I read an amazing piece over at RH Reality Check the other day, the tone of the article wasn’t extremist, or liberal… it was factual pointing out simple facts about our maternity care, statistics, and shortcomings while using valuable information provided by Amnesty International. Last spring the Deadly Delivery report was published. 154 pages of statistics, data, and stories of why our maternity care in the United States is failing. I also figured I have been really neglecting my blog while writing on Being Pregnant right now, so I knew I needed to step it up a notch… using something other than my own pregnancy to provide entertainment for my lovely readers.
In the United States we are spending the most per birth in the world. In one year, the United States spends a reported $86 Billion dollars in pregnancy related hospitalizations… That is a TON of money. Yet the maternal mortality rate in our country is higher than 49… Yes that is right… 49 other countries around the world, which include South Korea, and Kuwait. True story!
According to the Deadly Delivery report a woman in the United States is five times more likely to die during childbirth than in Greece, four times more likely to die during childbirth in Germany, and three times more likely to die during childbirth in Spain. All countries with birth rates that can be considered comparable to the United States.
While we have a higher population, and birth rate annually, these factors are certainly taken into consideration when calculating these statistics.
Every 90 seconds… a woman dies from a pregnancy related cause. 2-3 of those women are in the United States.
Since 1990, the maternal mortality rate here has DOUBLED. We have been taking steps backwards, clearly not forwards.
During this time we have also seen a rise in managed births, and the way childbirth is handled. More c-sections, more inductions, more complications in pregnancy, and a slight rise in multiples. Not enough to warrant the cesarean rise by any means, which some use as the main culprit.
During 2004, and 2005, a simple period of two years – 68,433 women died during childbirth, or from a complication of childbirth. That is simply way too many mothers gone.
Why am I being so gloom and doom about this?
I am not trying to scare women, or worry pregnant women, I am trying to help others to understand what kind of problem we are currently facing. We need to start with grassroots advocacy. Pissed off mothers on the ground level sparking a need for change, and helping others to become educated on what is going on. So many are oblivious to these numbers or think our country is top of the notch when it comes to birth. Believe me, I see it daily online. Whether on my due date month group, or in discussions on twitter (although most of my lovely ladies on twitter are great birth resources!)
The biggest problem in the maternity care system seems to be the lack of proper prenatal care for certain groups of women. There are the uninsured of course which is growing. Many women do not know the options that are available through government funded programs to help avoid the complications lack of prenatal care may cause. Then we have the immigrant communities, and of course women of color. While I am of neither community, it impacts us all as women. These are our sisters, mothers, cousins, and friends. Social barriers, and racial barriers should not be limiting access to proper care for anyone. Because you may not fall into these groups, does not make these women any less important!
The Universal Declaration of Human Rights includes: every human being has the right to health, including health care, unfortunately that is not being followed in the United States, especially when it comes to prenatal care. Unfortunately there is so much negative stigma surrounding the government funded programs, such as prenatal care for all women, which is available, that not all know this is an option. Insurance is looked at like a privilege, as well as health care when it should be a basic human right, not just for the rich, or people who happen to be lucky enough to have a job… this week. Fortunately for many, this is hopefully going to be changed with the health care plan, but there is so much he-said-she-said it virtually will never change, or be passed.
Women with limited English, and of the communities I spoke of above are at greatest risk. Women of African American background are four times more likely to die from a pregnancy related complication, or during childbirth than a woman of white background. And of high risk cases, African American women are five times more likely to die than white women. Shocking and seriously alarming numbers. But it is not across the board for all women of color in the country. Studies show that women in large metropolitian cities are at an even greater risk. Another example taken from the RHRealityCheck article :
The inequalities are also geographical; risk is not uniform across the 50 states. Women in DC are almost 30 times more likely to dies than women in Maine.
Also sparking concern about the lack of prenatal care providers in these areas. Lack of providers who will accept uninsured patients, lack of providers willing to accept women with government funded forms of insurance, and on, and on… It is a numbers and money game. Malpractice insurance is the main source for Doctors being so money hungry, I think second is the huge loans that need to be paid back after medical school too. I live in a state with the fourth highest malpractice rate for Obstetricians, I see it day in and day out with our local birthing women. Answer to the issue? Tort reform. But that is besides the point of my post today.
One out of ever 5 women in the entire country are uninsured, equaling over 13 million women in our country alone.
You know them too! They are your sisters, mothers, cousin’s, friends, co-workers, and may be the lady sitting next to you on a park bench. There is no discrimination as to who is excluded.
