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Bitch_PhD

Bitch_PhD

I'm lost
February 2007

AUG 12, 2007 12:38 PM



It's too easy, if you're part of the Industrialized World, to assume that a healthy live birth is the norm, that adequate medical care is a given, and that women are essentially selfish creatures who either don't want children because they care too much about their own comfort and convenience (god forbid) or do want children because they don't care about overpopulation and think that their own precious brats are the most important people on earth. Sometimes it seems as if 95% of the arguments we have about reproductive rights come from such narrow ignorance of what pregnancy and birth are really like that it tempts one to forbid people from having opinions.

Luckily, hope springs eternal that people can learn that what they think they know isn't necessarily all there is to it. E.g., this report from the Center for Reproductive Rights about maternity facilities in Kenya.

In the labour ward we were three women and there was only one nurse who was attending to us. She was not nice. She treated us badly. It was my firstborn. She came and abused me and slapped me as I was screaming. The other women were also being abused. . . . The first woman gave birth—she was helped—and within three minutes my baby came and the nurse used the same scissors she had used on the other woman. I can't forget. . . . There was no water there. There is always a complaint about water. She took my baby and wrapped my baby in my lesso. She asked me if I had cotton [and told me where to put it]. . . . I was just alone from 3:00 when I gave birth, to 7:00, [when] the woman next to me noticed I was bleeding. I couldn't sit. I was squatting on the bed. There was blood all over. . . . I was not checked. The woman got water for me and I bathed. I didn't have anything to wear or sleep on.


And that's if you're lucky enough to have access to a maternity ward and nurses. In Africa overall, women have a 1 in 16 chance of dying in childbirth from things like thromboembolism, hypertension, amniotic fluid embolism, infection, or hemmorhage[url]--not to mention the possibilities of dying while pregnant from an ectopic pregnancy, heart disease, or domestic violence.

Yes, for most people reading this, pregnancy is likely to go well. But that's no excuse for basing your opinions about what women need on your own experiences--or lack thereof.

Bitch_PhD's always been lucky with the whole birth control/pregnancy/childbirth thing, personally, but her own sister, giving birth in the hospital where Bitch and sis were themselves both born, was told to "shut up" by a nurse while laboring in a hallway. So it ain't just Africa.

theconservative

theconservative

Spring, TX
October 2004

AUG 12, 2007 04:06 PM

It's too easy, if you're part of the Industrialized World, to assume that a healthy live birth is the norm...

so you're saying that a live birth isn't the norm?

Ferretbite

Ferretbite

Mexico
September 2006

AUG 12, 2007 04:46 PM

theconservative said:

It's too easy, if you're part of the Industrialized World, to assume that a healthy live birth is the norm...

so you're saying that a live birth isn't the norm?



Should be, and because in the industrialized world it is, if you're a part of it, you would think it is the case for everyone else.

brett54

brett54

Australia
November 2004

AUG 12, 2007 04:59 PM

Amniotic Fluid Embolism

Frequency:
In the US: Incidence of AFE is estimated at 1 case per 8,000-30,000 pregnancies.
Internationally: Incidence is similar to that of the United States.
Mortality/Morbidity: Maternal mortality approaches 80%. Mortality was 61% in the national registry, which listed 46 cases. Five to 10% of maternal mortality in the United States is due to AFE. Of patients with AFE, 50% die within the first hour of onset of symptoms. Of survivors of the initial cardiorespiratory phase, 50% develop a coagulopathy.

Survival is uncommon. Most women who survive have permanent neurologic impairment. Neonatal survival is 70%. No evidence indicates that survivors are at risk for AFE during future pregnancies.

AFE affects the female population similarly, mortality 61% to 80%, survival is uncommon ..... that is in the US of A ........ so why do you list this as being something special to Africa?

If you get AFE, no matter where in the world, you are most likely going to die.

Don't let facts get in the way of an article.

LordHAlmighty

LordHAlmighty

Citrus Heights, CA
July 2007

AUG 12, 2007 05:11 PM

I think it was mentioned not so much as the focus of the article, rather as a side to the treatment the woman (women) got in the hospital, as well as its poor conditions and undertrained, underhanded staff.

