Wednesday, November 11, 2009

Maternal Mortality, or What is Going On?

I read this BBC news article and thought they did a good job putting the maternal mortality problem in perspective. Trust the Brits to keep us Americans honest. We're doing better than third world countries, but for spending as much as we do, our rates of maternal death during or after giving birth are the worst. So what's going on?

One of the most disturbing parts of this all (besides women are dying and we don't really know why) is the issue racial disparities. Even when controlled for education and income levels, black women are dying much more often than caucasians, Asians and Latinas. If you aren't a statistician, that means that Michelle Obama or Oprah have a greater risk of dying in childbirth than I do, simply because of the color of their skin. And if that seems wrong, you've got it right. It is wrong.

So what can we do about this? The International Center for Traditional Childbearing is working to train midwives of color to help explore and combat these numbers. Midwives of color are rare, and obstetricians of color are even more so. I would really like to see some answers here. Why is this happening?

One theory is that because Americans intervene in normal childbirth more than many other countries, which has led us to a 32% Cesarean rate, we might be actually seeing iatrogenic deaths. A sobering thought: Hazards of Cesarean Birth.

One of my favorite midwives and writers on the topic of maternal deaths is a pioneer in the homebirth field. You can read Ina May Gaskin's writing in this area and see what you think.

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