Perception holds that the United States has best possible health care and the days of fearing pregnancy are a thing of the past. To be fair, Maternal Mortality is rare, just 11 women in 100,000 pregnancies back in 2005. But it’s on the rise. A new report sponsored by the California Department of Health shows that the incident of Maternal Mortality has steadily grown over the past decade, rising to about 17 people in 100,000 in 2006. Statistically, it is safer for women in Poland, Croatia, Italy and Canada to give birth than it is here in the U.S. While there are a number of factors, including hemorrhage, deep-vein thrombosis, blood clots, and underlying cardiac disease, much of the risk is connected to C-sections. Dr. Mark Chassin, president of the Joint Commission, says that “as many as half of those deaths are preventable.”
One contributing factor is that more obese women are becoming pregnant — about 20 percent of all pregnant women in the U.S. these days are obese. Obesity, a danger in and of itself, becomes an even more problematic during pregnancy. What’s more, the obesity often suggests that a C-section is in order… which leads to the next cause for concern.
The CDC’s figures suggest that 31 percent of the mothers who died had chosen to have a C-section. What is in question is whether that was an actual preference or a policy decision. Studies consistently demonstrate higher mortality rates as a result of C-section deliveries — especially when the woman has had multiple C-sections. The mother herself may not prefer the C-section but many hospitals mandate C-sections for women who have had them before: even when this policy can increase the risk factors for the expectant mother and there may be no specific reason why the mother cannot deliver naturally
If C-sections are more dangerous, and multiple C-sections create an even higher risk, why would hospital policies require that a woman who has had a C-section before deliver by C-section again? When a standard policy contradicts patient safety, it seems clear that the policy must be modified.
Health care reform isn’t just a problem for the government. We, health care providers and patients, must take proactive steps to reform our health care systems; even when these steps mean questioning standard policies.