If this sort of thing occurred in the USofA, the hospital and its employees would have been burned figuratively (in the media) and more than likely, quite literally... yet this sort of treatment seems all to common in the sub-continent...

Oscar_Bronski

Oscar_Bronski

USA
October 2004

AUG 12, 2007 05:11 PM

I can't say if i agree or disagree with this article. I honestly can not see what the point of it is!

Necia

Necia

San Francisco, CA
August 2005

AUG 12, 2007 05:42 PM

Oscar_Bronski said:
I can't say if i agree or disagree with this article. I honestly can not see what the point of it is!



You know, it could just be to inform you.

I mean, maybe.

shocked

Roethke

Roethke

SUICIDEGIRL

California, USA

AUG 12, 2007 05:43 PM

Not to mention the rampant problems with fistulas. Many child brides are simply too small to give birth, and have horrible fistulas because of it.

Heathen_Dave

Heathen_Dave

Birmingham, AL
July 2005

AUG 12, 2007 06:03 PM

1 in 6? I wonder what the mortality rate is for a natural birth in the home with simple care and attendance.

Somnia

somnia

Victoria, BC
October 2005

AUG 12, 2007 06:07 PM

It makes you wonder how many thousands of woman would feel lucky for their biggest problems to be when to schedual their selective C-sections, or whether they want drugs or not.

I'm glad that when I have a baby, chances are good that myself and the baby will leave the hospital alive.

Bitch_PhD

Bitch_PhD

I'm lost
February 2007

AUG 12, 2007 06:30 PM

Heathen_Dave said:
1 in 6? I wonder what the mortality rate is for a natural birth in the home with simple care and attendance.



In a country with excellent health care and nutrition, where women have relatively few children relatively late in life, and where women with high-risk pregnancies are identified early and not part of the sample group, and where women whose deliveries take an unexpected turn are whisked off to the hospital in an ambulance? Probably fairly low. In the rest of the world? Somewhat higher than 1 in 16, I should think.

Oscar_Bronski

Oscar_Bronski

USA
October 2004

AUG 12, 2007 06:31 PM

this piece isn't really about informing, it is more about expressing an emotional opinion.

which i may or may not agree with....
it is just very scattered

sick

sick

Minneapolis, MN
June 2003

AUG 12, 2007 06:36 PM

Reading the stories of those women and the "care" they were given, I can't help but wonder if they would have been better off avoiding the hospital and having the children at home. I don't know if the women have mothers around, or know other women with children, but if they do...

Sure, there's something to be said for modern medicine and hospitals, but when the care is so atrocious, and the reason for going to the hospital is something women have obviously been doing more or less successfully for our entire history, I would trust the women I know who have experience over the evil nurses and doctors.

Phantasy

Phantasy

Australia
October 2005

AUG 12, 2007 06:55 PM

Roethke said:
Not to mention the rampant problems with fistulas. Many child brides are simply too small to give birth, and have horrible fistulas because of it.



I cannot even imagine the pain and suffering these women go through. To make matters worse, they are also often isolated and shunned due to the offensive smell caused by the fistula.

SPOILERS! (Click to view)

Zinder, NIGER%u2013For two days, 14-year-old Sari Zainabou pushed and pushed, her narrow body stubbornly refusing her baby safe passage into the world. At a clinic in her village outside the Sahelian trading town of Zinder, the women could do little more than wipe Sari's brow and encourage her to keep trying.

When the baby boy finally emerged, he was dead. And after two solid days of labour, with her baby's head pushed up against her pelvic bone, Sari was left with necrotic tissue that ate a hole in the lining separating her vagina from her bladder. The result was a constant trickle of urine splashing down at the grieving girl's feet.

Now 15, Sari sits in the courtyard of the Central Maternity Hospital waiting for a second surgery to finally repair the fistula.

