: “A vaginal birth puts all the risks on the baby, a cesarean puts it all on the mother.” The saying is wrong, but either way the implication is that the mother should be taking the risks, rather than letting the baby take any. Anyway, I have far to much to say about this, and I could babble in a hundred directions at once. Before I write an entire post-length comment here, I should stop. I’m looking forward to emjaybee joining this discussion.
Dr. C….ha. I didn’t expect a call-out. You pretty much nailed it. The stats thing I find frustrating; our lack of a national system or at least consistent reporting standards across states means to me that we don’t have the best stats we need about pregnancy complications and deaths. In fact, I’ve talked to many midwives who think that maternal deaths are underreported when complications happen after the fact; the complications are not always linked to the births by the hospitals. Having true national healthcare would keep women in the system and make it much easier to find those kinds of patterns, instead of relying on patchwork reporting. I liked the obesity thing too; we don’t *know* there’s a connection, but we must never miss an opportunity to blame overweight people for their health problems! The fact that African American women are *three times* as likely to die from childbirth as white women was by far the saddest statistic, to me. You couldn’t outline the legacy of racism any clearer than that.
I hate stats like “29% of births are by c-section” because it doesn’t say why. Of those 29%, how many of them were not the first birth for the mother? Many physicians will not support the choice of VBAC and push for a c-section the second, third and fourth time around. Then there are complications of being induced that lead to an “emergency” section, the actual scheduled sections chosen by women, and so on.
The problem is not obesity but diabetes and pregnancy diabetes which goes often unreported and untreated. But I gotta run, so no more to say now, sorry.
” I mean, I knew it was high, but dear lord, 29%????!!!!!! that is just f-ing insane!! Are we supposed to believe that nearly a THIRD of women supposedly are not able to give birth the usual way????” It was 34% and rising in Western Australia two years ago. Adding in episiotomy, over one half of births were surgical. Adding in induction and augmentation, more than three-quarters of all births were profoundly interfered with. 91% of augmented labours had a recorded total duration of fewer than 12 hours, and 44% fewer than four hours. I don’t know what to say. The numbers speak for themselves, I think.
I think a lot of women opt for c-sections because there’s not good mainstream information (mainstream meaning “your average everyday OB-distributed information) about childbirth. With my first baby, we went to the hospital and learned how the hospital births kids. They pushed painkillers, of course, and naturally I was on board because hey, who wants pain? Now that modern childbirth techniques can offer pain-free childbirth, go for it! Ha. My epidural numbed my legs but not my vagina. I pushed for 2-1/2 hours, to the impatient exhortations of nurses who couldn’t understand why I couldn’t push when I FUCKING COULDN’T FEEL THE CONTRACTIONS. Eventually I delivered with the aid of foceps (not a great choice, but what did I know?), and a tear all the way back to and including my anus, and an episiotomy, and an hour of post-partum stitching. Great pain-free birth. Second kid, I had 12 weeks of training on how to give birth naturally. The instructor had her baby a few weeks before the end of the class and said that during her labor, she thought to herself: I must remember to let my students know how much this HURTS. Because it does. Childbirth is rugged. But education, facts, techniques, a doula, supportive birth partner, and comfortable, nurturing surroundings can ease the pain a LOT. But we don’t do that in the U.S. We mix epidural/pitocin cocktails, give the woman about16 hours to give birth from the onset of the cocktail, and when the hospital needs the bed for the next laboring mother, they administer a C-section. Do I think mothers should not use painkillers? No. I think they should be offered painkillers, becase nobody knows beforehand how she will be able to tolerate pain, or whether her body will work easily, or whether she will give birth to a gigantic mutant-headed baby (like my first). But we skip over all the other pain management options and jump right to the epidural/pitocin technique. And that’s just backward. And childbirth today is organized around the schedulee and convenience of the OBs and the hospital, not around a good birth for the baby AND the mother. (Remember her? The mother? Oh, yeah. Her.)
Here comes the Voice From The Wilderness (TM) on c-section. I know about the stories of doctors performing unnecesary c-sections because of convenience issues, and I certianly agree that is a bad thing. However, the OTHER side of that story is the doctors who don’t perform needed c-sections, due to all of the “vaginal birth is best” hoo ha that is out ther. Oh yes, it exists. I was 23 and healthy, and pregnant with my first child. The only complication I had was late onset gestational diabetes which I controlled through diet modifications. I also have PCOS, which was probably the cause of the GD, and frankly, was supposed to keep me from getting pregnant anyway, but no one thought that would be an issue in labor and delivery (except me- silly girl). I was never able to establish regular contractions, and things began to lag. After 33 hours of absolute hell, an intimate encounter with a vaccum extractor, and enough pitocin to kill a bull, I finally gave birth. Why did this happen? My Ob/Gyn didn’t want to perform an “uneccesary c-section”. Sure, the experience was horrible and traumatic. Sure, my recovery from the marathon birth was slow, and I was at increased risk for infection. Of course, 33 hours of agonizing, irregular, pit-intensified contractions did something permanent to me that causes me to feel like my perineum is about ready to drop out when I stand for extended periods of time. But, hey. At least I didn’t have an uneccesary c-section. No, the real problem isn’t uneccesary c-sections, it is doctors not listening to patients. I had repeatedly told the doc that I was afraid my PCOS was going to give me trouble upon delivery. I got dismissed because I was young and healthy, and doctor knows best. When I suggested we might have to be ready for c-section, the doctor assured me that surgical birth wasn’t the answer for me. When you are pregnant in the patriarchy, you can’t win for loosing.
Because it does. Childbirth is rugged. But education, facts, techniques, a doula, supportive birth partner, and comfortable, nurturing surroundings can ease the pain a LOT It probably can. I had three midwives at home for my second birth, and my pain management technique was screaming a lot. Damn, do I wanna be a marsupial.
Neko-Onna, it may be that you did need a c/section. Or…and I won’t assume, because I’m not you…it may be that the induction itself made your pain and suffering so great when birthing vaginally that your body was damaged. Pitocin is a huge crutch for hospitals, who panic and administer it to any woman even a day over her due date, and often before, regardless of side effecs, in a breathtaking bit of irresponsible medicine. If your body is not ready to birth, pitocin can force things…and it can put you through hell while it does so. Your doc may have given you the worst of both worlds; a hospitalized induction plus a drawn out labor. Starting labor too early can mean the baby is malpositioned, which can lead to them getting stuck the way yours did. Which is why so many women in your situation would simply have been sectioned. Mostly, I’m just really sorry that you had the experience you did. You and your baby both deserved better (/steps off soapbox)
Adding on to what emjaybee said – someone should have walked you through birth and specifically helped you work out your fears with regard to your PCOS. People forget that your emotions are very powerful when it comes to labor and birth – if you have emotions and fears that are not dealt with, your labor often stalls. When I was working as a doula, I spent a good deal of time talking with my clients about their fears and concerns and making sure that we had at least discussed as many issues as we could find. Ideally, a birth professional will do this with his/her patient, but I didn’t experience it until I had a midwife. OBs were all about “we can take care of anything that happens. Next patient please!”
Yes, this awful rise in cesarians, and, gasp,episitomities, are the problem. If we could only go back to natural births, like 100 years ago, when the maternal death rate was a thousand times higher.