Samantha Bee on Maternal Death Rates

[Curious]

Samantha Bee had a good piece on maternal death rates in the US.  I found these statistics amazing (and quite sad).   She doesn't really address fundamentalism (other than the pro-fetus/anti-woman part).  Probably not surprisingly, Texas has the highest maternal death rate in the developed world

 

[VelociRapture]

35 minutes ago, Curious said:

Samantha Bee had a good piece on maternal death rates in the US.  I found these statistics amazing (and quite sad).   She doesn't really address fundamentalism (other than the pro-fetus/anti-woman part).  Probably not surprisingly, Texas has the highest maternal death rate in the developed world

 

I see stuff like this and feel so grateful I live where I do because Velocibaby forgot to how to breath shortly after birth. It was only for a minute or two and they got her breathing again no problem, but I see stories like this and wonder what might have happened if we lived in another state or if I was a black woman. 

I would love to see her really sink her teeth into various forms of Fundamentalism and how destructive they can be. 

[CaricatureQualities]

https://www.washingtonpost.com/news/fact-checker/wp/2017/01/18/paul-ryans-claim-that-for-every-planned-parenthood-20-health-centers-provide-care/

The fact that maternal death rates are that high in America is shocking and horrendous. Above is an article about Paul Ryan and the effort to defund Planned Parenthood. Apparently there are enough health clinics in the country that can totally absorb the work PP does without that pesky abortion issue.

So it is more important to appease the Pro-lifers who are concerned with every unborn life than to make sure that the women who carry babies actually get to keep their lives. They are pushing to get rid of PP to make part of the population feel better and then telling us it wont matter a bit, nobody will notice.

There are obviously not enough health resources as it is and esp in rural areas and instead of fighting for more clinics the focus is on just getting rid of Planned Parenthood because it offers abortions. According to their website abortion ends up being about 3% of the services the offer.. 14% being other women's healthcare, 45% STI testing and treatment and 7% cancer screening. etc.

Plus PP operates on a sliding scale for lower income and uninsured people. I don't think as many Americans have access to the clinics he is talking about even if there are 20 of them to every PP, not everyone can get care at those clinics.

Disgusting.

 

[Snarkangel Gabriel]

This is appalling in the richest country in the world.  I don't pretend to know the nuances of all the causes but it does make me wonder where the rabid pro-lifers are when the child is actually born or close to being so.

As i said, I don't pretend to know all the details but i strongly suspect that in certain areas and/or at certain income levels the US death rates are at least as good as (and maybe superior to) any Western country. These overall stats are likely to be a reflection of a collection of "problem" areas such as poverty, fundamentalism, ignorance (maybe part of fundamentalism) etc.

i could be wrong - not American after all! 

[smittykins]

I live in a rural county which lost both of its hospitals more than 25 years ago(and the maternity wards were already long closed), and our closest hospital, 10 miles away, stopped delivering babies several years ago.  Now, women have to travel anywhere from 12 to 25 miles to give birth. 

[Bethella]

29 minutes ago, Snarkangel Gabriel said:

This is appalling in the richest country in the world.  I don't pretend to know the nuances of all the causes but it does make me wonder where the rabid pro-lifers are when the child is actually born or close to being so.

As i said, I don't pretend to know all the details but i strongly suspect that in certain areas and/or at certain income levels the US death rates are at least as good as (and maybe superior to) any Western country. These overall stats are likely to be a reflection of a collection of "problem" areas such as poverty, fundamentalism, ignorance (maybe part of fundamentalism) etc.

i could be wrong - not American after all! 

