When I want to learn more about a subject I always turn to documentaries. They provide a quick way to get the facts and crucial information about an issue I am interested in and then if I want to learn more I turn to other resources including books, news articles, research papers, and the like.
While I know a considerable amount about two new documentaries coming to video on demand (VOD) this year, I know some don’t and can use these as jumping points to learn more about the maternal health crisis in the United States and sex trafficking around the world.
The COVID pandemic did much to upend global health. Not only were hospitals filled to overcapacity worldwide with patients experiencing severe COVID symptoms, but entire health systems were also brought to a halt. Routine medical procedures and quality care in other areas besides COVID were preempted by the global virus. This has caused global health goals to suffer, notably decreasing preventable maternal deaths.
This month the World Health Organization along with the UNFPA created new goals in order to get back on track to reach Sustainable Development Goal 3.1 – reducing the global maternal mortality ratio to less than 70 per 100 000 live births – by 2030. Right now, the estimates are at 211 deaths per 100,000 live births.
Currently, 810 women still die per day due to complications caused by pregnancy and childbirth. While this number is a drastic improvement from a decade ago there is still much to do in order to save more mothers’ lives not only in the United States but worldwide.
You have probably heard the story of Tashonna Ward, the 25-year-old Milwaukee woman who recently spent hours in the emergency room due to shortness of breath and died after waiting too long. Ward was told that she would spend between two to six hours in wait time at the ER according to distressing posts on her Facebook page. Preliminary tests were performed on Ward and showed she had cardiomegaly, an enlarged heart, but she was never admitted despite having chest pains and tightness of breath.
After waiting 2 hours and 29 minutes in the ER, Tashonna Ward and her sister decided to go to urgent care. She never made it. She passed out en route and collapsed and died in the urgent care parking lot. The cause of death: hypertensive cardiovascular disease.
While many reports mentioned the emergency room wait times that led to Ward’s death, a few have reported that she developed cardiomegaly due to pregnancy complications from a miscarriage in March of 2019. In fact, the Milwaukee County Medical Examiner’s Report states that the “decedent did develop cardiomegaly during pregnancy.”
The United Nations has designated Sierra Leone as the most dangerous place to have a baby. In fact, it has the highest maternal mortality rate in the world at 1,360 deaths per 100,000 live births. On average, most women have at least six babies in Sierra Leone. In a previous post I mentioned the Aminata Maternal Foundation that helps pregnant women in Sierra Leone. An … Continue reading [WATCH] Video Shows Horrors of Childbirth in Sierra Leone #MaternalHealth
One of the leading causes of maternal mortality in the United States is hemorrhaging. In fact, according to the CDC hemorrhaging accounts for 11.2% of pregnancy-related deaths. Based on these increasing numbers since 1986 the Joint Commission, the country’s leading accreditation organization for hospitals, has created 13 new standards for perinatal safety for hospitals to properly care for women who hemorrhage during or after delivery. These standards were designed specifically to prevent, recognize and treat, as well as evaluate patients for transfer to critical care for not only hemorrhage but also severe hypertension/preeclampsia.
As I have written many times before postpartum hemorrhage (PPH) or excessive uterine bleeding after childbirth is the leading cause of maternal mortality in low-and-middle income countries. The recommended drug to prevent PPH according to the World Health Organization (WHO) is oxytocin. When administered in its recommended dose it causes little to no side effects. Oxytocin, the WHO’s current gold standard therapy, however, must be refrigerated and administered by skilled health workers posing two obstacles to its wider use in low resource, tropical settings.
Some countries have approved misoprostol, an oral drug, to prevent PPH, but there are several concerns that its use can be misappropriated for abortions instead of used solely for PPH. The World Health Organization has listed misoprostol as an alternative to oxytocin if it is not available.
Now, another PPH preventative drug, carbetocin, has been added to the latest updated 2019 WHO Essential Medicines List. The announcement was made last week. Unlike oxytocin, even at high temperatures carbetocin remains effective. The recommendation is that carbetocin can be used when oxytocin is not available or if its quality is uncertain. Additionally, the cost must be comparable to oxytocin.
Maternal mortality continues to be a major problem the world over. The United States is the only developed country where maternal death rates are increasing especially for non-Hispanic black women. And in low-and-middle income countries, approximately 830 women die each day from pregnancy-related, preventable causes.
Maternal health organizations are working diligently to save more mothers’ lives, but one death is still too many especially when it is likely preventable. I like to list organizations that you can support with donations in order to help them keep more women and their children alive on the local level and make sure mothers are a part of their families’ lives.
This list highlights local organizations that help some of the most vulnerable communities in countries with some of the highest maternal mortality rates. And, in the cases of the United States and Australia, the organizations help the communities that experience the most maternal deaths. Each site allows direct donations that go directly to maternal care and/or advocacy.
