Maternal Health in Crisis

When a student of mine mentioned that she wanted to focus her research on the state of America’s maternal health — the health of women in the periods immediately before, during, and after childbirth—I was embarrassed to say that I had no clue how urgent the situation was. I had assumed that since we live in a country with some of the best healthcare professionals, having a baby must be straightforward and certainly safe for most Americans.

Maternal health is a global issue, but it’s an American issue as well. As the World Health Organization notes, approximately 830 women worldwide die every day during pregnancy or childbirth from causes that can be prevented, like infection or unsafe abortion—over 300,000 fatalities a year. Almost all of these deaths occur in developing countries; however, among developing nations, the U.S. ranks as one of the lowest in maternal health, far behind countries like the UK and Canada. But perhaps what’s most shocking is that it has actually become worse, not better for American women, within the past few decades.

American women of today face a greater risk of dying in childbirth than their mothers did before them. The rate of maternal mortality, defined as the death of a woman during pregnancy or the death related to complications from childbirth has more than doubled since 1990.

Race, ethnicity, and income level are all influential factors in maternal mortality, but exactly how they figure in is yet to be determined. The assumption is that women of color and those with low-income tend to have less access to quality healthcare and quality reproductive information, so they face a higher risk for maternal mortality. The fact is, the highest mortality rates are seen in African American moms, who in 2010 were three to four times more likely to die in childbirth than white women. American Indian and Alaskan Natives followed behind at twice the rate of white women.

But as recent reports by the likes of CBS News, NPR, USA Today, and countless others have revealed, women from all walks of life—from a nurse, to a marathon runner, to tennis pro Serena Williams—have either fallen victim to preventable death during childbirth or have had a bone-chilling “near-miss.” In fact, as a May 2018 NPR feature revealed, for every woman who dies in childbirth in the U.S., there are a whopping 70 more women who “nearly die”. The causes range from a failure of medical staff to recognize dangerous symptoms to hospitals cutting corners to save money. This translates to more than 50,000 American women a year who come dangerously close to dying when giving birth. These statistics are truly frightening, because it demonstrates the extent of the maternal health issue. They also point to its profound social impact: for these women, the severe medical complications they face—ranging from organ failure to infertility—last well beyond childbirth.

Why the dramatic rise in maternal deaths and near-misses? A recent op-ed piece by Dr. Rose Molina in The New England Journal of Medicine takes into account the changing demographics of today’s moms, who are having their first child later in life, or are more prone to conditions like obesity, diabetes, or high blood pressure. The rise in the rate of C-sections also adds to the mix.

How to Improve Maternal Health

Regardless of the cause, it’s clear that changes have to be made to ensure that women who become pregnant do not have to fear for their lives, whether or not they choose to have their baby. This means ensuring that all women are given access to proper healthcare and information on reproductive health during pregnancy, childbirth, and the postpartum period. Improvements to insurance coverage is one way to start. But it also means that healthcare professionals are given the proper training to recognize and respond to crises in a timely and efficient manner, and that hospitals are properly equipped to serve their patients. Because we’ve long believed that complications during and after pregnancy were no longer pressing issues in modern America, this involves transformative changes in our nation’s healthcare policies, our laws, and our way of thinking.

But until these changes are made, women need to be their own advocates for proper maternal healthcare. This means:

  • Seek emergency care if something feels wrong.
  • Voice your concerns to your healthcare professional, and persist even if they dismiss you.
  • asking questions to arm yourself with as much information as possible on your own health (and not settling for sub-satisfactory answers).
  • Keep your partner and family members in the loop, because if you are incapacitated and cannot speak up for yourself, someone else needs to speak up for you).
  • Connect with your state or local Health Department to find out what programs are in place to assist you during and after your pregnancy, especially if you’re a low-income woman. You may be eligible for federal government programs like Medicaid or Healthy Start.
  • Check out local pregnancy centers, some of which are sponsored by charitable organizations and offer services for free or low-cost.

Maternal health impacts all women, whether or not they’ve having a baby, or have daughters who will have babies, or just care about someone who’s a mom.

The MOMS Act

In August 2018, Senator Kirsten Gillibrand introduced a new bill called the MOMS Act (Modernizing Obstetric Medicine Standards Act), which would improve maternal care and ensure hospitals have the resources to do something about the preventable and treatable complications that still happen during pregnancy and childbirth.

Lynn Ink is a university-level educator, writer, editor, women’s rights advocate and mom to three teens and a Border Collie. She loves Netflix binge-watching, blueberry pancakes and researching everything from historical events to remote places. She squirrels away most of her writing for no one to read, but is happy to share her work with to help women and girls achieve their fullest potential. Currently, she’s working on a novel about a caregiver who chucks it all for an epic road trip and an In-N-Out burger. Maybe she’ll share it one day.

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