I'm not an expert but income levels do play a role, particularly with access to prenatal care. But as California has shown with their hemorrhage protocols it's also about recognizing there's a problem and choosing to do something about it. The main thing they changed was how medical personnel reacted to and treated hemorrhages. They've acknowledge that hemorrhages are dangerous for women and are taking them more seriously now. Instead of having to go looking for the medicines and tools, they're on the cart where they can easily be located. These are things as simple as a scale to determine how much blood a woman has lost, before they were relying on estimates of blood loss which could be very inaccurate. They also developed set levels, so if a woman loses x amount of blood, this is how it's treated. Before it was a judgement call and could vary from doctor to doctor, so many women weren't getting care as quickly as needed. 

https://www.vox.com/science-and-health/2017/6/29/15830970/women-health-care-maternal-mortality-rate

Quote

A group of concerned doctors, nurses, midwives, and hospital administrators, including CMQCC medical director Elliott Main, started a maternal mortality review board to pore over each death in detail and identify its root causes. Pretty quickly, hemorrhage and preeclampsia (pregnancy-induced severe high blood pressure) floated to the top of the list as the two most common — and preventable — causes of death.

It’s difficult to overstate how revolutionary this simple first step was in the arena of maternal health. About half of US states still don’t formally review the causes of maternal death on a regular basis to find out which deaths are preventable and how to stop future similar deaths from occurring. The US National Center for Health Statistics hasn’t even published an official maternal mortality rate since 2007 — that’s how low-priority this issue is.

Mothers die too often because women’s health isn’t valued in the US
One of the United Nations’ Millennium Development Goals focused on driving down the maternal mortality rate. This led to efforts in almost every country to save moms’ lives — and they were largely successful: The global maternal mortality rate dropped by 44 percent worldwide between 1990 and 2015, and by 48 percent in developed countries.

The US was one of only 13 countries, including North Korea and Zimbabwe, that saw its maternal death rate increase since 1990.

[47of74]

Many Reich to lifers have issues with women receiving health care in general. Here in Iowa there’s a women’s health center that does not do abortions nor does it do abortion referrals. It still got attacked in 2006.

http://qctimes.com/news/local/man-believed-clinic-performed-abortions/article_13f05e10-3a6d-550d-bf9f-e3f278c2bf59.html

[HarryPotterFan]

This is an informative piece about Serena Williams’ experience with childbirth. She’s prone to blood clots, and was having trouble breathing after giving birth to her daughter by C-Section. She got up out of bed and demanded a CT scan because she was worried about a pulmonary embolism. The nurse dismissed her concerns, and Sarena pushed until a doctor listened. And she was right. She could have died. She ended up having other complications as well. This article really gets into the especially high maternal death rates among black women:  https://www.vox.com/identities/2018/1/11/16879984/serena-williams-childbirth-scare-black-women

[Firebird]

As someone who works in a rural hospital with the large hospitals 45 minutes away in good weather, healthcare is very behind. It's not that people don't care, but it's hard as a nurse when on a day shift you can have up to 8 patients and on an evening shift up to 10 and even more on nights to provide consistent or quality care. Often times we work with one or no aides or secretary and have no doctors on the floor. The managers are blind to the problem or don't care and the patients suffer. This is on med surg. I will be going to work on maternity soon, but even up there they often work without an aide and only staff three nurses. One to work triage/ labor delivery, one to work nursery, and one to work post partum with Mom and baby.

I have even addressed concerns with my CNO and get platitudes. 

[Briefly]

As a redhead, there were serious concerns that I might have bleeding issues when my daughter was born.  The doctor was aware and he was prepared to deal with it.  I did bleed a little more than a non-redhead but not excessively for me.  But I never really thought about it not being addressed with any other woman.  I can see how it could be a serious problem that is not being addressed like it needs to be.

I have no idea how many clinics there are in the Tulsa area, I think we have one PP but there may be 2.  But I don't think there are that many clinics like Ryan seems to think.  PP does many other things besides only abortions.  They do a lot of general medical care and offer birth control - which is not a sin!  But they are very visible and well-known, so they get the negative attention which is really dumb.

[Firebird]

Another thought, could part of the reason for such high maternal death rates in the US be due to how rural a chunk of the population is? Countries like England and Ireland are so much smaller and the travel time to large cities with top rated medical care (I would assume) would be shorter. There are areas of NY where you have to travel an hour to get to the local Podunk hospital that can basically treat pneumonia and stitch up a farm accident. There may not be access to prenatal care let alone good prenatal care. A lot of people I have taken care of are vastly uneducated about their health in general and the internet is not always an easy accessible tool. I don't think fundamentalist ideals are the only contributing factor to poor maternal health.

