ABC News Reports on Rise in Maternal Mortality Rates

This video really drives home that there is still more work to be done in making birth safer for women and their babies (thanks to Walker Karraa for the pointer):

ABC News Video - New Moms at Risk: Why are a growing number of American moms dying shortly after giving birth?

It talks about a new report commissioned by the California Department of Health and presented by a watchdog group, California Watch (read their report: More women dying from pregnancy complications; state holds on to report), that shows that the number of women who die within 42 days of giving birth has nearly tripled over a decade.

In terms of maternal mortality, the US is moving backwards. These numbers haven't been seen since the 1970's. Causes include pre-existing maternal conditions such as diabetes and obesity, but they go on to talk about scheduled c-sections as being a large contributer to the increase in deaths.

The advice? Avoid interventions during labor - particularly inductions, and avoid c-sections.

The video ends with this very important point: If you see something that's wrong, say something.

I want to raise a few points along with this.

First, the final advice about "saying something" is really quite hard, particularly if you are a low-income or minority woman. Why? The medical system is intimidating. Sure, many women feel perfectly comfortable talking to their medical professionals about their concerns, but many do not. If you are someone who is not used to speaking up to people in authority (doctors, nurses, medical professionals), then speaking up when one is vulnerable, a new mother, and in bed wearing a hospital gown is not something that comes easily. For some women and in certain cultures, challenging a man in charge is practically unthinkable. And if you are a woman for whom English is not a first language, then this is even harder. To cap it off, even if she does say something, there is a chance that concerns will be dismissed or ignored - "She's just a complainer."

There's a skill to speaking up in a way that can be heard, and a way of being persistent if one's concerns are not heard the first time, but if one has no guide on how to do this, concerns can easily go unspoken or unheard and the medical professionals lose the opportunity for gathering very important medical information. Having a doula can really help, because she can help create the space for the woman to speak to her medical provider and help her articulate what is going on so it can be heard. The doula doesn't speak for the woman, but allows the woman's own voice to come through and speak for herself.

Second, how does one reduce interventions or reduce the c-section rate? Well, one peer-reviewed, statistically significant way of doing so is... to have a doula.

I for one find it shocking that the maternal mortality rate is so high in the United States. I am glad to know that ABC News finds this shocking as well. Anyone notice how in the video, the announcer appears genuinely surprised and dismayed? I'm so glad information like this is finally getting out.

Maybe now, something can be done.

Inspired

Recently we had our monthly board meeting. As usual, I came away completely inspired by Open Arms.

Annie Moffat, our WCELI Program Director, presented to the board on the many new program changes and updates for this year. The staff have clearly been working extremely hard to implement a whole new model for client visits and recordkeeping that streamlines processes and ensures that every client receives all information.

Some highlights:

• We now have a much more efficient system of collecting data about births and outcomes. Although this is all information we've tracked since Open Arms opened its doors, it will be a lot easier for our doulas to keep records with the new system, and it will be a lot easier for us later to go back and run statistical analysis on our outcomes to bring you solid quantitative data about the work we do. You'll be hearing more about this for sure.


• Our doulas now routinely screen for perinatal depression. As seen in previous posts, this is critical for maternal and baby health. By addressing this routinely with every client, we hope to remove the stigma and enable women who experience perinatal depression to seek help early.


• Our doulas also spend time with every client discussing the signs and symptoms of preterm labor, and how to bring this to the attention of caregivers. Preterm labor is not like traditional labor, and the signs and symptoms can be subtle. By making clear what to look for, women can return to their caregivers with clear information to seek medical help when they experience something out of the ordinary. Already we've seen this information make a difference to our clients, who were then able to seek help early enough to stop labor.

I'm thrilled with the hard work that the staff has been doing and their clarity in forming such a robust program. I think both our doulas and clients will benefit from the new guidelines.

And who knows - out of all the women who learn what preterm labor is like, some percentage might tell a sister or friend, and help another woman avoid delivering prematurely. Out of all the women who receive screening for perinatal depression, some percentage might recognize the signs in a cousin or daughter and help her seek help in a nonjudgemental way.

Open Arms hopes, by supporting, educating, respecting, honoring and empowering women, to make a difference not only to the women who are our clients, but the women who know them as well.

As the commercial goes, "And they tell two friends, and so on, and so on..." And that's how change happens.

Once a woman finds her voice, connects with her power, it's awfully hard to take that away. She will go out in the world and help others become knowledgeable.

We support the women who will teach the village that will raise the children.

Describing Open Arms

I was at the board executive committee meeting today and we were discussing how we describe Open Arms. We do a lot in unique ways - sometimes it's hard to describe.

Many of the terms we use have specific meanings in the nonprofit community. We do home visits, we are community-based, and we provide doulas for the perinatal period (before, during and after birth). It's the combination of these things that provides the magic of what Open Arms is. But each of the terms is limited - and our mission spans all of them.

We do home visits - but most home visitation services don't attend births, so we are unique in that way. We attend births, but we do a lot of our work before and after the birth through our home visits and the scope is broader than what traditional, private-pay doula services provide. And, our community-based work ensures that the services we provide are culturally-relevant and anchor the family in the larger community that will continue support for years to come - something generally not done by either home visitation services or doula work.

And what comes out of this unique combination? We have a wide range of impacts - supported family, fewer interventions during birth, shorter hospital stays, increased breastfeeding, parent education, community support, increased support for early learning, lower postpartum depression, increased bonding....

We hope that the impact of support services at a pivotal time will last for many years. One of the things we discussed today is that our outcomes follow studies done nationally - we know that - for example, our breastfeeding rate is well over 90% and our c-section rate is more than half of the general Seattle population. But we need to apply statistical analysis to our data so that we will be able to say for sure what our outcomes are. We hope to get this kind of analysis underway this year. We also hope to follow our clients over the past 11 years (which can be hard with a mobile population) and find out what the long-term impact really is. We think we know, but we want to quantify it.

We'll keep you updated as this progresses.