We are very pleased and excited to announce our new weekly chats all about maternal health with some of the leading maternal health experts, researchers, practitioners, and organizations in the world under the #maternalhealthchat hashtag. Starting on Tuesday, November 8 at 1 PM EST with Jacaranda Health we will host 30-minute chats each week all about maternal and reproductive health as well as the health of newborns. We will dig … Continue reading Announcing #MaternalHealthChat Starting November 8 With Jacaranda Health
When everyday Americans think about women dying during childbirth it is probable that their initial thoughts travel directly to Africa where it is quite well known that maternal mortality is rife. Chances are their thoughts never focus on the deaths and near deaths during childbirth that women experience right here in the United States. After all, the overwhelming consensus is that the United States has the best medical care, superior health workers and health system in the world despite some of its inherent challenges. This thinking renders maternal mortality in the US thoroughly inconceivable to many even while data reveal it should not be inconceivable at all. In fact, maternal mortality is on the rise in America having doubled over the past 25 years all while global maternal deaths are steadily declining. Globally, maternal mortality was effectively reduced by 44 percent according to the World Health Organization.
The United States, while not the overall leader in maternal mortality among all countries, it is the leader among all developed nations. The United States ranked number 33 out of 179 countries in Save the Children’s 2015 Mothers’ Index Ranking and 46th in the world due to the rate of women who die from pregnancy and childbirth complications. Compared to other developed countries, the United States’ ranking is abysmal, especially with Norway, Finland, and Iceland ranking in the top three overall. Even countries like Estonia and Belarus, whose GDPs are considerably lower than ours, far outrank America.
Every year just over 500,000 women die from complications in pregnancy and childbirth across the world. Another 20 million experience severe complications. But many of these complications are entirely avoidable – including obstructed and protracted labour and one of its side-effects, obstetric fistula.
An obstetric fistula is a hole in the birth canal between the vagina and the rectum or between the vagina and the bladder that is largely caused by obstructed and prolonged labour. This can occur when the mother’s pelvis is too small or the baby is too large.
In sub-Saharan Africa for every 100,000 deliveries there are about 124 women who suffer an obstetric fistula in a rural area. Obstetric fistulas predominantly happen when women do not have access to quality emergency obstetric-care services. Antenatal care could help to identify potential problems early but will not have an impact if there is no skilled surgeon to assist with the labour.
For years researchers who study maternal morbidity and mortality have been stumped as to why rates continue to rise and why women of color are adversely affected despite education, health care, and socio-economic factors.
A new report and the first of its kind released in May, New York City 2008 – 2012: Severe Maternal Morbidity, shows the myriad reasons why women of color, especially low-income, Black non-Latina, women fare the worse with severe maternal morbidity (SMM). While most studies in the past across the country focus on maternal mortality, this report focused on maternal morbidity, the causes of maternal mortality.
At most hospitals in low-resource settings it is very unlikely that women would receive pain medication during labor. This is a problem, however, when women must receive emergency C-sections. While some administer general (inhaled) anesthesia, the spinal anesthesia poses more risks when there is no adequate training. However, doctors and researchers have shown that spinal anesthesia can be successfully given in low -resource settings with proper training.
Doctors and researchers from the non-profit, Kybele, Inc, have worked at Ridge Regional Hospital in Accra, Ghana, a regional referral hospital that has an estimated 8,000 births per year, many high-risk deliveries. Kybele, Inc began the MOMS (Making Obstetric Management Safer) program at Ridge Regional Hospital where they teach nurses practical skills for spinal or epidural anesthesia.
“We demonstrated that spinal labor analgesia can be provided in a low-resource setting with the development of appropriate protocols, staff education, and the availability of a few basic drugs,” write Dr. Adeyami J. Olufolabi of Duke University Hospital and colleagues in Teaching Neuraxial Anesthesia Techniques for Obstetric Care in a Ghanaian Referral Hospital: Achievements and Obstacles (June 2015). They describe their “achievements and obstacles” in working to implement an effective labor analgesia service at a busy hospital in Accra, Ghana.
Once girls get their period in low- and middle-income countries where resources are low, their lives change — sometimes irreparably.
When girls get their periods they oftentimes have to drop out of school and work around their home instead. And on top of that, many cannot afford sanitary napkins.
Irise International, an East African organization, is fighting the stigma of menstruation and providing easy, affordable solutions for girls when they get their periods.
See their work in their video: Periods Change Lives