[treehugger]

@Firebird, a lot of the US is very rural, but we also have a large population of people in Canada who live very rural (it is a real problem). I wonder if it could be a combination of rural and poverty, since the US does not have socialized health care, and private care is so expensive. 

I also found this to be interesting: https://www.npr.org/2017/05/12/527806002/focus-on-infants-during-childbirth-leaves-u-s-moms-in-danger

Apparently some of the problem could be in part because focus on the newborn infant health is pushed so much in training for OB's they are not trained as intensely as they could be on maternal health. 

[WhatWouldJohnCrichtonDo?]

6 hours ago, Briefly said:

As a redhead, there were serious concerns that I might have bleeding issues when my daughter was born.  The doctor was aware and he was prepared to deal with it.  I did bleed a little more than a non-redhead but not excessively for me.  But I never really thought about it not being addressed with any other woman.  I can see how it could be a serious problem that is not being addressed like it needs to be. 

snipped 

I'm also a redhead. I never talked with my OB about my bleeding risk, but I did ask the nurse who taught our childbirth class if it is true that redheads are at a greater risk for bleeding. She assured me that it is an old wives tale.  (There was one other thing she said in that class that seriously pissed me off, but I'll save that for another day.)

Fortunately, when I started bleeding after my first birth, I was quickly given an injection that stopped the bleeding. (It may have happened the same way at my second birth, but I don't remember.) I don't know whether it was a hospital policy to keep that medication handy, or whether my OB and nurses were just prepared. Either way, I don't think I realized just how fortunate I was, to have good care and to not have personnel who took things for granted. I'm also fortunate to live in an urban area of a rural state and (frankly) to be white and English speaking.

We have the ability to do better for all mothers. We need to do better for all mothers.

[Briefly]

15 hours ago, WhatWouldJohnCrichtonDo? said:

I'm also a redhead. I never talked with my OB about my bleeding risk, but I did ask the nurse who taught our childbirth class if it is true that redheads are at a greater risk for bleeding. She assured me that it is an old wives tale.  (There was one other thing she said in that class that seriously pissed me off, but I'll save that for another day.)

Fortunately, when I started bleeding after my first birth, I was quickly given an injection that stopped the bleeding. (It may have happened the same way at my second birth, but I don't remember.) I don't know whether it was a hospital policy to keep that medication handy, or whether my OB and nurses were just prepared. Either way, I don't think I realized just how fortunate I was, to have good care and to not have personnel who took things for granted. I'm also fortunate to live in an urban area of a rural state and (frankly) to be white and English speaking.

We have the ability to do better for all mothers. We need to do better for all mothers.

It's not an old wive's tail, the so called Redhead Curse is real. But we don't all have the same aspects of it.  There has been a lot of research done over the last few years.

But yes, we do need to do better for all mothers.

[Eternalbluepearl]

I gave birth a month ago in New England. I was truly amazed at how much work the nurses had to do. I had two nurses with me in my labor and delivery room and they were with me the entire time. They did everything. They were also very engaging and chit chatted and joked with my hubby and I the whole time while caring for me, watching monitors, making sure I was feeling good, helping me with absolutely everything. There was no searching for a nurse if we needed one, they stayed right there in the room for hours until I delivered. During the pushing stage, the nurses kept me focused and really gave me the confidence that I was doing everything right. The care I received was phenomenal. The doctor came in near the end, saw that I was ready to deliver and delivered my baby. But I have no doubt that those two nurses could have done it all on their own. The delivery doctor was wonderful, but for days afterward I couldn't stop talking about the nursing staff. 

[VelociRapture]

On 1/14/2018 at 3:41 PM, smittykins said:

I live in a rural county which lost both of its hospitals more than 25 years ago(and the maternity wards were already long closed), and our closest hospital, 10 miles away, stopped delivering babies several years ago.  Now, women have to travel anywhere from 12 to 25 miles to give birth. 

