Monday, May 24, 2010

Dying in childbirth...in 2010???

I read the Sunday LA Times yesterday and was beyond shocked to come across an article that discussed the alarming trend in American maternal deaths. Each day in The U.S., two women die of problems related to pregnancy. Black maternal deaths are four times higher. The numbers are rising for reasons which are unknown, and in California alone the rates have tripled since 1999. One third of these deaths are preventable, say experts. What's even more alarming is that the U.S. spends more per birth than any other nation, yet the mortality rate is higher here than in 40 other industrialized countries, and is double that of Canada and Western Europe. That's tough to make sense of. Which is why the human rights organization, Amnesty International, released a report this year calling for sweeping changes in our maternal healthcare.

Experts are weighing in and giving some opinions and their reasons for the rise. It seems there's a mismatch between the way American medicine delivers babies and the changing profile of the American mother. We are getting pregnant older, with more of us are giving birth in our 30's and 40's when risks of complications can occur. And almost 25% of women of childbearing age are obese and thus at higher risk for complications. The bottom line is physicians haven't adapted their approach to childbirth to accommodate these new risks.

We as mothers need to educate ourselves to certain trends in childbirth and the risks they carry with their seeming benefits. Experts are implicating the rise in rates of cesarean sections - which account for one third of all births (I can't believe this stat) - also up from 1999, playing a part. Although some are done to save the life of a mother and her baby, half of them are elective, and therefore, unnecessary. After one C-section, they are typically recommended for subsequent pregnancies. Yet, we should remember,these are major operations and should not be taken lightly because each additional C-section can increase the risk of placental complications and threaten the lives of mother and baby. Also a trend in childbirth is the induction or prompting of labor by medication (pitocin), which is sometimes necessary, but more often than not just elective for a doctor's or patient's convenience. When did childbirth become a convenience? That has climbed by 22% in the last decade! The problem with induced labor is the uterus may not be ready, leading to prolonged labor. After delivery, the exhausted muscle may not contract properly to stop bleeding. Then blood can no longer clot and can lead to hemorrhaging which obviously elevates the risk of death. Another culprit is the widespread use of electronically monitoring women in early labor which keeps staff passive, the patient neglected, and warning signs may be missed.

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