Michelle Teheux: Yes, women still die in childbirth
I was truly astounded to read, on Mother's Day weekend, that according to the Centers for Disease Control and Prevention, American women giving birth today are twice as likely to die in childbirth as their mothers were.
This statistic was in a Daily Beast story by midwife Ina May Gaskin.
How can we spend more on maternal health care than any other nation but have such poor outcomes for mothers and babies?
True, dying in childbirth is still quite rare, but it’s becoming slightly less rare, and part of the problem is illustrated by the fact that we’ve accepted the illogical belief that a third of human women are unable to give birth without being cut open.
Criticize the state of modern obstetrics and you will hear, “Women used to die in childbirth all the time!” Modern medicine is given the credit for today’s rare (albeit increasing) maternal deaths.
But a great deal depends on what part of the past one is examining. In the 1800s Ignaz Semmelweis figured out that when doctors washed their hands between patients, many more mothers lived. But his ideas were ridiculed. Childbed fever raged among those delivered by doctors but was rare among women attended by midwives. Meanwhile, the women in the hands of colonial midwife Martha Ballard fared quite well considering there was no Plan B hospital to go to for those times when a cesarean was truly needed.
The absolutely ideal situation, available throughout much of Europe, is to have well-trained midwives handle the births of healthy, low-risk mothers, with obstetricians available in the unlikely (more unlikely than most think, in fact) event that an unforeseen emergency should occur. This ideal no doubt accounts for the much better birth outcomes there.
Part of the value of prenatal care is in distinguishing which women can safely give birth at home and/or with a midwife, and which ones need to be in the hospital under a doctor’s care.
We tend to believe that sudden obstetrical emergencies “just occur” quite often based on the birth stories we’ve heard from our friends and relatives. But most of those emergencies occur because we simply cannot keep our cotton-pickin’ fingers off laboring women and let the process occur normally.
We don’t trust that her body will go into labor at the right (or convenient) time, so we induce. We don’t think the labor is fast enough, so we augment her labor with pitocin. That makes contractions more painful, so we give her an epidural. That slows down the labor, so we up her dose of pitocin. That pushes the baby into distress, so we jump in with a cesarean, and as the mother will forever after tell the story, “Thank God I was right there in the hospital or my baby would have died. His heartbeat had slowed way down.”
If we want safer mothers and babies and lower maternal health care costs, we will work to bring more midwives into the system, and we will keep obstetrical interventions for those cases in which they are actually needed.
Pekin Hospital is doing an admirable job of finding ways to bring the best of both worlds to birthing women, and that’s why well-informed women from surrounding areas will bypass closer hospitals to come here.
We somehow got the idea that the same extreme measures that save lives in a birth gone wrong must also be helpful to use during a birth that is going just fine. That was a tragic mistake to make, and until we face that, we can look for maternal mortality rates to remain higher than they have to be.
Michelle Teheux may be at firstname.lastname@example.org.