• Hey, guest user. Hope you're enjoying NeoGAF! Have you considered registering for an account? Come join us and add your take to the daily discourse.

Focus On Infants During Childbirth Leaves U.S. Moms In Danger

dramatis

Member
The U.S. has the worst rate of maternal deaths in the developed world, and 60 percent are preventable. The death of Lauren Bloomstein, a neonatal nurse, in the hospital where she worked illustrates a profound disparity: the health care system focuses on babies but often ignores their mothers.
The ability to protect the health of mothers and babies in childbirth is a basic measure of a society’s development. Yet every year in the U.S., 700 to 900 women die from pregnancy or childbirth-related causes, and some 65,000 nearly die — by many measures, the worst record in the developed world.

American women are more than three times as likely as Canadian women to die in the maternal period (defined by the Centers for Disease Control as the start of pregnancy to one year after delivery or termination), six times as likely to die as Scandinavians. In every other wealthy country, and many less affluent ones, maternal mortality rates have been falling; in Great Britain, the journal Lancet recently noted, the rate has declined so dramatically that “a man is more likely to die while his partner is pregnant than she is.” But in the U.S., maternal deaths increased from 2000 to 2014. In a recent analysis by the CDC Foundation, nearly 60 percent of such deaths were preventable.

While maternal mortality is significantly more common among African Americans, low-income women and in rural areas, pregnancy and childbirth complications kill women of every race and ethnicity, education and income level, in every part of the U.S. ProPublica and NPR spent the last several months scouring social media and other sources, ultimately identifying more than 450 expectant and new mothers who have died since 2011. The list includes teachers, insurance brokers, homeless women, journalists, a spokeswoman for Yellowstone National Park, a co-founder of the YouTube channel WhatsUpMoms, and more than a dozen doctors and nurses like Lauren Bloomstein. They died from cardiomyopathy and other heart problems, massive hemorrhage, blood clots, infections and pregnancy-induced hypertension (preeclampsia) as well as rarer causes. Many died days or weeks after leaving the hospital. Maternal mortality is commonplace enough that three new mothers who died, including Lauren, were cared for by the same OB-GYN.
At the federally funded Maternal-Fetal Medicine Units Network, the preeminent obstetric research collaborative in the U.S., only four of the 34 initiatives listed in its online database primarily target mothers, versus 24 aimed at improving outcomes for infants (the remainder address both). Under the Title V federal-state program supporting maternal and child health, states devoted about 6 percent of block grants in 2016 to programs for mothers, compared to 78 percent for infants and special-needs children. The notion that babies deserve more care than mothers is similarly enshrined in the Medicaid program, which pays for about 45 percent of births. In many states, the program covers moms for 60 days postpartum, their infants for a full year. The bill to replace the Affordable Care Act, adopted by the U.S. House of Representatives earlier this month, could gut Medicaid for mothers and babies alike.
[...]
The growing specialty of maternal-fetal medicine drifted so far toward care of the fetus that as recently as 2012, young doctors who wanted to work in the field didn’t have to spend time learning to care for birthing mothers. “The training was quite variable across the U.S.,” said Mary D’Alton, chair of OB-GYN at Columbia University Medical Center and author of papers on disparities in care for mothers and infants. “There were some fellows that could finish their maternal-fetal medicine training without ever being in a labor and delivery unit.”
In the U.S., unlike some other developed countries, maternal deaths are treated as a private tragedy rather than as a public health catastrophe. A death in childbirth may be mourned on Facebook or memorialized on GoFundMe, but it is rarely reported in the news. Most obituaries, Lauren’s included, don’t mention how a mother died.
To Larry, the fact that someone with Lauren’s advantages could die so needlessly was symptomatic of a bigger problem. By some measures, New Jersey had one of the highest maternal mortality rates in the U.S. He wanted authorities to get to the root of it — to push the people and institutions that were at fault to change.

