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The Rising Maternal Mortality Rate: What You Need To Know

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Did you know that approximately, 830 women die every day due to preventable causes that are related to pregnancy and giving birth?

Perhaps what is even more disturbing than that is the fact that 99% of all maternal deaths occur in developing countries it is still a problem in developed countries like the US. While the global maternal mortality rate decreased by 36.6% between 2000 and 2015, the United States (along with five other countries) saw the MMR increased during this period.

Let’s take a closer look at the potential complications women face while giving birth, both in developed and developing countries.

Common Reason for Maternal Mortality: Hemorrhaging

While the majority of women in developed countries experience a safe childbirth with little to no complication. Sadly, things don’t always go as planned and complications do happen. The most common complication is excessive bleeding also known as hemorrhaging.

The leading cause for maternal mortality around the world is hemorrhaging, in fact 27% of maternal deaths are the result of hemorrhaging. 1 to 5 women will experience postpartum hemorrhaging, and those who have had a cesarean have a higher likelihood of experiencing it.

On average, a woman will lose about 500 ml of blood during a single vaginal birth, this amount is doubled with a cesarean.

When the baby has been delivered, the uterus will continue to contract until the placenta has been expelled. Once this happens, those contractions will help compress the bleeding blood vessels where the placenta was attached. Hemorrhaging happens when the uterus doesn’t create strong enough contractions to stop the bleeding.

The risk of hemorrhaging increases when a woman has:

· Early detachment of the placenta from the uterus (Placenta Abruption)

· The placenta covers or is near the cervical opening (Placenta Previa)

· Uterus is too big because of too much amniotic fluid, or if the baby is over 8.8 pounds

· More than one placenta and over distention due to a pregnancy with more than one baby

· Giving birth numerous times in the past

· Prolonged labor

· Infection

· Obesity

· Needed to have labor induced

· Given medication to stop contractions

· The use of forceps or vacuum-assisted delivery

· The use of general anesthesia

Of course, there are other factors that can cause a woman to bleed too much after giving birth. These factors include:

· A tear in the cervix or vaginal tissue

· A tear in a uterine blood vessel

· Bleeding that develops into hematoma in the vulva or vaginal area

· Disorders that prevents blood from clot properly; disseminated intravascular coagulation

· Placenta tissue takes over the muscle uterine muscle (Placenta Increta)

· Placenta tissue ruptures the uterine muscle (Placenta Percreta)

What are the Other Causes of Maternal Mortality?

Hemorrhaging, cardiovascular and coronary conditions are responsible for over a quarter of maternal deaths, what about the others? Conditions that contribute to the high MMR include cardiomyopathy (11.4%), infection and embolism (9.5% for each), mental health conditions (8.9%) and preeclampsia and eclampsia (7.6%).

While the majority of these deaths are related to the patient, 56.5% of maternal death can be attributed to either the health care provider or the system of care she receives. Sometimes it can be a combination of one or more of these things.

How to Prevent or Reduce the MMR?

So how do we reduce the MMR? There are a few things that can be done to make sure fewer women die during or after childbirth.

58.9% of the causes of maternal deaths are preventable. One of the first lines of defense against maternal mortality is to give expectant mothers access to education about how to care for themselves and their baby while pregnant, symptoms of an at-risk pregnancy, and access to safe abortion services.

Proper education can go a long way toward teaching women how to care for themselves and their unborn child.

Beyond education, it’s important that women have access to affordable healthcare, regardless if they have adequate insurance.

Unfortunately, women who live in low-income areas and do not have insurance or enough insurance are more likely to have complications during delivery that results in death – although it is important to note that maternal mortality affects women regardless of race, ethnicity, education, and income.

More and more women forego pregnancy and newborn care because it’s to expensive.

However, depending on what state you’re in, you could pay anywhere from $5,017 (Alabama) to $10,413 (Alaska) for a vaginal birth. The average cost for a cesarean could run you anywhere from $7,439 (Washington DC) to $14,528 (Alaska).

Giving more women access to affordable healthcare in both developed and developing countries is one way to reduce the maternal mortality rate.

How Does Healthcare Play a Role in the MMR?

Other than being incredibly expensive, healthcare providers and hospitals can also do more to reduce the MMR.

Women in general have inadequate access to healthcare, even before they become pregnant. The lack of proper healthcare in rural neighborhoods means a woman could go through her pregnancy without realizing she has a chronic condition that could be harmful to her and/or the baby.

Healthcare providers pay close attention to the care of the newborn, but they don’t pay nearly enough attention to the mother.

What’s scary is young doctors who want to specialize in maternal-fetal medicine, “could complete their training without ever being a labor and delivery unit,” reported Mary D’Alton, chair of OB/GYN at Columbia University Medical Center.

The focus is so intense on the baby, 20 hospitals have created fetal care centers for babies who have high risk for a multitude of conditions, however, there is only one hospital that has a similar program for pregnant women. That hospital is NewYork-Presbyterian/Columbia University Medical Center.

Mount Sinai Medical Center in New York is an example of a center that is trying to reduce the MMR with something as simple as compression boots that are worn around mom’s calves. The boots keep her blood pumping so that clots don’t occur. On top of the boots, doctors and nurses are always working to improve training and communication so that patients won’t hesitate to speak up when something is wrong.

Final Thoughts

Developing countries around the world are seeing a decline in maternal deaths, but our MMR here in the States is on the rise. Women are the life-bringers. Without a mother, we wouldn’t exist.

It’s clear that a well developed country like the United States, with all of our rights, freedoms, and wealth can do more to reduce the rate at which pregnant women are passing during birth. While it is true that we have government programs that are set into place to help low-income Americans, only 6% of block grants that are allocated for “maternal and child health” go to the mother’s care; and that needs to change.

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