It's a condition the United Nations hopes to erase from the developing world in the next seven years, spending $20 million (U.S.) on prevention, education and training in 40 countries and enlisting the help of celebrities like Australian singer Natalie Imbruglia to drum up attention in the West.

Eradication is not likely to happen unless the more worrying problem of child marriage is solved, says Dr. Lucien Djangnikpo, one of six doctors in Niger trained to surgically repair fistulas. Judged the poorest country on the planet by the United Nations in 2006, more than half of Niger's girls are married before the age of 15.

Nearly 90 per cent are pregnant before the age of 18. In a country where malnutrition and difficult living combine to create small, sinewy women, the conditions are ripe for fistula. "The body isn't mature enough to handle (giving birth)," Djangnikpo says.

In developed countries, fistula is mostly confined to complications from colon cancer surgery or botched hysterectomies. But in the developing world, where women suffer without proper medical care, the condition is devastatingly common. About 2 million women worldwide are thought to suffer the embarrassing incontinence that fistula brings.

Niger is estimated to have one of the highest rates in the world: one to two of every thousand births in the country result in a permanently disfiguring fistula.

Girls need the chance to grow into women before being pressed into pregnancy, Djangnikpo says, otherwise they will continue to suffer fistula no matter how much money is spent on the problem.

For Sari, that means a foley catheter tube now stretches from her bladder into a pink plastic bucket at her feet. Still, a smile brightens her face.

After an agonizing birth and a year of embarrassing smells and soiled wraps, Zainabou knows she is six weeks away from returning to her husband. She says she can't wait to see him and hopes to conceive again.

That's the real problem, Djangnikpo says. There is no law against teenaged marriage in Niger. Many of the women sitting clustered in the shade of a tree outside his office were married before they experienced their first period. Their first pregnancies often coincided with the arrival of puberty.

That leads to patients like Djoumer Habou, who had a fistula repaired six years ago. Now 23, with tight braids and an intricate pattern of dark facial scars, she lies on a gurney in the hallway of the hospital, a plastic tube snaking from her arm to a clear bag of pain drugs.

Beneath her brightly coloured wrap is a bandage covering an incision that runs length of her abdomen. Nestled by her left side is a tiny baby boy, born the night before by Caesarean section. Habou's first two children died; if this baby survives his first seven days, he will be named by his father.

For women with fistula who are culturally accustomed to wanting big families, a costly Caesarean section is the only way to ensure a safe birth.

"In Africa, the women are in the bush, in the country, a long way from a hospital," Djangnikpo says, "She's in difficulty and it's 15 to 20 kilometres just to get to the road. At the road, it's still a two- to three-hour wait to find a vehicle to come to the hospital."

Two dusty ambulances sit outside his office, each immobilized by a flat tire. Women like Zainabou are completely isolated if they aren't treated, says nurse Soueba Koudou.

"They live with the odour from 16 to 60, every day, until the end of their days," says Djangnikpo. The women are shunned, the smell and soiled clothes turning away their husbands. They're perceived as unclean, leaving them unable to help cook or care for children.

"Her husband cannot have a normal life with her and one to two years later, he chases the woman away," he explains. "She returns to her family and her family, after four to five years, they also chase her away. She finds herself alone with this problem. She cannot work. She's excluded," he says.

In the past decade, the clinic has treated about 650 women, averaging about three women per week. The operation %u2013 costing about $300 (U.S.) and paid for by a UN program %u2013 is relatively simple and involves removing scar tissue and sewing up the fistula hole.

"We give them back their dignity," Djangnikpo says simply.

A few years ago, he started a non-governmental organization called Solidarite, which gives the women a $125 microcredit loan and the skills to make soap to start a business to support themselves.

Otherwise, he says, the women were being surgically repaired, then working as prostitutes.

"It's a reality in Niger, and no one is thinking about it," he says.

Source

sick

sick

Minneapolis, MN
June 2003

AUG 12, 2007 07:00 PM

Also, after doing some research, I found out that the 1 in 16 number is the "lifetime risk of materrnal death." That is, it's the chances of dying in childbirth over the woman's entire reproductive years, not her chance of dying on any single occassion. Not that that makes it any better.