That’s the approach in the United Kingdom, where maternal deaths are regarded as systems failures. A national committee of experts scrutinizes every death of a woman from pregnancy or childbirth complications, collecting medical records and assessments from caregivers, conducting rigorous analyses of the data and publishing reports that help set policy for hospitals throughout the country. Coroners also sometimes hold public inquests, forcing hospitals and their staffs to answer for their mistakes. The U.K. process is largely responsible for the stunning reduction in preeclampsia deaths in Britain, the committee noted its 2016 report — “a clear success story” that it hoped to repeat “across other medical and mental health causes of maternal death.”
ProPublica and NPR collaborated on this report.

The text of both is the same. NPR's comes with a short 7-minute audio report; the ProPublica version has a comments section.

It is a long read, but well worth reading.

Also randomly
As the maternal death rate has mounted around the U.S., a small cadre of reformers has mobilized. Some of the earliest and most important work has come in California, where more babies are born than in any other state — 500,000 a year, one-eighth of the U.S. total.
Whoa California
 

Laekon

Member
I did an RN labor and delivery clinical at a very busy hospital in Los Angeles this year and didn't see this at all. The L&D nurse is more focused on the mom. Another RN comes in to assist when the delivery is about to happen to take care of the infant.
 

Trojita

Rapid Response Threadmaker
I did an RN labor and delivery clinical at a very busy hospital in Los Angeles this year and didn't see this at all. The L&D nurse is more focused on the mom. Another RN comes in to assist when the delivery is about to happen to take care of the infant.

It's mentioned in the article that California has had some of the earliest and notable advancements. You are seeing the effect of that most likely.
 
Once my son was born, and the cord cut, a different nurse took care of him, leaving her main doctor to tend to my wife.

After that, they were over both of them pretty regularly.
 

Mr. X

Member
Not surprised, our government works very hard to make sure women get screwed out of proper health care and services.
 
The US has not only the worst maternal mortality rate but also the worst infant mortality rate in the developed world. It's incredibly tragic.

The most disgusting part, imo, is that that the rates of maternal and infant mortality can differ greatly within the same city; some neighborhoods that are right next to each other can both be on complete opposite ends of the spectrum of those rates. It just shows how scrambled and fucked up the quality of healthcare in the country. (You can probably guess which neighborhoods get the best medical treatment and which get the worst)
 

Lamel

Banned
Having worked in the labor and delivery setting, I think this has more to do with lack of access to care and proper prenatal monitoring than the actual delivery room. Moms aren't just ignored by the healthcare providers the way this article makes it sound.

They usually return the baby within minutes for skin to skin. Pediatrics has to take a look at all babies first to make sure they are okay.
 
Defunding reproductive health care clinics and making them illegal or just nigh-impossible to visit for reasons (mostly Christian, GOP, anti-abortion, etcetera) is a huge driving force behind the USA's insane percentage of preventable maternal deaths.

Texas was our bellwether for this alarming trend. Highly suggest reading this older article: https://www.theguardian.com/us-news/2016/aug/20/texas-maternal-mortality-rate-health-clinics-funding

...the doubling of mortality rates in a two-year period was hard to explain ”in the absence of war, natural disaster, or severe economic upheaval".
 

tbm24

Member
My wife is due in a few weeks, not the Thread I wanted to stumble on. Will be telling if the doctors ignore her after the birth.
 

Keri

Member
It's mentioned in the article that California has had some of the earliest and notable advancements. You are seeing the effect of that most likely.

I gave birth in California last summer, at a Kaiser Permanent hospital and was very fortunate to do so, because I experienced massive hemorrhaging and blood clots, which are both leading causes of maternal death. I learned later that California and specifically Kaiser have worked extensively on protocols to deal with these issues. Thankfully, I was examined closely after birth and the hemorrhaging was noticed quickly and a team of doctors and nurses were instantly in my room, to treat me. It's really scary to think that other women in the U.S. are dying for similar, completely preventable reasons, because no one is checking on them carefully.
 

