Issues in Maternal Health
When I developed this passion for birth work, I knew I would have to do a lot of research on maternal health. I’m not just talking about the anatomy of a pregnant woman, signs of labor, various pain medications used during labor, and different comfort measures to use during contractions, but looking into significant issues that society doesn’t discuss. I knew some of the crucial situations that would occur in the healthcare system, but; I wasn’t aware of how atrocious it was and how the medical system is negligent and incompetent with the care of pregnant women.
What Is Maternal Mortality?
Maternal Mortality is the passing of a woman due to pregnancy or delivery problems during her pregnancy or within six weeks after it ends, regardless of the length or location of the pregnancy, from any cause associated with or aggravated by the pregnancy or its management, but not from accidental or incidental causes.
In 2018, the media began to publish stories of women who died during childbirth. Because of these stories, the federal government started recording maternal mortality rates in the healthcare system; precisely. After accumulating information, the rate of cesarean sections skyrocketed. The amount of significant surgery performed in the United States healthcare is 500% higher than in the 1970s, and the maternal mortality rate in the U.S. has increased from 11.3% in 1995 to 32.1% in 2021.
This is an epidemic of doctors/nurses who don’t listen to the women telling them something is wrong. We know our bodies more than anybody; we are in tune with our bodies to know when a problem appears and feel the physical changes in our bodies. Statistics from CDC Pregnancy Mortality Surveillance Systems are broken down by the rate of maternal deaths per 100,000 live births by age group, race, and Hispanic origin. Black Women are four times more likely to die during or after childbirth than White Women. Black women had a maternal mortality rate of 69.9 per 100,000 live births in 2021, which is 2.6 times higher than the rate for White women (26.6). In the United States, 1,205 women passed away due to pregnancy-related causes in 2021, as opposed to 861 in 2020 and 754 in 2019. The unfortunate part is that the majority of these cases are preventable or curable.
What developed the stereotype?
A common stereotype that has been around for years is that “Black women have stronger anatomy” African Americans are less heard when they voice concerns about pain or other symptoms. In the medical field of maternal health, the healthcare system developed an algorithm that confounded prejudice and race. The likelihood of a woman having a successful vaginal delivery (VBAC) can be calculated, and the odds decrease for African American women. In maternal health, African American women would be used as guinea pigs. Every woman has her vagina cut open. While a woman does not need an episiotomy discharged on her unless her baby experiences fetal distress or is in the breech position, they nonetheless perform the procedure to practice their sewing skills.
In the late 1800s, Gynecology had undergone testing on black women to perfect the field. The United States had a population of enslaved women, so they were free to do whatever they wanted to perform, whenever they wanted to, and however they wanted to. Here comes James Marion Sims, also known as the father of gynecology. He would cut open the woman however many times, and after that, there were modules made about these surgeries, claiming that the woman doesn’t experience pain, but the woman is screaming. Learners continue to take care of black women overwhelmingly.
Informed Consent in Pregnancy & Birth
Every person giving birth should have access to a solid communication structure that ensures everything they want to say is heard, including what they expect and want to know. The care providers (OBGYN, midwife, or family practitioner) should be transparent with their patients to be well-informed of the birth plan and fulfill their desired birth. Every birth person has the legal and moral right to decide what medical treatment they receive. Except; for situations in which your life and your baby's life are in danger, you can always request further information and time.
Informed Consent IS:
- Your healthcare provider has a conversation with you about ALL of your options and their pros and cons, including not going forward with their recommended treatment
- You have the opportunity to ask questions
- Your healthcare provider answers your specific questions with specific answers to your satisfaction, not their own
- You have the time and opportunity to discuss these with your support team
- Your decision is respected
Informed Consent IS NOT:
- Your healthcare provider refuses to discuss, omits, or glosses over your choices and their pros/cons
- Your healthcare provider is dismissive of your questions, refuses to answer, or answers your question in vague or confusing terms
- You are not given any time to discuss your options with your trusted support team
- Your healthcare provider pressures you into consenting or makes you feel afraid not to go forward with their recommended treatment
- Your healthcare provider makes decisions about treatments and or procedures without informing or discussing them with you
When discussing care options, ask your provider these questions:
How will/do you know _______ is happening/requires intervention? (How do you know my labor has stalled and requires augmentation?)
Why is this course of action necessary at this time/ Is it an emergency? (Am I or my baby currently in danger?)
What if we try something different and re-evaluate later? (What if I try different positions or walk to help things along; and discuss this again in an hour?)
Use BRAIN to help you make informed decisions about your care
B- What Are The Benefits?
R- What Are The Risks?
A- What Are The Alternatives?
I- What’s Your Intuition?
N- What If We Do Nothing?
S- Space to think
You Have Autonomy Over Your Body and Your Baby
Just because you have all the information; DOES NOT mean you have to consent.
Declining as a valid choice
