Saturday, October 18, 2008

Maternal Mortality

I read an article about the maternal mortality rate in Sierra Leone, one of the poorest countries in the world. 1 in 8 women die in childbirth there. This truly is a horrendous problem, one that is frequently overlooked when dealing with other health crises and providing other services in such areas. The poor family the article talked about suffered a terrible loss in the death of a young mother. But there is more happening there than just having a doctor on call to staff the hospital. This poor mother did not know that fasting for the last three weeks of her life in observance to Ramadan would affect her health. Pregnancy is not a time to fast. This poor mother and many like her also need education and nutrition. Many of the problems they face could be resolved right there.

One of the shocking facts in this story (yes, absolutely shocking!) was that the rate of maternal mortality in the U. S. 1 in 4800. Doesn't sound too, bad, does it? Compare it to another statistic in the article... the maternal mortality rate in Ireland: 1 in 48,000. Hmmm. Maybe I'll have my next baby in Ireland. This little island has the best maternal mortality rate in the entire WORLD. And those of us here in the United States face mortality rates 10 times worse.

The AMA keeps telling us we have the best medical care in the world, and that the hospital is the safest place to have a baby. Apparently, neither is true! While the AMA is supporting legislation to OUTLAW homebirth in the United States, telling us that birthing at home is risky, they're actually losing more women in the hospital.

About 1 or 2% of birthing women choose to have their babies at home. Even if 1 or 2% of those mortalities took place at home, that would be 48 to 96 out of 4800. The other 4752 to 4702 mortalities are in the hospital. I know women are subjected to interventions that end up causing problems during labor in the hospital... I've been subjected to them myself. What about giving women hands on care instead of using monitors? What about educating them about nutrition? Helping them to labor naturally instead of breaking their waters, stimulating their labors with pitocin, or cutting them open when they don't need a cesarean? Just last year a news story broke about two teachers at the same school who both ended up with cesareans... and both died.

Midwifery care has been shown to have better outcomes and less intervention. I support more midwives. Obstetricians are trained to handle emergencies... they should do just that, and stop messing with normal labor until they cause emergencies.

For those poor women in countries like Sierra Leone... many of them can be saved with the same answers that will save more women here in the States. Let OBs take care of the real emergencies and midwives take care of normal pregnancies and births. With better mother education that most midwives provide, there should be an improvement all the way around.


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