Why Mothers Deserve Better Maternal Care

Giving birth is as old as time. Our bodies instinctively know what to do. Except in the U.S., where American women are dying (and suffering from debilitating complications) at far greater rates than any other industrialized nation. For two decades, these rising rates received little to no recognition.

It’d be a different world if over half of fathers tore their ball sacs open. If one, out of every 10 men, experienced a rip extending into their ass, costing them raises and paychecks, then we wouldn’t be waiting 20-years to address the issues.

The truth is that one out of 10 women will tear through her anal sphincter muscle. And 50 to 80% of women tear pelvic skin and muscles every time they give birth. These rates have grown unchecked for 20 years. Few new prevention and treatment options exist for these conditions.

Is it because bearing children is a woman’s job, her choice, so she has to live with the results? Is it because deaths and injuries occur more in black women and women living in rural areas?

Tennis star, Serena Williams, brought these issues back on stage. Williams, along with Kate Clancy, an associate professor of Anthropology at the University of Illinois, (and many more) are speaking out on the reality of motherhood. If credible women aren’t taken seriously during and after pregnancy, then how do doctors hear someone, like you or me? Now that others are speaking up, will something get done?

These issues aren’t solely women’s issues. They impact spouses, families, careers, and finances. On a greater scale, maternal injuries place the cost burden on all of us, men and women alike.

After a traumatic birth in 2001, I started asking questions. In 2016, I again suffered complications and my newborn had a large blood-filled bubble on her head. I felt ignored by my doctors, who told me that everything I felt was normal.

At five months postpartum, I read an article titled: “Focus On Infants During Childbirth Leaves U.S. Moms in Danger,” written by Nina Martin and Renee Montag, as part of a joint effort between NPR and ProPublica.

It dropped me to my knees. Again and again, I turned my head from my tablet, as my eyes filled with tears, and sobs wracked my body. I’ve since read this article several more times, yet never make it through dry-eyed.

It’s a long read. It’s an emotional read. In order for people to demand action we must feel uncomfortable, sad, and even outraged. Scroll down to read shocking statistics from the CDC, along with several more articles (and an audio interview) on these issues.

The numbers, statistics from the Center for Disease Control (CDC), are overwhelming. In their report, the CDC lists nine medical terms. These medical terms, called indicators, are used in maternal billing and coding.

Are you seeing this? Rates of medical issues rose at an astounding pace over the last two decades. More than 135 moms suffer from severe complications Every Single Day.

According to Anna Almendrala, in her Huffington Post article, “The U.S. Is The Only Developed Nation With A Rising Maternal Mortality Rate,” other countries are seeing some of the lowest rates ever, whereas here in America, we share the bench with countries, like Afghanistan.

We are talking about billions of dollars on additional medical procedures, along with lost work time, PTSD, and a variety of disabling physical conditions.

At some point, the focus became so great on saving babies that doctors stopped caring about a mother’s quality of life.

I used that term during my last pregnancy, quality of life. The doctor looked at me like I was crazy and told me (for the third time) that women have been doing this for centuries.

It’s hard to describe my feelings of hopelessness, after doctors reminded me again and again, that severe issues, such as muscle and nerve damage, were unpreventable. Or my exhausted disbelief as nurses brushed off my postpartum complaints, as normal.

If my experience is normal, then it’s a terrifying time to give birth in America.

In the midst of postpartum exhaustion and medical issues, I read an article by Kiera Butler, called “The Scary Truth About Childbirth,” published on Mother Jones. This intelligent and honest piece pulls together cold-hard-facts, personal accounts, and more. It tells a story of how women (and their problems) get pushed to the wayside. One of the best articles I’ve ever read.

Hans Peter Diatz, an Australian urogynocologist who studies maternal childbirth injuries, put it like this:

Butler mixes raw humor with statistics that make us yelp in pain. If you’re in a room with three women, then at least one of you suffers from urinary incontinence. And one of you suffers from a pelvic floor disorder (think fecal incontinence and uterine prolapse). But don’t stop there.

