I know I'm passionate about birth and everything surrounding it. It is emotional for me. And I'm glad actually. I am proud of the work I do with women and for women. I really care about women and babies. It is not something to be handed over to medical technology as a condition (most of the time). So this kind of update just infuriates me and makes me even more vocal. I respect informed choice. Truly informed choice. And good prenatal care. I cannot respect the current state of maternal health care in any way. I do, however, feel that change is coming. Because of these maternal and infant mortality statistics and US pride, yes, AND because of people like me, yes. I am proud of the support, education, and advocacy I provide women. Doulas and other birth professionals and advocates are out there everyday letting women know their options and that there is MORE TO KNOW than they are being told. We are helping to guide them through their pregnancies and stay with them during their entire labor. That alone is making a difference! But, every woman deserves that, not just ones who can pay. Midwives and doulas are being requested more and more. Women are taking more independent childbirth classes and opting to have care and births outside of hospitals. They are asking for more nutrition counseling, yoga classes, chiropractors, and water exercise classes. Insurances are reimbursing more now for alternative out of hospital care, education, and therapies. AND, I must say, too, that SOME hospitals are taking steps in the right directions. Yes, maybe accreditation pressures is a push they need, but they are trying to implement changes in some places regarding birth and baby care - I see it when I attend births at different locations. Praise to them, too! And shame on those who are banning birth plans, doulas, and VBAC's and those that don't encourage skin to skin time immediately following birth. Improvements are coming because of the demand for it, though. But we have lots of work to do! I must discuss why it is so sickening to me to see our maternal and infant mortality rates so poor. Don't get me started on the disparities those face who are on medicaid. I've been through a pregnancy on it. I know firsthand! And lucky for me I was who I was and I knew health and I knew my options! Oh, AND I figured out a way to eventually pay my midwife since she was not covered by medical assistance. Lucky for me, right? That's me - someone who is health, pregnancy, and birth informed and involved. What about all the other women on medicaid?
SOOO......Not only does the US (with all of our money and technology) fall 50th in line after 49 other countries for our maternal mortality, but we have THE HIGHEST infant mortality rate among developed nations (18). THE highest! Please read this article and see the research yourself on maternal mortality, and be informed as a woman or someone who loves one. Yes, it applies to you or someone you love. As our cesarean rate continues to increase, so do our maternal deaths. Even more so if you are a woman of color - 4 TIMES more likely to die during birth than white women. And no, don't even go there anyone - It is NOT because women of color have higher prevalence of disease! Treatment and care is NOT equal! Please recognize the disparities, and acknowledge the truth in that.
"In contrast to many countries where women lack access to life-saving medical interventions, women and infants are often exposed to more procedures than are medically necessary or beneficial. This overuse of medical procedures increases injuries as well as costs. Indeed, we are unaware of any study indicating that the 56% increase in the rate of surgical births from 1996 to 200827 as improved outcomes. However, there are data to show that the overuse of medical procedures has increased both infant28 and maternal morbidity.11, 29"
ALL women need to protect themselves with information and share it with the women we love. Do not trust you are safe because you 'really like your doctor' and you know 'he/she wouldn't ever make choices for you that could be harmful'. Be an informed party in all decision making. Get the information you need from other sources in addition to what you get at your office appointments and ASK QUESTIONS. Demand better choices, chances, and cut your risks down - take an independent childbirth class and hire a doula, learn about proper nutrition during pregnancy, the importance of healthy living, and how to make that all happen so you can prevent hypertensive disorders and interventions that can both lead to riskier births then and later.
"Because all medical interventions carry risks, their use in situations when they are not demonstrated to offer benefits exposes women to risks that are unwarranted. For example, overuse of induction of labor and of cesarean sections, and lack of access to vaginal births after cesarean sections, all can lead to higher incidences of postpartum infection and higher rates of hysterectomies.30, 31"
And also, we need to stop making excuses when moms do die during childbirth and afterwards. I'm tired of hearing all the reasons it wasn't related to the 'actual' birth or that there was nothing that they could have done. Prevention, as far back as we can get prior to pregnancy or early on, is #1. Cut down on unwanted pregnancies. Educate our teens on the responsibility not only of having a baby but of gestating! And hospitals need to learn how to better support women who want to birth without medication or those who want to move freely for a good bit of labor instead of being in bed hooked to a monitor the entire time (continuous monitoring has not been proven to improve outcomes for moms or babies and in fact IS directly related to increasing the risk of cesarean), decreasing surgical births (even more risky as the number of cesareans a mother has), and REAL post partum CARE where someone is checking on mom's uterus and her overall well being - no, not just to document on their checklists, but to actually spend some time sitting with a mom who just had a baby and get a good sense for how she's feeling.
"It is a human tragedy when a woman dies giving birth; her death forever changes her community and family for all future generations. It is both a tragedy and a human rights failure when a woman dies needlessly of preventable causes in a country that lacks the political will to have prevented her death."
The way we are treated and cared for prenatally needs to CHANGE! More routine procedures prenatally and in the labor room lead to more interventions and technology. More interventions and technology = more deaths. PERIOD.
Thank you Ina May for all the work you are doing to bring awareness to the public and to the obstetrical community on what we can all be doing to save mothers, and of course for remembering those lost with the Safe Motherhood Quilt Project.
For more information visit the Healthy Mothers Healthy Birth Summit page.