For comparison, according to the WHO's maternal mortality report for 2000, the lifetime risks for various regions follow:

Devoloped regions (US, Canada, Europe, Australia, Japan, etc.) - 1 in 2800
Europe - 1 in 2400

Africa - 1 in 20
Northern Africa - 1 in 210
Sub-Saharan Africa - 1 in 16

Asia - 1 in 94
Eastern Asia - 1 in 840
South-central Asia - 1 in 46

Bitch_PhD

Bitch_PhD

I'm lost
February 2007

AUG 12, 2007 07:07 PM

Sick said:
something women have obviously been doing more or less successfully for our entire history



See, this is precisely the kind of assumption that I'm trying to get people to realize is false. Yes, women have been "more or less" successful in birthing children. A 1 in 16 death rate is "more or less" successful. Historically, pregnancy and labor are difficult and dangerous. It's only with the luxury of living in wealthy countries (and not oneself being poor in a country without national health insurance) that people buy into these ridiculous ideas about how "natural" acts are always safe or easy.

DownNeck

DownNeck

Jersey City, NJ
March 2006

AUG 12, 2007 07:25 PM

Bitch_PhD said:

Sick said:
something women have obviously been doing more or less successfully for our entire history



See, this is precisely the kind of assumption that I'm trying to get people to realize is false. Yes, women have been "more or less" successful in birthing children. A 1 in 16 death rate is "more or less" successful. Historically, pregnancy and labor are difficult and dangerous. It's only with the luxury of living in wealthy countries (and not oneself being poor in a country without national health insurance) that people buy into these ridiculous ideas about how "natural" acts are always safe or easy.



+1

childbirth is dangerous stuff. back in the dark days before modern medicine the mortality rate during childbirth was absurd

sick

sick

Minneapolis, MN
June 2003

AUG 12, 2007 07:44 PM

Bitch_PhD said:

Sick said:
something women have obviously been doing more or less successfully for our entire history



See, this is precisely the kind of assumption that I'm trying to get people to realize is false. Yes, women have been "more or less" successful in birthing children. A 1 in 16 death rate is "more or less" successful. Historically, pregnancy and labor are difficult and dangerous. It's only with the luxury of living in wealthy countries (and not oneself being poor in a country without national health insurance) that people buy into these ridiculous ideas about how "natural" acts are always safe or easy.



I quite agree that you're right in combating that assumption. My intent wasn't to claim that child birth, as a "natural" act, is always safe or easy. My point was that the mother trusting in experienced women she knows may be safer than trusting in a faulty and abusive hospital system, as can be seen in my original quote, in context:

but when the care is so atrocious, and the reason for going to the hospital is something women have obviously been doing more or less successfully for our entire history, I would trust the women I know who have experience over the evil nurses and doctors.



Also, it is not a 1 in 16 death rate, which would mean that 1 in 16 women die in childbirth. The 1 in 16 means an individual woman has those odds of dying in childbirth over her reproductive lifetime. If you want to discuss the "rate", or maternal mortality ratio, the correct number for Sub-Saharan Africa is 920 per 100,00 live births, or approximately 1 in 109.

Edit: Added my original quote.

brett54

brett54

Australia
November 2004

AUG 12, 2007 08:33 PM

Bitch_PhD said:

Sick said:
something women have obviously been doing more or less successfully for our entire history



See, this is precisely the kind of assumption that I'm trying to get people to realize is false. Yes, women have been "more or less" successful in birthing children. A 1 in 16 death rate is "more or less" successful. Historically, pregnancy and labor are difficult and dangerous. It's only with the luxury of living in wealthy countries (and not oneself being poor in a country without national health insurance) that people buy into these ridiculous ideas about how "natural" acts are always safe or easy.



... like usual .... and your point is?

A work colleague of my 30 week pregnant wife, recently died from AFE - so my wife asked about AFE to her obstetrician, who boldly said, as she has said all along,

"having a baby can be a dangerous thing, lot's of things are dangerous in life - but is it a risk you want to take to have a baby?" - the answer is an unequivocal yes.

