Wednesday, June 17, 2009

Continue rant

Shay made a point in my comments about maternal mortality decreasing by leaps and bounds in the past 100 years. This is very true, as the number has decreased from 7.2 deaths per 1,000 live births in 1915 to about 7.7 per 100,000 today. Some of that has come from medical interventions being able to save mothers who are high-risk, however, the majority of deaths that are averted today are from basic knowledge of germs. A good portion of women dying 100 years ago were dying from puerpural fever, often in hospitals, from doctors not washing their hands between patients, or when going from patient to cadaver to patient (or as the CDC notes below, from unnecessary intervention).

According to the CDC: "Inappropriate and excessive surgical and obstetric interventions (e.g., induction of labor, use of forceps, episiotomy, and cesarean deliveries) were common and increased during the 1920s. Deliveries, including some surgical interventions, were performed without following the principles of asepsis. As a result, 40% of maternal deaths were caused by sepsis (half following delivery and half associated with illegally induced abortion) with the remaining deaths primarily attributed to hemorrhage and toxemia." And there was also a decrease in the mid-century due to the legalization of abortion (CDC: "The legalization of induced abortion beginning in the 1960s contributed to an 89% decline in deaths from septic illegal abortions during 1950-1973")

Furthermore, even with the drastic increase in c-sections, inductions, and epidurals, our maternal mortality rates have not decreased since 1982. And based on some research I've read, maternal mortality is underreported because there is not a consistent criteria across states that defines when pregnancy/childbirth should be listed as the cause of death.

Yes, we've come a long way in preventing maternal deaths. Managing pre-eclampsia, detecting fetal abnormalities, inducing labor or performing relatively safer cesareans when absolutely necessary... but we still have women needlessly dying or suffering complications from interventions.

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