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Maternal Mortality in the US
- Jul 14, 2009 at 3:08 PM
- By
- Comments (50) Total Views (1134) Everyone can see this journal post.
In the past couple of days I have been hearing about how great all this medical technology is regarding labor and delivery, but nothing to really back up these claims.
Let's start back in the early 1900's when birth first made it into the hospitals. Doctors did not know how to keep clean, spread infection, and best of all, doctors actually graduating from medical school 9 times out of 10 had never seen a live birth before, let alone delivered a baby.
Women were dying from infections being spread from doctors who would see sick or dying patients, than scoop right in to save the day with the mom in labor.
Then came the smear campaigns against the midwives, who had been delivering most of the babies up until that time. These women were trained from generation to generation to do nothing but deliver babies. There was cases where mom's would die without cesareans, from postpartum hemorrhage, or other complications, because there was no monitoring like we have today (even for home births).
The doctors and hospitals would paint pictures of a poor black grannie midwife in the south, that came from a poverty stricken area, and make people believe this was the type of care everyone would get from a midwife, which as we all know was bogus. But because these shiney, new, big, glorious hospitals were telling us this, we magically started to believe it. (Just like we do today.)
In 1920, when birth really first started to move into hospitals, the maternal death rates ballparked around 900 per 100,000 live births according to the US CDC, and we did see a decline in the maternal death rates, for a long while. Until recently.
The lowest Maternal death rate the United States has seen since the early 1900's was in in the late 1980's which ballparked to be around 7-8 deaths per 100,000 live births.
Let's look at the birth climate in the late 1980's.
Fewer cesarean sections, fewer inductions, only 45% of births were continuously monitored, the VBAC rate was much higher, and all in all the mortality rate was low.
I think we can all say 7-8 per 100,000 is a good rate.
Well then it started climbing again, slowly at first during the 1990's, there were lots of medical "experiments" on mothers with medications, monitoring types, cytotec was being used to induce almost every VBAC (until they found out that it was CAUSING uterine ruptures) and the cesarean rate started to creep up again.
In 1990 the national cesarean rate overed around 24% which is still almost 10% more than the WHO recommends as a safe cesarean rate for The United States (10-15%). In 2007 our cesarean rate hit an all time high of 31.8% nationally. For the past 11 years straight, the cesarean rate has increased.
The VBAC rate has decreased.
The induction rate has increased.
The continuous monitoring rate has increased to 80%.
And guess what? More women are dying today.
Today, ballpark according to the CDC 20-30 women will die per 100,000 live births.
We are going backwards.
Denmark, Japan, China, Germany, Great Britain, Holland.... all have lower maternal mortality rates.
All have lower intervention rates.
All have lower cesarean rates.
ALL HAVE HIGHER MIDWIFERY CARE RATES!
ALL HAVE HIGHER HOME BIRTH RATES.
Congratuations if you read this far. Maybe you learned something!
Tags: maternal mortality, mortality, cesarean, birth, united states, c-section, vbac
Comments:
I read the book "your best birth"....well I read most of it , it started to annoy me after the first few chapters. I think that the statistics and data absolutely need to be evaluated for medical practices regarding childbirth. I do not believe homebirths are for everyone and I do feel that medical intervention is necessary for some. Going back to your statistics, you said the 80's was the best time for our maternal rate, it was during that time that doctors and midwives worked together for their patients, instead of doctors being allowed to run the situation. I think there needs to be a balance met somewhere, more insurance companies need to pay for midwives and doulas and there needs to be some sort of procedures and policies in place for women that choose not to homebirth. Awareness for the moms is number one, we all need to be able to make educated decisions. There also needs to be some sort of financial intervention, which is why I believe c-sections are up.....look at everyone that gets paid from it. If doctors and hospitals were not paid so much extra for csections, then it wouldnt be in their best interest. Imagine how much would change if we said "from now on, you will be penalized for every unnecessary induction that leads to c-section" I bet they would shape up real quick.
voted popular.
Voted up. Can't post this kind of info enough...there are always going to be moms reading things like this for the first time. Information is everything...thanks for helping to get moms informed.
I agree with Goodwoman614. There is SO much information like this that I have never heard about, or read about before, and I appreciate any new knowledge, especially when it comes to the health and well-being of my child, myself, and well anyone that I know! Thank you. (Hubby and I are currently trying to concieve, so I'm doing lots of reading about everything I can find lol)
Voted popular. I had an unnecessary c-section in a hospital after 31 hours of labor, and while nothing did go wrong, I don't deny the statistics. Things could have gone horribly wrong. Had I been in a more peaceful environment with more support, my labor quite probably would have been shorter and my baby would have come out as nature intended. Despite all of my reading and learning about natural birth before having my baby, there were many things I didn't realize I didn't know, and learned the hard way through experience. I encourage moms, especially first time moms planning to have a natural hospital birth, to read my birth story in my journal and learn from my mistakes. Things will be very different when we decide to have baby #2.
I heard of this before, after I had my son. It is making me think I would do things differently if I was to have another baby.
I agree with the pp about doctors working with midwives. At present they are competing with midwives for money and influence. In countries where midwives are a full participant in the health care system, OBs are speacialists, not the "general practitioners" of obstetrics they are in the US.
I know one military wife that gave birth in a German hospital. She was completely cared for by a midwife and the doctor sat in a corner reading the paper.
I know another woman who gave birth in Holland where midwives are the standard of care (though US methods are making inroads) and a postpartum doula type person comes to care for you the week after delivery in your home.
My mw assisted pregnancy was healthier than the one overseen by a doctor.
If you feel you must use a doctor rather than a midwife or deliver at a hospital at least pick one that is midwife friendly. If your hospital has a 40+% c-section rate and doesn't admit midwives find one that does.
I will vote popular. My first son was a c/s and I hated myself for letting it happen I swore I would have a VABC with my second and I did. It was not my dream birth but close and I am happy with that. My hubby was the only person in my family that supported my decision untill they saw how easy things were for me. My cousin who told me a repeat c/s would be much easer wont even talk to me.
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Voting popular:) I was very lucky to have such an awesome midwife while pregnant with my daughter, and since she decided to move out of the state, I'm doing it all myself this time, since no midwife in the area will do a homebirth.