My OBGYN is 32 miles away. The Hospital I had my daughter at and where I was treated for my miscarriage at is 31 miles away. Both take around 35 to 40 minutes for us to reach if traffic is good.

I live in a small state and there are Doctors and Hospitals much closer to us... but I love my Doctors. They took care of me during both my pregnancies and they kept my baby safe during her premature birth - with helping her breath again and cutting the cord wrapped around her neck so she wouldn’t be strangled as I pushed. I consider myself exceptionally fortunate that we are able to freely choose to stay with those Doctors. Many women don’t have the luxury of choice either because they don’t have reliable transportation or (like you said) there are no other options within a reasonable distance for them to travel. 

On 1/14/2018 at 4:32 PM, HarryPotterFan said:

This is an informative piece about Serena Williams’ experience with childbirth. She’s prone to blood clots, and was having trouble breathing after giving birth to her daughter by C-Section. She got up out of bed and demanded a CT scan because she was worried about a pulmonary embolism. The nurse dismissed her concerns, and Sarena pushed until a doctor listened. And she was right. She could have died. She ended up having other complications as well. This article really gets into the especially high maternal death rates among black women:  https://www.vox.com/identities/2018/1/11/16879984/serena-williams-childbirth-scare-black-women

I saw this a few days ago. If Serena Williams can’t get medical professionals to listen to her then what hope does anyone else have?

[Curious]

On 1/14/2018 at 6:58 PM, Firebird said:

Another thought, could part of the reason for such high maternal death rates in the US be due to how rural a chunk of the population is? Countries like England and Ireland are so much smaller and the travel time to large cities with top rated medical care (I would assume) would be shorter. There are areas of NY where you have to travel an hour to get to the local Podunk hospital that can basically treat pneumonia and stitch up a farm accident. There may not be access to prenatal care let alone good prenatal care. A lot of people I have taken care of are vastly uneducated about their health in general and the internet is not always an easy accessible tool. I don't think fundamentalist ideals are the only contributing factor to poor maternal health.

I wasn't suggesting that ONLY fundamentalist thinking was the cause for this.  I grew up in a rural community (pop: 4000ish).  When I had my "emergency c-section" with my first pregnancy I had to wait for a surgeon from another town (pop: 1000ish) to finish up a surgery he was doing and then drive over to do my c-section.   I'm sure if it had been a true "she's going to bleed out" type situation they would have either transported me or someone would have figured out how to get a c-section done.  As it was a low fluid situation, they monitored the baby and it was fine to wait the few hours it took to get the surgeon over.

If we wanted/needed any kind of specialized care, then it was a 2 hour drive in either of 2 directions to get to the "big city hospital."   I imagine it's still very similar in that area.  I haven't been back there since I left in the early 90s.

On 1/15/2018 at 12:20 AM, WhatWouldJohnCrichtonDo? said:

(There was one other thing she said in that class that seriously pissed me off, but I'll save that for another day.)

You can't just drop a bomb like that and then say "I'll save that for another day"  When will another day come?  Maybe never and then I will always be thinking "I wonder what that other thing was.'  I have enough useless worries taking up space in my brain that could be used for other things.  Dish!

[Naga Viper]

53 minutes ago, Curious said:

You can't just drop a bomb like that and then say "I'll save that for another day"  When will another day come?  Maybe never and then I will always be thinking "I wonder what that other thing was.'  I have enough useless worries taking up space in my brain that could be used for other things.  Dish!

In Maxhell we call that "the pizza cutter wait." Spoiler: It's been months, possibly years on that one.

[NotQuiteMotY]

On 1/14/2018 at 5:18 PM, Firebird said:

As someone who works in a rural hospital with the large hospitals 45 minutes away in good weather, healthcare is very behind. It's not that people don't care, but it's hard as a nurse when on a day shift you can have up to 8 patients and on an evening shift up to 10 and even more on nights to provide consistent or quality care. Often times we work with one or no aides or secretary and have no doctors on the floor. The managers are blind to the problem or don't care and the patients suffer. This is on med surg. I will be going to work on maternity soon, but even up there they often work without an aide and only staff three nurses. One to work triage/ labor delivery, one to work nursery, and one to work post partum with Mom and baby.

