Mamas on Bedrest: Giving Life: A Risky Proposition

December 17th, 2011

Wow, I just watched Diane Sawyer’s special on ABC’s  20/20, “Giving Life: A Risky Proposition”.

First and foremost, I am really glad to see mainstream media tackling such an important global issue. Diane Sawyer and her colleagues traveled around the world to some of the most impoverished countries and witnessed some of the most horrendous conditions under which the world’s women are giving birth (and losing life!). The statistics were often staggering and disheartening,

  • Girls under 15 are 5 times more likely to die in childbirth (and in many developing countries, girls even younger are giving birth!)
  • In developing countries, 20% of women will give birth with no medically trained attendant.
  • 1 in 21 women die in childbirth in Sierra Leon, more than in any other country in the world.
  • Peripartum hemorrhage is the leading cause of maternal mortality. Misoprostol is critical to stop post partum hemorrhage and is in short supply to developing nations.
  • The US ranks 50th in maternal mortality in the world. (This is the stat presented in the TV piece. “The US rank is 41st in maternal mortality” is what’s printed in the ABC News Press release.)
  • Georgia has one of the highest rates if maternal mortality in the US.
  • 2 women die in childbirth daily in the US. Rates are 4x higher for African American women in the US.

As one expert (sorry, I didn’t catch his name) said so eloquently,

“We have what it takes to save lives. The Question is will we decide to do it?”

I just had a similar conversation with Jennie Joseph, LM, CPM, founder and Executive Director of Common Sense Childbirth, The Birth Place, Easy Access Prenatal Clinics and creator of prenatal care “The JJ Way”.  Jennie has put together an effective early access prenatal care program and is working tirelessly to bring it to women throughout central Florida, across the United States and globally where ever needed. As we talked about the issues affecting maternity care in the United States, we reached a similar conclusion; That low cost, low intervention, effective methods of delivering prenatal care are available. We have to decide as women and as a nation whether or not we are going to make the choice to make safe, accessible maternity care available to ALL women.

It really is a choice. While watching the 20/20 special, they showed a young obstetrician who had traveled to Sierra Leon and was desperately trying to help women in a nationally funded hospital that was so poorly equipped and so poorly staffed that she literally watched as a woman hemorrhaged post partum because there were so few tools available for her to intervene. Yet, there was a clinic staffed and supported by the women of Sierra Leon and there, women received supportive care and the outcomes at this locally supported clinic were far better than the outcomes for the nationally funded hospital.

In Bangladesh, maternal mortality was spiraling out of control. When skilled maternity workers realized that women were not coming to the hospitals and clinics erected, they started taking maternity services to women in their homes-the method used for centuries and the method of childbearing most familiar to the women. As a result, Bangladesh has dropped is maternal mortality rate 43%.  In addition, birth workers in Bangladesh are using cell phones and an increasing rate and as a result, they are able to communicate with physicians and other workers as needed while still serving women in their most comfortable environment.

In Mexico, the government started a national campaign for contraception when birth rates and maternal and infant mortality were skyrocketing. Since implementing a contraceptive campaign and extolling the benefits of smaller families and fewer conceptions for women, Mexico has seen 76% of women using contraception. It must be noted that for all its benefit, contraception is still not widely accepted amongst men, and many still hold onto old notions of “Machismo” where the more children a man sires, the more manly he is! As a result, many women access contraception secretly in an effort to improve their opportunities in life, to have reproductive choice and to improve their overall health.

So what’s it going to be? Are we going to continue to wring our hands and lament the abysmal maternal and infant mortality numbers in this country or are we going to do something about it? Jennie Joseph is doing it. Shafia Monroe is doing it with her International Center for Traditional Childbearing. DONA International is doing it. Centering Healthcare is doing it. We can do it. Million Moms Challenge showed what can be done when we work collectively. When Johnson & Johnson pledged to donate $100,000 if the Million Moms Challenge gathered 100,000 supporters, they went to work, gathered the supporters and recouped the money. In fact, Million Moms raised more than $1.5 million dollars to support work that improves health of women, infants, children and communities.

