Pregnancy is a thrilling and scary time in a woman's life. There's so much to celebrate, but we also face the risk of unexpected complications and serious health issues. Of course we worry about our babies, but what about our own health and safety? In modern society, having a baby seems like it's a safe thing to do, but you might be surprised to learn just how at risk mothers are in particular: A recent report on maternal mortality uncovered some extremely disturbing facts about the too-often grim fate of mothers in America, and the way the system is failing them is heartbreaking.
For six months, NPR's Renee Montagne and ProPublica's Nina Martin investigated the health of mothers and babies in the US, and what they found is that health-care providers aren't making the health of mothers a priority.
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While the infant mortality rate in this country has fallen to its lowest point in history, more American women die of pregnancy-related complications than in any other country in the world -- and only in the US is the rate rising, with 700 to 900 women dying every year (and another 65,000 nearly dying). In every other wealthy country, the maternal mortality rate is on the decline. And while some mothers are hit harder than others -- African-Americans, low-income women, and those in rural areas, for example -- women of all backgrounds, ethnicities, and income levels are dying from complications such as cardiomyopathy, blood clots, infections, and preeclampsia.
According to the CDC, almost 60 percent of these deaths are preventable. So why are they still happening?
Too many health-care resources are going toward babies.
Under the Title V federal-state program, states devoted just about 6 percent of block grants for "maternal and child health" to mothers, with 78 percent going to infants and special needs children. Over approximately the last decade, at least 20 hospitals have established centers for high-risk babies, but only one hospital in the US (NewYork-Presbyterian/Columbia) has a similar program for women with high-risk pregnancies. Changing requirements for new ob-gyns have also played a part in skewing the focus of the medical community toward babies instead of mothers. In fact, the report found that some physicians in the US entering the field of maternal-fetal medicine completed their training without ever spending time in a labor-delivery unit.
The average pregnancy and birth looks different now than it used to.
New mothers are often older now, which means they can have more complicated medical histories, the report mentions. Plus, about half of US pregnancies are unplanned, which means women don't have a chance to address health issues pre-pregnancy. We also induce labor more frequently and have higher C-section rates, which can lead to more potential complications.
Too many women don't have adequate health insurance.
Even for women who are insured, adequate care isn't a guarantee, as the investigation showed a lack of consistency in hospital protocols for dealing with postpartum complications (which can quickly become lethal). Surprisingly, the report found even hospitals with neonatal intensive care units are often unprepared for maternal emergencies.
Women don't get enough instruction about self-care when they leave the hospital.
Women aren't told how to take care of themselves or what symptoms to worry about, and this can lead to infections and other problems once new moms get home. As maternal health advocates told NPR and ProPublica, babies are watched more closely than moms during and after childbirth, which means that doctors and nurses can sometimes miss important warning signs.
It's an incredibly scary situation, and, frustratingly, one that could be remedied. A CDC analysis from earlier this year identified over 20 "critical factors" that contribute to pregnancy-related deaths, among them: "lack of standardized policies, inadequate clinical skills, failure to consult specialists and poor coordination of care." The average maternal death was found to involve 3.7 of these critical factors.
Other countries have found ways to address these factors, as is evidenced by their low maternal mortality rates. Britain, for example, has reduced preeclampsia deaths to one in a million by standardizing hospital protocol -- that's just two deaths from 2012 to 2014. In America, preeclampia is to blame for a whopping 8 percent of maternal deaths (about 50 to 70 women per year). If other countries can save these lives, why can't we?
Some states, it should be noted, are making an effort to follow the leads of other countries (California, for one), and are having some success. But, experts say, even hospitals that are willing to try new approaches need more resources, better training, and, ultimately, more funding. Of course it's an undeniably good and important thing that the infant mortality rate is dropping. But the maternal mortality rate shouldn't have to rise as a result. We can, and must, find a way to take care of both women AND children in this country. Too many lives are at stake.