Wednesday, December 8, 2010

Pregnancy Should Bring Life, Not Death

Those of you who have been reading me for a while should know that I'm kind of obsessed with everyone having a fair shake in life. It's what led me to be a feminist and and activist, and I just can't imagine any other way to be. I'm also very interested in/concerned by the medical treatment of women, especially pregnant women, as someone who's suffered through two unintended pregnancies that ended in horrific miscarriages, and as someone wants to reproduce with her partner sometime in the near future (assuming we'll ever be able to afford it).

So when I saw the RH Reality Check article "Human Rights-Based Approaches to Maternal Death," I knew I'd stumbled across today's blog topic. Here's the gist of the article:

Two to three women die each day in the US because of pregnancy-related causes. A further 34,000 more women experience “near misses” each year. Women in the US are more likely to die of complications resulting from pregnancy or childbirth than women in 49 other countries, including South Korea, Kuwait, and Bulgaria. In fact, according to recently released UN numbers, the maternal mortality rate nearly doubled between 1990 and 2008.

There are shocking inequities in maternal health in the US. Women of color, low-income women, Indigenous women, immigrant women and women with limited English proficiency all face additional risks. For example, black women are nearly four times as likely to die from pregnancy related causes as white women. In high risk pregnancies, black women are five and a half times more likely to die. The inequalities are also geographical; risk is not uniform across the 50 states. Women in DC are almost 30 times more likely to dies than women in Maine.

These inequities are a result of systemic barriers to maternal care in the US. One of the largest problems is the lack of access to care caused by discrimination, language barriers and financial troubles. Women have been turned away because they couldn’t speak English and subjected to racial stereotyping and disrespect which affected their treatment. There are also problems with shortages of medical providers, a lack of culturally appropriate care, inadequate implementation of protocols, and a severe lack of accountability.


Many women lack access to information about family planning and affordable contraceptive services. In reality, about half of all pregnancies in the US are unplanned. This is significant because women with unintended pregnancies are more likely to develop complications, face worse outcomes, start prenatal care late and receive inadequate prenatal care.

Pre-natal care is incredibly important because women without it are three to four times more likely to die. However, Native American women are 3 ½ times more likely and African American and Latina women are 2 ½ times more likely to have no prenatal care as white women. 21 states do not offer “presumptive eligibility,” which allows pregnant women to get temporary access to Medicaid before their paperwork is completed.

There is a very real shortage of health professionals, including maternal health care providers. There are particular shortages among providers who accept Medicaid – this scarcity being even worse among specialists. 65 million people live in medically underserved areas – primarily in inner cities and rural areas. This lack of health care providers can have deadly consequences...

Just as important is receiving care after birth. Postpartum care in the US is inadequate, generally consisting of a single office visit with a physician around 6 weeks after birth. To help women, there also has to be better access to information about family planning and affordable contraceptive services. Women are 2 ½ times more likely to die if they become pregnant again within 6 months of giving birth.

When you look at all these barriers together, the US lack of an accountability system obviously contributes to the rise of maternal mortality. There is no nationwide requirement to separately report maternal deaths. So in other words, many maternal deaths are never identified as pregnancy related. In fact, 29 states and the District of Columbia have no review process at all.

Nearly half of all maternal deaths could be prevented with better access to good quality maternal health care. From a human rights perspective, this is completely unacceptable.
I don't know about you, but this makes me very upset (although it also makes me feel lucky that I didn't die or anything after my first miscarriage for which I received absolutely ZERO medical treatment because I couldn't afford it). This is just another clear symptom of how messed up and bigoted our political and healthcare systems are. We're supposedly the "greatest nation on Earth" and yet we can't collectively care enough about the women birthing new citizens into our nation to make sure they're cared for?

Total Bull Crap.

Related posts:
Tick Tock Goes the Clock
Happy Birthday to Me

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Radioman KC said...

I do enjoy your blog, May, so long as you don't sing. (grin). But it's funny listening to a polyqueer muse about pregancy when you have such perfect birth control.

Otherwise... feminists are in some ways screwing up the country because they're too preoccpied with their gender characteristics. And the word 'choose'? As in Choose to have a baby with your partner?

I think you're way too internally focused to be a good parent although I'm sure you hope to be good at anything you choose to do.

Choose instead to get a cat. I'm sure you'll get him neutered. If you do choose to have a baby, I hope you get a boy, just don't try to neuter HIM. He will teach you a great deal.

With love and respect, sis!

May said...

I don't see anything loving or respectful about judging my worth as a parent. Just because you read my blog, doesn't mean you know me, and you've certainly never witnessed the amazing knack I have for dealing with children.
Being self-aware doesn't make one ineligible for parenthood. In fact, all the good parents I know are highly self-aware people.

I have no idea what you mean by feminists screwing up the country, or what you mean about my having "perfect birth control." I have no idea what you mean by most of this, but I find it insulting, pointlessly blame-shifting, and extremely rude.

Neil said...

"We're supposedly the "greatest nation on Earth" and yet we can't collectively care enough about the women birthing new citizens into our nation to make sure they're cared for?"...
Every prenatal death is not caused by the unavailablity of resources.
I imagine many (though not all)prenatal problems are the results of bad personal habits that women refuse to forego when they learn they are pregnant.Unprotected premarital sex is bad personal habit number one in this logic tree. I think it is not the government's responsibility to make sure expectant mothers are cared for, but the mothers'. For someone who speaks a lot about empowerment, this message of helplessness sounds odd.

May said...

Neil, I often talk about people who need help in our society because they are often overlooked and uncared for. Empowerment is an important part of life, but so is caring for others. Individuals are responsible for themselves, but many do not have the resources to know how to care for themselves, and that's where society should step in. We spend so much money on warfare, it is clear that is a priority compared to healthcare, and as a society this is a problem that can only be fixed by us collectively, not by individuals.

And, to your first point, I never said all prenatal death was caused by resource problems.

Secondly, you said "I imagine many (though not all)prenatal problems are the results of bad personal habits that women refuse to forego when they learn they are pregnant." The problem is, this is something you MADE UP, what I'm talking about are facts and figures that are REAL. There's a huge difference between the two.

stefany said...

Have you read the National Women's Law Center's health care report card that just came out? Relevant and alarming.

May said...

Stefany - I hadn't! Thanks for pointing me to it!

Anonymous said...

May, Radioman seems to hate everyone. Its not personal. He would like to be a protector of women & children, but he wants to hate on the poor, other races, immigrants, etc. You can't have it both ways; because when you're talking about these groups, you're talking about women & children. As always, I salute your bravery.

P.S. Its okay if you don't post this, because its late & its mostly for your edification.

May said...

Thanks, Byron. I know it's not personal, but it is completely ridiculous IMO.