Mother’s Day is usually a time for celebration in the United States, but celebrating it in a culture that devalues women, women’s health, and sets back the clock on Roe v. Wade are reasons to take stock, take a stand– not to smile and sit quietly.
Earlier this week, I attended a premiere of Christie Turlington’s movie, No Woman No Cry, which shows the hard public health work to improve maternal health globally. See it. It will be on this weekend on Oprah Winfrey Network on Saturday,May 7th, 9:30 PM EST.
Ninety-nine percent of maternal deaths occur in the developing world.
Statistics on maternal death and access to care among poor and minority women in the United States are staggering. The maternal death rate for black women in New York City is especially astounding. 2008 statistics reveal:
- a maternal death rate for black women of 79 per 100,000 live births for black women, compared to 10 white maternal deaths per 100,000 live births.
These numbers ought to be embarrassing for a city like New York.
If Mayor Michael Bloomberg wants to leave office with a decent record in public health, he should make improving maternal health a priority and invest dollars in restoring nurse midwifery programs in the City’s public hospitals. Sure you can tell a woman not to eat salt or drink sugary beverages. Obesity and diabetes make for trouble in pregnancy and labor. Prenatal care is paramount. These programs are valuable, but alone, they will not resolve these statistics. Resources are desperately needed at the time of labor and delivery.
Guidance for Quality Care
Cesarean section rates are abysmal in the United States, and cesarean sections have been associated with maternal deaths. Without concerted efforts to change practice patterns, these statistics won’t change. Other startling statistics, buried in federal reports, but extracted in a Childbirth Connection fact sheet are as follows:
- The 2009 cesarean section rate of 32.9 percent set a record nationally. It marks the 13th consecutive year of increase, and a record level national rate;
- Variation in practice patterns across the United States is pronounced, with New Mexico having the lowest cesarean section rate of 22.8 percent, Louisiana a high of 39.6 percent, and 48 percent in Puerto Rico;
- Vaginal births after cesarean (VBAC) are declining, not improving. In 1997, vaginal births after cesarean sections accounted for 35.3 percent; in 2006, the VBAC rate was 9.7 percent.
Maternal death review boards may help inform quality care, if they are not used to punish overworked workers. Texas is considering a bill. If you know how Boards have helped or hindered, say so in the comments here.
Back High-Quality Care
Childbirth Connection, formerly the Maternity Center Association in New York City, has a wealth of information and expertise on evidence-based, quality maternity care. Maternal health advocates are working hard in the developing world, where travel for care, nutrition, and access to quality maternal programs in a safe setting are especially daunting.
Honor the fine public health work of groups, such as Partners in Health and Save the Children, as well as your local workers, striving to improve these statistics with limited resources.
Happy Mother’s Day, everyone!