Maternal mortality rising in the U.S.

by Lisa Conley

The above video discusses the troubling trend of maternal mortality increasing among US women. The two main causes mentioned are obesity/preexisting health problems and planned (Cesarean) C-sections. The Sentinel Event Alert mentioned in the ABC news clip lists the following as the most common preventable errors in hospitals “failure to adequately control blood pressure in hypertensive women, failure to adequately diagnose and treat pulmonary edema in women with pre-eclampsia, failure to pay attention to vital signs following Cesarean section, and hemorrhage following Cesarean section.” While The Joint Commission makes recommendations for prevention of maternal mortality, they also grimly noted the findings of the Hospital Corporation of America who said the majority of maternal deaths are not preventable.

It is no surprise that with rising obesity in the US, come obesity related health complications from hypertension and diabetes. But how do c-sections fit into this increase in maternal mortality? A 2008 article from Syracuse, NY stated, “The local increase [in C-sections] reflects the national trend. Thirty-one percent of births nationally — the highest on record — are through C-section, compared to about 5.5 percent in 1970.” In her book The Purity Myth, Jessica Valenti discussed the forced c-sections of women who wanted to deliver vaginally but were made to have the surgery since they had c-sections for a previous birth. In one extreme case, Laura Pemberton of FL who refused a forced c-section, returned home only to be brought back to the hospital by a sheriff who shackled her feet. The c-section was performed against her will.

This leads one to ask, how many of these c-sections are truly planned by women? An article on Childbirth Connection states that out of the 1600 survey participants who had had a c-section, only 1 woman stated she had planned it with no medical reason. The article goes on to state that health insurance coverage often grants hospitals an incentive for a speedy c-section over a potentially longer vaginal birth. “A planned cesarean section is an especially efficient way for professionals to organize hospital work, office work and personal life. Average hospital charges are much greater for cesarean than vaginal birth, and may offer hospitals greater scope for profit.” How many c-sections are performed against a woman’s will solely based on the assumption that previous c-sections rule out future vaginal births?

Regardless of whether the increase can be blamed upon obesity or planned c-sections, one thing is certain, the US finds itself trailing many countries in the European Union and also Canada who enjoy “socialized medicine.” According the the ABC news clip, the US ranks behind 33 countries including Latvia, formerly part of the Soviet Union, which had a 16.6% unemployment rate in 2009 compared to the 2009 US unemployment rate of 9.4%. Perhaps the release of this report will add another aspect to the health care debate in the US.