Alarming Rise of Maternal Deaths in California
May 29, 2011
by Brooke Ezzat
|The opinions expressed herein are those of the author, and not necessarily those of The New Agenda.
Older mothers, obesity, poverty and C-sections were blamed on the spike in maternal deaths. - California Watch
Giving birth for women in the Golden State, according to these statistics, is now as dangerous as giving birth in Bosnia.
Why the spike in the maternal deaths (defined a death from childbirth complications within 42 days of delivery)? There are a number of reasons for the jump in maternal deaths, some factors are preventable and others are not. To begin with, the report cites better record keeping as a major factor in the increase in maternal deaths.
Nearly 33% of the reported increase in maternal deaths were due to better recording keeping, according to the authors of the report.
Other contributing factors appear to be changes in the population of women who are giving birth—women are delaying pregnancies because of financial and career issues, women who have undergone fertility treatments, and more obese women.
These factors can compromise the health of the mother. In fact, 60% of the patients were obese and heart disease was listed as a contributing factor in the deaths.
But there are other factors besides better recording keeping and the health of the mother that account for maternal deaths and those factors include racism and poverty.
African American women are four times more likely as white women to die in childbirth as white women, regardless of the economic status of the African American women. Is this fact attributable to the racism is a stressor or to the fact that the medical community dismisses or minimizes the information African American patients present? Poverty and lack of education seems to be a factor in the pregnancy related mortality rate; women who did not complete high school were four times more likely to die than women who attended college.
Another factor that may have played a role in the rise of maternal deaths is the increase in C-sections during the same period; C-sections rose by nearly 50% during the course of the study. C-sections have long been the subject of debate in the medical community because of the benefits and potential risks to mother and child; many of the health risks do not come to light until years later. While the surgical delivery may be necessary in some cases, there is a great disparity in C-section rates.
Some patient advocates believe that the difference in C-section rates is partially based on economics. According to CaliforniaWatch.org this C-section disparity is clearly illustrated in rates of two non-profit hospitals in the Inland Empire. Both hospitals serve similar ethnic communities with the same number of patients below the poverty line; one hospital had a C-section rate of 28.7 % for low risk pregnancies while the other hospital’s rate was 9%. Why the difference? The vice chairman of obstetrics at Riverside County Hospital believes the lower rate at his hospital is the result of doctors working in shifts, so there is no incentive to speed up deliveries. C-sections under this model are performed only when necessary.
So why has there been an increase in maternal deaths in California? There are multiple reasons from better record keeping, to later pregnancies, patients with multiple medical conditions, racism and poverty, and complications resulting from C-sections. While this may explain the increase in pregnancy-related deaths, it does not excuse the rise, and it is important the medical community and the government to acknowledge the issue exists so that patients can be made aware and deal with their pregnancies accordingly.
I don’t understand the following sentence from this article…
“Is this fact attributable to the racism is a stressor…” endquote.
“..women who did not complete high school were four times more likely to die than women who attended college….”
Obviously the educational level of women has nothing to do with their deliveries. It’s not as if having a degree or a high school diploma somehow magically makes women have easier deliveries and better health. Your body does not see a diploma and suddenly become strong and healthy. These kind of studies really bother me, because they are sneaky in the way they put the blame on women. If women who did not complete high school are at higher risk, it is because the medical profession does not value these women as much and is being more careless with them.
C-sections are huge in California. The poor are pushed into them because they often have medicaid and doctors don’t want to wait out a natural delivery. They also face huge malpractice premiums and are probably quite terrified of being held accountable if something goes wrong. But it’s not just poor women, Hollywood has promoted this idea of scheduling your birth, avoiding discomfort, and allegedly reducing damage to your vaginal area. Seriously, I’ve read some horrendous articles about the importance Hollywood places on having a C section to preserve your vaginal area for cosmetic reasons and men’s pleasure. First of all, this is completely untrue, but second of all, it’s atrocious to risk your life and your health, and your abdomen, because you feel pressured to make sure your vagina meets some patriarchal definition of perfection. Of course, this is quite common in our culture, women have been subjecting themselves to all sorts of other dangerous medical procedures for cosmetic reasons.
No every c section is a mistake, but when the rates double and the reasons for them are rooted in sexism, there’s a problem.
Actually, educational level has *everything* to do with birth circumstances. As educated persons tend to seek more education… and will attend childbirth classes.
Educational level also affect income. And, sadly, income level does make a difference as to the kinds of options one has.
I’m speaking here as a nurse with a MS in Family Studies, specializing is Mother-Baby care. I was a CBE, IBCLC and Doula for many years. And… quite frankly, level of education may be the single most salient factor in Maternal-Child health.
Agree with yttik on one thing, tho. The poor and uneducated are often pushed into dangerous birth situations by a medical community that is ever so eager to “cut and run.” And by that I mean … do a C/S to “get it over with” and run to the state for twice the reimbursement a vaginal birth would get them.
That’s only part of the puzzle tho. Because, C/S are also popular among the affluent. For all the dumb reasons yttik stated. And….
that brings us back to *education.*
I have felt lately that when I go to the doctor, I have to diagnose my problem myself in order to get any help. It seems the establishment has divided up the various organ systems into jurisdictions that don’t quite add up to a complete human. So you have to be aware of every possible specialty and the limits and specifics of what they cover or you just get the run around. They jam your situation into some rigid coding system and give you the predetermined cure and often they are curing one symptom of a problem but never addressing the underlying disease. Frankly I don’t see how an uneducated person or a non assertive person gets anything from the medical system.
I wonder if removing child birth from hospitals would help the situation. Just have birthing centers and have the profits from them going back to the birthing center not diverted to some obscure pet project of the hospital they are associated with. I also think women should be allowed to stay at the birthing center as long as they want. Some women have a lot of support and are eager to go home. Some women live in difficult circumstances and might want to linger some place safe for a week. This would also probably help identify a bunch of serious social problems before they could take a toll on the babies who are born into them.
These kind of studies really bother me, because they are sneaky in the way they put the blame on women.
I’ve noticed that the american health care system has been very cleverly shifting the responsibility for proper health care from the medical community to the patient, especially where women are concerned. So, if the medical community fails to diagnose and manage, for example, heart disease in women more than in men, then it is framed as the responsibility of women to research and recognize their symptoms and properly describe it to the doctors, ask the proper questions to get diagnosed. Similarly, with the Obgyns. It is the responsibility of women to get proper care, rather than the responsibility of the doctors to provide proper care. You need to do the research yourself, and if you don’t, it’s your own fault that you are dead, you stupid uneducated woman.
Leave your Response Want an avatar? Get a gravatar!
Community Room
February 22, 2012 at 11:22 am
February 17, 2012 at 2:39 pm
February 6, 2012 at 4:25 pm
January 30, 2012 at 2:36 pm
January 26, 2012 at 4:38 pm
January 23, 2012 at 1:04 pm
January 15, 2012 at 11:37 am
January 9, 2012 at 6:36 pm
BUILD your NETWORK
Our Network of College Women
Protecting our Teenage Girls
We’re in the Media »
Click to see our latest stories in the media
More Stories »Recent Comments
The Latest from our Blog
Archives
Pioneer Mentors
Blogroll
Find us Online
Subscribe Entries (RSS) | Comments (RSS)
The New Agenda is a 501(c)(4) organization dedicated to improving the lives of women and girls by bringing about systemic change in the media, at the workplace, at school and at home. More...