Check out Katherine Ellison and Nina Martin’s article, “Nearly Dying In Childbirth: Why Preventable Complications Are Growing In U.S.,” for a fact-based report that breaks down the CDC statistics.

Kate Clancy, an associate professor, started a Twitter storm after tweeting about her childbirth-related issues. In her 21st Show radio interview, Clancy suggests that we don’t do enough for new moms in the U.S. From “terrible maternal leave” to minimal postpartum care, we are not serving our mothers well. Hear the entire interview here. Clancy also hosts a podcast discussing physical issues relating to women. My favorite is, “What’s the range of normal in pelvic floor health,” where she interviewed Julie Wiebe, a pelvic floor therapist. Wiebe’s website provides a wealth of information for moms and providers.

Kate Clancy isn’t the first person to speak out about the lack of postpartum care. Serena Williams came out to Rob Haskell at Vogue to talk about her issues. Black mothers die and suffer complications at far greater rates than other mothers. Williams’ voice is desperately needed. Maya Salam, with the New York Times, took this interview a step further by claiming that Williams is not alone. NPR takes a closer look at the disparity between races here.

Parenting blogs fought to address these issues for years. The most recent to catch my eye is Wendy Wisner’s “Preventable Maternal Complications are on the rise, and this is not okay, over at Scary Mommy. Her down-to-earth writing provides facts while reminding us that this is not okay! Devastating medical problems, stemming from childbirth, should not be rising. Wisner writes, “Of course, women who survive these things should certainly be grateful that they lived, but the question is, at what cost?”

Nearly everything I’ve read left me asking more questions and inevitably feeling more frustrated. I came up with a list of “why’s” based on my research. I’m not a doctor, or any other type of expert. I’m a mom who reads and writes. These lists are in no way complete. Why are rates rising?

Lack of:

  • Federal oversight. It’s been left up to individual states and they failed us
  • Proper coding and tracking. Complications are rarely investigated or tracked by hospitals
  • Prenatal and postpartum education on issues relating to mothers
  • Access to health care and insurance
  • Studies and research
  • Treatments and protocols in place, with hospitals slow to adopt change

Combined with increasing:

  • Obesity (and related diseases like hypertension and diabetes) rates
  • Advanced maternal age of mothers (over 35)
  • Racial inequality
  • Use of interventions, such as c-sections and inductions
  • Rising poverty rates

This is a long list. Quite a bit to discuss, research, and debate. Next, I looked into what actions could help these issues.

We need:

  • More recorded, collected, and reviewed data
  • Federal actions and guidelines
  • Education of hospital systems, doctors, and nurses that includes toolkits (for hemorrhages or preeclampsia)
  • An increased focus on teamwork with practiced plans in place
  • A standardized approach to hemorrhage and hypertension
  • Doctors talking to their patients BEFORE CHILDBIRTH and AFTER
  • More studies and research on better treatment for complications
  • Better access to prenatal and postpartum care

This knowledge hasn’t curbed my frustration. Yes, I’m done having children. I will never be terrified of labor again, fighting for my voice to be heard, while doctors ignore me. I won’t hear the word unpreventable or listen to another doctor tell me that my body was made for this.

But I have two daughters and the rates of obesity, hypertension, and diabetes in older mothers show no signs of slowing. The lack of access to health care won’t be rectified any time soon. What if our bodies haven’t adapted to our changing medical conditions? Are we equipped to handle larger babies and more difficult births? Are there genetic causes for childbirth-related trauma? I know very little science behind it all.

And yes, I’m angry. I’m angry that doctors don’t talk about it. That nurses don’t talk about it. I’m furious that I, along with 50,000+ new women every year, suffer from injuries.

If uterine prolapse, torn anal sphincters, and rectovaginal fissures are unavoidable, then why doesn’t better treatment exist? More than 20-years passed us by and what was done? As a mom, you’re expected to wait until your uterus falls into the toilet, then maybe, just maybe, you’ll have a complicated, painful, surgery.