I have even addressed concerns with my CNO and get platitudes. 

Whoa. The maternity ward at the hospital I delivered at assigned a nurse for every four mothers in recovery. The numbers at yours are insane.

[Bethella]

6 hours ago, NotQuiteMotY said:

Whoa. The maternity ward at the hospital I delivered at assigned a nurse for every four mothers in recovery. The numbers at yours are insane.

The nurses at the "big" hospital in my area went on strike last fall. They've been working without a contract since the end of July and the main issue is under-staffing. They've filed a formal complaint with the state citing 6:1 patient loads (or higher in some cases) and numerous (like more than 200) cases of nurses being required to work double (16 hour) shifts. I don't know how many beds are in the birthing center but on some nights they had 2 RNs staffing the unit with no scrub tech, so if there was an emergency c-section one of the RNs would have to scrub-in, leaving the other nurse responsible for the entire unit.

[formergothardite]

My mom and I were discussing this and how the hospital where I was born closed their maternity ward years ago. Now all the women from that area have to drive 25-30 minutes to another hospital. 

[Hane]

Years ago, I read an article on the finances of hospitals, in which the author “rejoiced” whenever a (small) hospital closed. I wanted to hunt him down and demand what he proposed as an alternative for emergencies, trauma surgery, and childbirth.

[Someone Out There]

If we want to talk about remoteness being a factor,  Aside from Canada, Australia is a good example of rural and remote systems for maternity health without as large an issue as the USA.  Also maybe its just me but I just don't see a 30 minute drive being all that far... (I do understand that it can be the difference to life and death though...)

I found the following report from 2012-2014 about maternal death rates in Australia.  On page 15 it has the remoteness of the women and the mortality rate.  It does indicate that there is no data for one state, and one territory in regards to remoteness, which also happen to be the locations that would have the most remote areas though...  It should also be noted that at home births are rare in my understanding.

https://www.aihw.gov.au/reports/mothers-babies/maternal-deaths-in-australia-2012-2014/contents/table-of-contents

In my search I also found the following article which discusses how things are done in the Northern Territory with the very remote people.  It also discusses some of the issues around how remoteness is dealth with (i.e. in the Northern Territory women are sent to Darwin or Alice Springs away from family and friends a bit before the birth), and some of the issues with obstetric care in remote locations.  The article also does seem to indicate that unfortunately a hotel room is not provided in other states though (which is problematic if you don't have the money for a hotel room and need to go elsewhere for giving birth)...

http://www.abc.net.au/news/2016-03-24/waiting-for-baby-childbirth-in-remote-northern-territory/7046284

Something else that is interesting in regards to health care in the USA is that your government actually spends more on health care than a lot of the other OECD countries according to this article...  This is on top of the high private costs as well.

https://www.pbs.org/newshour/health/health-costs-how-the-us-compares-with-other-countries

 

[December]

What a great/scary piece. It's terrifying to think how far some people need to go for medical care, but especially pregnancy-related care. I can't wrap my head around how it's acceptable to close something like a maternity ward. The cognitive dissonance in all these cuts to and restrictions on women's healthcare is shocking... 

[JMarie]

On 1/15/2018 at 3:56 PM, Eternalbluepearl said:

I gave birth a month ago in New England. I was truly amazed at how much work the nurses had to do. I had two nurses with me in my labor and delivery room and they were with me the entire time. They did everything. They were also very engaging and chit chatted and joked with my hubby and I the whole time while caring for me, watching monitors, making sure I was feeling good, helping me with absolutely everything. There was no searching for a nurse if we needed one, they stayed right there in the room for hours until I delivered. During the pushing stage, the nurses kept me focused and really gave me the confidence that I was doing everything right. The care I received was phenomenal. The doctor came in near the end, saw that I was ready to deliver and delivered my baby. But I have no doubt that those two nurses could have done it all on their own. The delivery doctor was wonderful, but for days afterward I couldn't stop talking about the nursing staff. 

Congrats on your new little one!