SweetIyvie

SweetIyvie

Santa Rosa, CA
September 2004

AUG 12, 2007 09:10 PM

Sick said:

Bitch_PhD said:

Sick said:
something women have obviously been doing more or less successfully for our entire history



See, this is precisely the kind of assumption that I'm trying to get people to realize is false. Yes, women have been "more or less" successful in birthing children. A 1 in 16 death rate is "more or less" successful. Historically, pregnancy and labor are difficult and dangerous. It's only with the luxury of living in wealthy countries (and not oneself being poor in a country without national health insurance) that people buy into these ridiculous ideas about how "natural" acts are always safe or easy.



I quite agree that you're right in combating that assumption. My intent wasn't to claim that child birth, as a "natural" act, is always safe or easy. My point was that the mother trusting in experienced women she knows may be safer than trusting in a faulty and abusive hospital system, as can be seen in my original quote, in context:

but when the care is so atrocious, and the reason for going to the hospital is something women have obviously been doing more or less successfully for our entire history, I would trust the women I know who have experience over the evil nurses and doctors.



Also, it is not a 1 in 16 death rate, which would mean that 1 in 16 women die in childbirth. The 1 in 16 means an individual woman has those odds of dying in childbirth over her reproductive lifetime. If you want to discuss the "rate", or maternal mortality ratio, the correct number for Sub-Saharan Africa is 920 per 100,00 live births, or approximately 1 in 109.

Edit: Added my original quote.



Sick, I'm on your team. <3

unfiltrator

unfiltrator

San Francisco, CA
April 2004

AUG 12, 2007 11:19 PM

The US get criticized for it's infant mortality rate just like it does it's large prison population, but to be honest I don't know anything about these criticisms.

gcash056

gcash056

Orlando, FL
October 2004

AUG 12, 2007 11:31 PM

Who cares. It's people having children. The less of these whiny shrieking evil monkey things I have on the plane (or in the theatre, or being breast-fed at the local restaurant) the BETTER. Having a brat needs to be as risky as possible.

BurningKrome

BurningKrome

San Jose, CA
April 2005

AUG 12, 2007 11:42 PM

I'm just amazed at how Bitch_PhD managed to find such an unusual way to turn an issue of horrific child-bearing conditions on the other side of the globe into a hateful commentary on Americans. And she didn't even take the slacker way out like commenting on how little financial, medical and political support the U.S. gives to countries like sub-Saharan Africa. She went for the long 'way round and decided Americans suck because the birthing process here has gotten too Goddamn easy...and we know it!

Sakes....

Clidna

Clidna

Canada
January 2005

AUG 13, 2007 12:38 AM

Hey... just because the nurses don't slap us, don't make it easy... having just had my third child a few months ago, I say this - if you've never done it, shaddap. wink

Bitch_PhD said:

...lucky enough to have access to a maternity ward and nurses.



Lucky enough? Sounds like they are luckier if they don't, and have the baby at home with family. It doesn't sound like the nurses would do a whole lot if there were complications, unfortunately.


And to those jumping on the "1 in 16 chance of dying in childbirth", do we really need to argue points about rates, and what word should be used, etc? I think the point is that childbearing women in Africa have a 1 in 16 chance of dying at some point in their reproductive years from childbirth. As compared to our developed regions (which includes Canada, USA, Japan, Australia & New Zealand), 1 in 2,800.

Maternal Mortality in 2000 - page 9 has the table.

DhD_No_Pants

DhD_No_Pants

Katy, TX
May 2006

AUG 13, 2007 05:53 AM

My mother was told by her doctor here in the good ol' US of A that my little brother was missing the top half of his head and that she should go ahead and abort the fetus.

Turns out that he was just hiding behind her hugely infected bladder.

Now we wonder if all of the drugs they pumped into her, with the combination of said drug induced early labor is the reason he still wears diapers at the tender age of 18.

Not exactly slapping her around and leaving her in a pool of her own blood, but also not what you really expect from our advanced maternity care wards.

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