NEWS: Count Your Blessings, But Don't Count On Them

CULTURE: Count Your Blessings, But Don't Count On Them

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.

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.

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.

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.

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...

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.

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

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.

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.

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

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.

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.

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

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

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:

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.

... 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.

Sick, I'm on your team. <3

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.

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.

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....

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.

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.

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.