Reading Ina May's Guide to Childbirth (see post of best pregnancy book ever), I was really suprised at the statistics that the book presents on maternal mortality and morbidity. Hers' are stats from the States, but I got curious as to what it was like in Canada. (all of this is from a published paper, by the way... here's the link http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1216316).
This paper had some interesting results.
"In summary, we found that severe maternal morbidity occurs in about 1 of 250 deliveries in Canada. Considerable increases have occurred over the past decade in rates of venous thromboembolism, uterine rupture, adult respiratory distress syndrome, pulmonary edema, myocardial infarction, severe postpartum hemorrhage requiring hysterectomy, and the need for assisted ventilation. Because adjustment for maternal age, multifetal pregnancy and previous cesarean delivery did not change the overall results, these changes are unlikely to be caused by demographic trends; investigational attention should be paid to the reasons for these increases."
This is better than in the US, but the fact that morbidity is increasing is alarming. You would think that it would be going down, that all the docters and interventions involved in pregnancy/labour/delivery now would make it safer to have a baby. But the rates are going up. In her book, Ina May discusses reasons for this. Things like amniotic fluid embolism (major cause of maternal death) occur naturally about 1 in 50, 000 - 1 in 80, 000 births. Being induced increases this. One hospital in Phoenix had a AFE rate of 1 in 6000. If you get this complication, you have a 50% chance of dying. Other complications, such as uterine rupture, also increase with interventions like c-sections and induction.
On the WHO database of maternal mortality stats (http://www.who.int/reproductive-health/global_monitoring/RHRxmls/RHRmainpage.htm), Canada did pretty well for maternal mortality (6 per 100,000 births). Other countries like Denmark, Iceland, Norway, Ireland, Sweden and Spain did better. As it turns out , Sweden, Denmark, and Norway all have most of their babies delivered by midwives, not obstitricians. I couldn't find out anything about Iceland. Ireland and Spain both have midwives, but babies are delivered in hospitals, much the same way it is in Canada. I wonder what causes the very high infant/maternal death/morbidity rates in the US, as compared to Canada? I would have to guess at the lack of universal health care and prenatal care. One more reason to not privatize health care in Canada.
Not a very eloquent blog entry tonight, but i'm kind of tired, and i'm writing this as i'm doing the research, instead of putting it all together,and writing it out logically.
Only 2.5 weeks left :) Baby is posterior (facing my tummy instead of my back), by the way. I hope he/she turns around, or it might be a long, tough haul for me.
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2 comments:
hey Leah! When I went into labor with raye, she was facing the wrong way too. I got into the shower and did yoga (mainly downward dog position) and I turned her, she was born facing down. Might be worth a try! Hold the position for at least 10-15 seconds and do lots of reps.
Preventing maternal mortality is one of the cardinal goals of maternal and child health services and obstetrics. The godfather of the quest to reduce maternal mortality in Sri Lanka is Dr Nalin Rodrigo, the well-respected doyen of obstetricians. In his introduction to the preface to the publication, "maternal deaths in Sri Lanka" he opines, "to obstetricians, maternal mortality is not about numbers. It is about making safe for women, the life enhancing process of giving birth. Safety depends on women's own ability to seek care and the service providers’ ability to provide timely and quality care. Almost every maternal death is an event that could have been avoided. Such deaths should never have been allowed to happen in the first instance.
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jones
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