It has been stated and shown, “We have what it takes to save lives.”   The question now is, “Will we do it?”

Photo is courtesy of yfrog and printed with permission.

What will you do to improve maternal mortality in the US and abroad? What would you like to see done? Share your vision with us here, or send an e-mail to info@mamasonbedrest.com. We’re talking about it on Twitter, @mamasonbedrest, and will also take your comments on Facebook. To stay in the loop, be sure to subscribe to our blog via the RSS feed on the upper right hand corner of our pages.

2 responses to “Mamas on Bedrest: Giving Life: A Risky Proposition”

  1. Mazy says:

    While I found this episode of 20/20 very informative, I was a little uncomfortable with their portrayal of “unassisted” births (meaning, births where medical professionals were not present). I felt that it gave a negative light on homebirths & unassisted pregnancies. It did, however, clearly make a connection between the access to information & decreased maternal mortality rates. This, I believe, is the key nugget of information to be gleaned from this piece.

    I have given birth to two children. The first was in a birthing center (with Jennie Joseph as my midwife!) & the second was a planned unassisted pregnancy & unassisted homebirth (I did, however, have a doula in the event I would transfer to the hospital, who was also training to be a midwife). I had two very different birth experiences & have to say that, for me, the second was more enjoyable.

    My unassisted pregnancy & baby were both easy & healthy, BUT I had access to the Internet & could Google any question that popped into my head. I had access to INFORMATION, easing some of the risks of unassisted childbirth. Having said this, I would like to be clear that a normal, healthy pregnancy does not necessarily need “medical assistance”. However, knowledge about the female body, child birth, and infant CPR, as well as access to information about warning signs & how to get help when needed is imperative.

  2. Darline says:

    Mazy, I am not sure where you are writing from, but given that Jennie Joseph delivered one of your children, I am going to assume that you are in the US (Florida??). This is a HUGELY different picture than what was portrayed in the 20/20 show. First and foremost, you are educated (at least beyond grade school. Not the case for women in many developing nations). You are more than likely older than 15 (the age of they young Afghan woman and many young “brides” in developing countries). You are likely well nourished and have access to resources. In fact, you clearly state that in your “unassisted” birth, you had a doula and internet access. Believe me, you were LIGHT YEARS ahead in terms of assistance! If you watched the show, many of these women were giving birth on dirt floors, no sanitation and no resources. In Bangladesh, the availability and use of cell phones greatly changed birth outcomes as women then had access to resources. If many of these countries had internet access (and the ability to read!), I strongly believe that the maternal and infant mortality rates would be very different.

    I am hugely in favor of home births and midwife assisted births in uncomplicated pregnancies. But for the women in these segments, they were not always uncomplicated births. I can say from experience, had I been in one of those situations (or even your unassisted birth) with my first child, I would be dead (hemorrhage). There are lots of things that can go wrong and I believe that there should at least be one other person present. The fact that you had a doula to me means that you were assisted and that is good. Someone needs to be present and able to intervene-even to call 911-should the need arise.

    Correct me if I am wrong, but I am hearing that you felt the 20/20 segment portrayed unassisted births as somehow “less safe” than medically assisted (lots of intervention) births. What I glean from your comment is that you are in favor of less intervention. On that note, I agree. There needn’t be a lot of intervention for a birth to proceed normally. But there should be someone there to “assist” mama should she need help and both mama and the attendant should be prepared in the event things begin to turn for the worse. And I agree with you, this is where education and information are key.

    The “take home message” that I got is that globally women need access to information and resources (internet, medical advice, sanitation and simple supplies such as clean pads, clean water, etc…). It is women themselves who will turn the tide on maternal and infant mortality, but we can’t do that if we don’t know what we need to do and once we know, can’t access the supplies (birth control, medications, supplies, education, etc…) we need.

    Thanks so much for taking the time to comment and share your views. You raised some really good points.
    Darline

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