California's push to drive down maternal mortality

zoogs

zoogs

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https://www.vox.com/science-and-health/2017/6/29/15830970/women-health-care-maternal-mortality-rate

Maternal mortality in the U.S. has increased from 19 to 24 per 100,000 from 2000 to 2014. It's three times the rate in the UK and eight times the rate in the Netherlands, Norway, and Sweden. Many of these deaths are considered preventable.

Visually:

Maternal_Mortality.jpg


 
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This is something that quite frankly is shocking to me.

I have only at best scanned most of the article and haven't read it in detail or in entirety.

But, I would love to see the data behind this. Not that I doubt it. Just that the stat is shocking. I (like all of us) know one hell of a lot of women who have had babies. I am struggling to remember one where the baby or mother died during child birth. The only exception is a woman who had triplets and there were major complications and two of the ended up dying. But, I consider that to be an extreme situation.

So, obviously, this isn't happening at a high level within the demographic I am personally aware of. If that's the case, there has to be a demographic out there that this is an absolute horrible problem to get the overall stat to where it is.

 
BigRedBuster said:
But, I would love to see the data behind this. Not that I doubt it. Just that the stat is shocking. I (like all of us) know one hell of a lot of women who have had babies. I am struggling to remember one where the baby or mother died during child birth. The only exception is a woman who had triplets and there were major complications and two of the ended up dying. But, I consider that to be an extreme situation.
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Keep in mind that 24 per 100,000 is .024%. Per 1,000 it's 0.24. Which, when you think about it, is still quite a high number globally -- something that begs an urgent remedy. There are lots of factors that go into it, of course, but what CA has done suggests the rise can be curtailed with determined effort within the medical arena. I think there's also a strong argument for upstream mitigation (e.g, available contraceptives, better population health).

 
I'm not down playing the need for better healthcare in this area. Again, I would like to see more specific data on this subject.

But, I wonder how much of an affect more advancements in other areas of American healthcare have contributed to this. Let me point just two out:

1) The woman I know and described above was pregnant with triplets due to advancements in fertility practices. They couldn't get pregnant so they went to a specialist and ended up with triplets. If she had lived in a country where that technology wasn't available, those infant deaths wouldn't have happened.

2) I've read articles showing that American women are waiting longer to have babies. The number of births from women in their 30s and 40s has increased quite a bit over time. As a woman gets older, there is a higher chance that there will be problems with pregnancy.

Something else that would be interesting to see. At what point do they consider it part of this statistic. We had a miscarriage in the second trimester. Would that be included?

 
Yes, I think (2) was brought up in this article, and that's going to affect complication rates. Even in this case, I think you want advancement in medicine to combat it. They also discuss how reporting changed in the 1980s (although the timescale we're looking at is 2000-present).

Generally I think the argument made here (and I agree) is that the stronger cause is not advancements but neglect. Population wise we're not in the best of health. And lack of contraceptive access, etc contributes to unintended pregnancies in poorer, younger, and higher-risk demographics. There's an ongoing war to restrict contraceptive access and defund Planned Parenthood, and that can't be helping.

All of this aside, CA's gains look demonstrable still. So it looks like they're developing a model worth following.

 
zoogs said:
BigRedBuster said:
But, I would love to see the data behind this. Not that I doubt it. Just that the stat is shocking. I (like all of us) know one hell of a lot of women who have had babies. I am struggling to remember one where the baby or mother died during child birth. The only exception is a woman who had triplets and there were major complications and two of the ended up dying. But, I consider that to be an extreme situation.
Click to expand...
Keep in mind that 24 per 100,000 is .024%. Per 1,000 it's 0.24. Which, when you think about it, is still quite a high number globally -- something that begs an urgent remedy. There are lots of factors that go into it, of course, but what CA has done suggests the rise can be curtailed with determined effort within the medical arena. I think there's also a strong argument for upstream mitigation (e.g, available contraceptives, better population health).
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True enough that it is a very tiny percentage. But that tiny number tripled in only 15 years. Makes you think something must be going on.

Have the technologies or procedures used in child delivery changed? I wonder what the deaths are due to? Seems like this would be easy to investigate, especially considering the vast amounts of money thrown at medical care in the U.S.

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Edit: Also, it's gotta be more than a humorous coincidence that the author used the word "push" in the title of the article.
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Moiraine said:
Pre-natal care can be expensive and not all mothers can afford it.
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That very likely could be a huge contributing factor to the rapid increase in mortality rate. I don't know much about it but common sense tells me the rate at which our care costs are escalating would be a factor in people not receiving the proper pre-natal care and therefore developing more serious risk factors to their pregnancy.

Of course this doesn't explain what Cali has done to buck that trend....

 
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