The Kenyan Medical Practitioners and Dentists Board has stopped the NGO Marie Stopes International from performing abortions in Kenya. Marie Stopes is a global organisation that provides contraception and safe abortion to women in urban and rural communities. Abortion is illegal in Kenya, unless a trained medical professional judges that there’s a need for emergency treatment, or that a woman’s life or health is in danger.
The Conversation Africa’s Moina Spooner spoke to Michael Mutua about the Marie Stopes ban and its implications.
How did the ban come about?
According to the Kenya Medical Practitioners and Dentists Board, they banned abortion services provided by Marie Stopes following complaints from the general public. The public claimed the organisation was running pro-choice media campaigns. These adverts specifically sought to provide women with a solution when faced with crisis pregnancies.
The adverts were also criticised by the Kenya Film Classification Board, which ordered Marie Stopes to pull them down for allegedly promoting abortion.
The relatively large number of American women who die due to childbirth is one of the little-known facts in our country. In a nation where we spend exorbitant amounts on healthcare, we have the highest maternal mortality rate of any other developed country. Word, however, is getting out that women are increasingly susceptible of dying during childbirth with a surge in articles in major publications and of hospitals, healthcare workers, and researchers working together to solve this problem.
We know that women in low-and-middle income countries are especially prone to maternal mortality. Those of us of who write about maternal health and keep up with worldwide maternal health, mortality, and morbidity statistics understand that in the world’s poorest countries we find the worst outcomes for both mothers and their infants. In recent years, we have also discovered that maternal health rates in the United States are far higher than acceptable. In fact, the United States has the highest maternal mortality rate than any other developed country in the world. The countries that have the lowest maternal mortality rates are European. But that can be misleading as well.
Safe Motherhood Week , that is recognized each year between October 2 – 8, is the first coalition of partners of its kind to focus on maternal health in Europe. Some statistics will surprise you. Did you know five European women die every day from maternal health complications and in 2013, 1900 European women died from maternal health complications. Additionally, 1 in 10 women in Europe does not have access to maternal health care in the first few months of their pregnancies.
As a mother of two, I did not have optimal experiences either time I was pregnant. Each of my pregnancies was different, but the feeling I had with both of them was identical. I never felt like my physicians really cared about my pregnancies or deliveries, but that I was just a number to them. I have always chalked it up to being relatively young. I was in my mid-twenties. Even still, I believe to this day that I should have been treated with more dignity and respect. Even in two different states, I was treated the same way – with relative indifference. Even though my oldest daughter is 19, I’m still bitter about it.
Globally, there’s a general decline in the number of women who die from pregnancy or childbirth complications. However in Kenya, it remains high at 488
deaths per 100,000 live births. Maternal mortality is a health indicator of the wide gaps
between rich and poor, urban and rural areas within countries.
Women in low-and-middle-income countries need clean birth kits in order to stave off deadly infections in themselves and their newborns. This is the case not only during home births with midwives but also in institutionalized settings. Zubaida Bai, founder of Ayzh, a social enterprise that creates clean, safe birthing kits for women as well as reproductive, newborn and adolescent kits, discusses how she included women’s voices in … Continue reading [Featured Video] Simple Birth Kit for Mothers in Developing World
Every day 800 women die during childbirth or from pregnancy complications. This startling statistic represents women who not only live in sub-Saharan Africa where most maternal deaths occur but also throughout the world. In order to reduce the number of maternal deaths in low- and middle-income countries across the globe design teams, social entrepreneurs, innovators, and NGOs are creating innovative ways in which to save more … Continue reading 5 Maternal Health Interventions That Save Mothers’ Lives
But Trump wants to go even further than his GOP predecessors by slashing spending on global health efforts funded through the United States Agency for International Development (USAID). Deeper family planning retrenchment would, however, put millions of lives at risk.
After eight years of practicing obstetrics and researching childbirth in the United States, I know as well as anyone that the American maternal health system could be better. Our way of childbirth is the costliest in the world. Our health outcomes, from mortality rates to birth weights, are far, far from the best.
The reasons we fall short are not obvious. In medicine, providing more care is often mistaken for providing better care. In childbirth the relationship between more and better is complicated. Texan obstetricians, when compared to their counterparts in neighboring New Mexico, are 50% more likely to intervene on the baby’s behalf by performing a cesarean section. Nonetheless, Texas babies still have a lower survival rate than New Mexican babies.
I long assumed that our most puzzling American health care failures were idiosyncrasies–unique consequences of American culture, geography, and politics. But a trip to India for the 2017 Human Rights in Childbirth meeting led me to a humbling realization: when it comes to childbirth, both countries fall short in surprisingly similar ways.
Human rights in childbirth
I take care of patients in at a well-funded teaching hospital in Boston, where pregnant women seem well-respected and have clear, inviolable rights.