Nelo Ice

Banned
Sent this article to my sister since she and her eventual fiance are going to have a baby soon. Thank goodness we all live in CA. That article was tough to read and it's absurd so many life saving protocols were only recently adopted.
 

Linkura

Member
This chart is crazy, scary, rage-inducing, and depressing.

propublica-mortality-rates.png

The personal story in the article is just fucking heartbreaking. The mother's husband was a doctor and he tried his damned hardest to get her proper care, and the shitbag doctor ignored all the signs that she was in serious trouble. I hope the widow bankrupts that fucker and the doctor permanently loses his license.
 

Forearms

Member
Once my son was born, and the cord cut, a different nurse took care of him, leaving her main doctor to tend to my wife.

After that, they were over both of them pretty regularly.

This was our experience as well. We're in Washington state, for reference.


Our daughter never left our sight for the entire visit. They checked her out using a free-wheeling baby care unit in the delivery room, but that wasn't done until after she had skin to skin time with my wife for a good while.

Additionally, the staff made sure to warn us that none of the staff would ever ask to remove the baby from the room unless there was a medical emergency, which we would most certainly know about.

In reply to the OT - it's sad to see these numbers. I know my next door neighbors had a near-death scare for mom as some internal bleeding went unnoticed, but she was able to recover and is happy and healthy.
 

lightus

Member
It's interesting to see this. I work with a large variety of medical professionals and I hear from all of them that the mother comes first.

In fact most don't even like the idea of risking the mothers life for the chance to save the child.

I've only skimmed the link so I'll have to really sit down and read it when I get the chance.
 

Keri

Member
My wife is due in a few weeks, not the Thread I wanted to stumble on. Will be telling if the doctors ignore her after the birth.

FYI, some hospitals have what they call a condition "h" and a number patients can call, if they feel there is something medically wrong and it's being ignored by their care givers. This brings an emergency medical team that evaluates the situation. So, you may want to check if your hospital offers the same.

I read a pregnancy/mom subreddit and this came up in the discussion about this article, since a lot of the expectant mothers are obviously worried.

Also, here is a semi-related article about how Doctor's Take Women's Pain Less Seriously. So, really try to keep an eye out and advocate for your wife, just in case. I mean, in the case of maternity care she won't be competing with men for care, but still.
 

Linkura

Member
It's interesting to see this. I work with a large variety of medical professionals and I hear from all of them that the mother comes first.

In fact most don't even like the idea of risking the mothers life for the chance to save the child.

I've only skimmed the link so I'll have to really sit down and read it when I get the chance.

Definitely read it in full. In the personal story, it's more about the mother having issues AFTER childbirth as opposed to before. Like, once the baby was out, they pretty much ignored all the huge red flags that were popping up. Though there were signs during labor, but the situation wasn't dire for hours after.
 

mreddie

Member
The irony, they focus on the fetus yet after birth, they give no fucks about the mother and the baby.

They don't see people in need, just dollar signs.
 

GashPrex

NeoGaf-Gold™ Member
Not my experience at all either time - they check on both regularly

In fact, they wouldn't leave my wife alone either time, checking on her regularly (and the baby) - in fact I think they checked her more often.

And yes, I just had my second 4 days ago
 

Jenov

Member
That story was heart-wrenching. Unbelievable how careless they were with the mother, and the pain she suffered. Reforms definitely need to happen, and I'm glad her story is being told.
 
My wife is due in a few weeks, not the Thread I wanted to stumble on. Will be telling if the doctors ignore her after the birth.

Literally in the same boat here.

It forced me to read up on HELLP and hopefully I can recognize any symptoms if anything were to happen. Horrific stuff.
 

Jinaar

Member
"What is a woman? A miserable little pile of secrets. But enough talk… Have at you!"

USA USA USA! Number 1 worst in the developed world! USA USA USA!
 
Top Bottom