Archive for March, 2010

Amnesty Calls U.S. Maternal Health Care a “Crisis”

Ina May Gaskin's Safe Motherhood QuiltAmnesty International minces no words in its new report on U.S. maternity care. Deadly Delivery: The Maternal Health Care Crisis in the U.S.A., reports that more than 2 women die per day in the United States from pregnancy- or childbirth-related complications, a rate that’s worse than in 40 other industrialized countries. “Preventable maternal mortality
is not just a public health issue, it is a human rights issue,” states Amnesty.

“Women in the USA face a range of obstacles in obtaining the services they need. The health care system suffers from multiple failures: discrimination; financial, bureaucratic and language barriers to care; lack of information about maternal care and family planning options; lack of active participation in care decisions; inadequate staffing and quality protocols; and a lack of accountability and oversight.”

The report profiles several women who died or nearly died because of inadequate, inappropriate, or discriminatory care: one woman dies of a blood clot following a cesarean section, which could have been prevented with simple circulation stockings (a standard prophylactic for other major surgeries); another woman bleeds to death following a C-section, even after she and her husband plead with medical staff to address her troubling symptoms; a high-risk woman experiencing complications late in pregnancy is turned away from a prenatal clinic because she can't afford a $100 deposit; both she and her baby die after care is delayed.

Each death represents dozens of “near misses” that often leave women in worse health; of the 4 million American women who give birth each year, 1.7 million women experience complications that lead to adverse effects. "The US health care system is failing women," says Amnesty. Read the full report here.


NYT: Res Midwives a Model for U.S. Health Debate

courtesy NYT

In today’s New York Times, Section A, a story about a tiny, impoverished Navajo hospital in Tuba City, AZ, doing birth better than anyone: “this small hospital in a dusty desert town on an Indian reservation, showing its age and struggling to make ends meet, somehow manages to outperform richer, more prestigious institutions when it comes to keeping Caesarean rates down, which saves money and is better for many mothers and infants.”

How do they do it? Midwives attend the majority of births; obstetricians are available if needed. All the providers are on salary, so the profit motive is gone. And the hospital is federally insured, so it hasn’t been bullied into banning VBAC like so many others around the country. Even though the patient population has risk factors like hypertension and diabetes, the cesarean rate is a mere 13.5%.

“Tuba City…could probably teach the rest of the country a few things about obstetrical care,” writes the Times. “But matching its success would require sweeping, fundamental changes in medical practice, like allowing midwives to handle more deliveries and removing the profit motive for performing surgery.”