Again from the RERealityCheck piece :
Nearly half of all maternal deaths could be prevented with better access to good quality maternal health care. From a human rights perspective, this is completely unacceptable. To reverse these trends Amnesty International is calling on the government to implement a robust and systematic response to the issue of maternal health in the US using a human rights framework. Domestically, Amnesty International recommends establishing and strengthening Maternal Mortality and Morbidity Review Boards to investigate maternal deaths and improve care and ensuring presumptive eligibility for Medicaid for pregnant women in all states.
We have to start somewhere. Something needs to be done, and it not only needs to be changes in insurance coverage, and ways for women to get prenatal care, but there needs to be a big change in…
I mean, the list could go on for hours with all the changed that need to be made. It is a seriously broken system. What birth has become in even the last 20 years has done no justice for our mothers.
I am sorry this was so long winded, but I have been aching to write something to passionate for a while. Between sick children, commitments on other websites, real life, and the holidays… I just haven’t had time, but let me tell you this felt amazing! I will be getting back into my normal swing of things.
In our society today, women often believe that if your provider tells you something not only is it best for you, but it is also your only real option. Because of this type of thinking in pregnancy and birth today, we are seeing women having increasingly negative birth experiences. Recently while working on the Post Cesarean Feelings Survey, I have noticed really how much of a problem it is in our society.
Childbearing women have rights, and choices.
According to the Childbirth Connecticut brochure I liked above, your rights include :
1) Every woman has the right to healthcare before, during, and after pregnancy and childbirth.
2) Every woman and infant has the right to receive care that is consistent with current scientific evidence about benefits and risks. Practices that have been found to be safe and beneficial should be used when indicated. Harmful, ineffective, or unnecessary practices should be avoided. Unproven interventions should be used only in the context of research to evaluate their effects.
3) Every woman has the right to choose a midwife of a physician as her maternity care provider. Both caregivers skilled in normal childbearing and caregivers skilled in complications are needed to ensure quality care for all.
4) Every woman has the right to choose her birth setting from the full range of safe options available in her community, on the basis of complete, objective information about the benefits, risks and costs of these options.
5) Every woman has the right to received all or most of her maternity care from a single caregiver or a small group of caregivers within whom she can establish a relationship. Every woman has the right to leave her maternity caregiver and select another if she becomes dissatisfied with her care.
6) Every woman has the right to information about the professional identity and qualifications of those involved with her care, and to known when those involved are trainees.
7) Every woman has the right to communicate with caregivers and receive all care in privacy, which may involved excluding nonessential personnel. She also has the right to have all personal information treated according to all standards of confidentiality.
8 Every woman has the right to receive maternity care that identifies and addresses social and behavioral factors that affect her health and that of her baby. She should receive information to her her take the best care of herself and her baby and have access to social services and behavioral change programs that could contribute to their health.
9) Every woman has the right to full and clear information about benefits, risks, and costs of the procedures, drugs, tests, and treatments offered to her, and of all other reasonable options, including no intervention. She should receive this information about all interventions that are likely to be offered during labor and birth well before the onset of labor.
10) Every woman has the right to accept or refuse procedures, drugs, tests, and treatments, and to have her choices honored. She has the right to change her mind.
11) Every woman has the right to be informed if her caregivers wish to enroll her or her infant in a research study. She should received full information about all known and possible benefits and risks of participation, and she has the right to decide whether to participate free from coercion and without negative consequences.
12) Every woman has the right to unrestricted access to all available records about her pregnancy, labor, birth, postpartum course and infant; to obtain a full copy of these records and to received help in understanding them if necessary.
13) Every woman has the right to receive maternity care that is appropriate to her cultural and religious background, and to receive information in a language which she can understand.
14) Every woman has the right to have family members and friends of her choice present during all aspects of maternity care.
15) Every woman has the right to receive continuous social, emotional, and physical support during labor and birth from a caregiver who has been trained in labor support.
16) Every woman has the right to receive full advance information about the risks and benefits of all reasonably available methods for relieving pain during labor and birth, including methods that do not require the use of drugs. She has the right to choose which methods will be used and to change her mind at any time.
17) Every woman has the right to freedom of movement during labor, unencumbered by tubes, wires or other apparatus. She also has the right to give birth in the position of her choice.
18) Every woman has the right to virtually uninterrupted contact with her newborn from the moment of birth, as long as she and her baby are healthy and do not need care that requires separation.
19) Every woman has the right to receive complete information about the benefits of breastfeeding well in advance of labor, to refuse supplemental bottles and other actions that interfere with breastfeeding, and to have access to skilled lactation support for as long as she chooses to breastfeed.
20) Every woman has the right to decided collaboratively with caregivers when she and her baby will leave the birth site for home, based on their conditions, and circumstances.
Being armed with the knowledge that we as women are human beings, with rights that heavily stand in our favor is the most important thing we need to know and be familiar with in the current climate birth is in today!