Wednesday, October 24, 2007


According to TIME magazine, that's the U.S. rank, out of 171 countries, of women who die from complications in pregnancy or childbirth. The U.S. death rate is 1 in 4800 women, compared to the average of 1 in 16400 in Europe. That's a huge difference. For a country that boasts itself on its medical advances, new and groundbreaking technologies, etc., that's quite shocking. With a c-section rate exceeding 30%, you'd think we should fare better, right? Or maybe, just maybe, are we overly managing pregnancy and birth? Could some of these deaths be prevented if women were cared for according to a midwifery model of care, rather than medical? Could the World Health Organization be on the right track if they say that if a country's c-section rate exceeds 15%, the risks of c-section begin to outweigh its benefits? Of course, the USA is also one of the leading countries for assisted reproductive technology. More and more women get pregnant who wouldn't normally have been able to, at increasingly advanced ages. Maybe that plays some part in why the maternal death rate is higher. There is a higher incidence of multiples (especially triplets and more), which bears more inherent risks. And the older the mother, the more risky pregnancy becomes, especially for first-time mothers. Whenever I see statistics like this one, I wonder what exactly it is that makes me so much more likely to die in childbirth here in the US than if I were to give birth in Europe. It does make me question the way pregnancy and labor are so activley/medically managed here. Technology has its place, no doubt about it, but is it possible to over-use this technology? Could routine use of IV's, pitocin, other drugs to induce and manage labor, epidurals, c-sections, etc. actually have a negative impact on maternal outcome? Or do women just die more easily here than they do in Europe? Is it coincidence that, generally, pregnant women in Europe receive care from midwives, and OB's are "reserved" for high-risk pregnancies and births? The majority of births in Europe are attended by midwives, be it at the hospital, birth center, or at home. If medical equals better, shouldn't the US rank number 1? Or, as far as normal birth is concerned, maybe medical doesn't equal better? There is no doubt that techonlogy has the power to save lives, but how much does it contribute to the loss of lives? And how much does the big dollar influence what's happening to maternity care in this country? I really want to see this movie. As well as this one, if it's ever released. Yes, we still do a lot better than other countries in this world. Yes, things do sometimes go wrong. But we can do a lot better. The birthing environment can be a lot better, and a lot safer, for women than it currently is.

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