Kiera Butler, with Mother Jones, writes,

If you are pregnant, or suffered from a severe complication, or know someone who has, then reach out. It’s time for open and honest discussion about the challenges women face in getting the medical education and care they deserve. It’s time to speak out and tell America that this is not okay.

Join the discussion with me on Twitter and Facebook.

Resources:

The U.S. Is The Only Developed Nation With A Rising Maternal Mortality Rate. Anna Almendrala https://www.huffingtonpost.com/2014/05/19/us-maternal-mortality-rate_n_5340648.html May 19, 2014.
Nearly Dying In Childbirth: Why Preventable Complications Are Growing In U.S. KATHERINE ELLISON, ProPublica and Nina Martin, ProPublica. https://www.npr.org/2017/12/22/572298802/nearly-dying-in-childbirth-why-preventable-complications-are-growing-in-u-s December 22, 2017.
Many Nurses Lack Knowledge Of Health Risks To Mothers After Childbirth. NINA MARTIN, ProPublica and RENEE MONTAG.https://www.npr.org/sections/health-shots/2017/08/17/543924405/many-nurses-lack-knowledge-of-health-risks-for-mothers-after-childbirth August 17, 2017.

“Up to 40 percent of new moms, overwhelmed with caring for an infant and often lacking in maternity leave, child care, transportation and other kinds of support, never go back for their follow-up appointments.”

Focus On Infants During Childbirth Leaves U.S. Moms In Danger. NINA MARTIN, ProPublica, and RENEE MONTAG. https://www.npr.org/2017/05/12/527806002/focus-on-infants-during-childbirth-leaves-u-s-moms-in-danger May 12, 2017.
Preventable Maternal Complications Are On The Rise, And This Is Not Okay. Wendy Wisner. Scary Mommy.http://www.scarymommy.com/childbirth-more-dangerous/?utm_source=FB
“Getting Real About Postpartum; Testing For Drug-Impaired Driving; Funding And ‘Safety Net’ Hospitals.” Niala BOODHOO, ALAN MONTECILLO AND ROBIN LINN. The 21st Show. https://will.illinois.edu/21stshow/program/being-open-about-postpartum-testing-for-drug-impaired-driving-funding-and-s January 10, 2018
Severe Maternal Morbidity Indicators and Corresponding ICD Codes during Delivery Hospitalizations. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/smm/rates-severe-morbidity-indicator.htm
Severe Maternal Morbidity in the United States. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html
Black Mothers Keep Dying After Giving Birth. Shalon Irving’s Story Explains Why. Nina Martin, ProPublica, and Renee Montagne. https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dying-after-giving-birth-shalon-irvings-story-explains-why December 7, 2017
The scary truth about childbirth. Kiera Butler. Mother Jones. http://www.motherjones.com/politics/2017/01/childbirth-injuries-prolapse-cesarean-section-natural-childbirth/ January/February 2017

50-80% of women experience tearing of pelvic skin and muscles

1 in 10 severe enough to damage anal sphincter muscle

“Rare is the obstetrician who has a frank conversation with a pregnant woman about the long-term problems she might face.

⅓ of all women will develop stress incontinence

1 in 3 women suffer from a pelvic floor disorder, of which 80% are mothers

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2 thoughts on “Why Mothers Deserve Better Maternal Care

  1. This post is unreal! The amount of research and invoking thoughts you put into this is so inspiring. I am not a mother yet but I’d be lying if I said I wasn’t terrified for that moment. It’s incredible what mothers go through during childbirth and afterwards and how little care is administered to them. What an outstanding blog post! I really think it’s important to bring light to this issue and the statistics are absolutely mind-boggling.

    Liked by 1 person

    1. Thank you! My goal was to inform & provide plenty of links for further reading. Even if you’re not a mom, you have a mom or know moms, so chances are someone you know went through some of the issues mentioned. I appreciate your kind words & encouragement!

      Like

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