There are a lot of benefits to living in the United States, but every once in a while, something comes along that reminds us that a lot of works still needs to be done. Most recently, a shocking new report found that giving birth in the United States is the “most dangerous” among developed nations. These findings come from a long-term study led by Alison Young for USA Today that parallels research recently done by ProPublica and The New York Times.
The crux of the problem revolves around simple procedures, not yet standard protocol in the United States, which could help medical personnel determine if a woman is at risk after birth, as Young reported for USA Today. Examples of simple protocols include, according to USA Today, "weighing bloody pads" to determine the amount of blood loss and providing medication quickly after seeing elevated blood pressure to protect against strokes.
While much of the developed world has already addressed the issue of maternal mortality the United States has lagged behind, as prior research has found as well as USA Today reported. That has resulted in a sharp rise in post-birth fatalities since 1990, while Germany, France, England, and Japan have all seen a steady decline, according to The Lancet. Research showed that hemorrhage and hypertensive disorders were the two leading causes of maternal deaths in the developed world with more complex causes like sepsis and ectopic pregnancy far behind, according to The Lancet.
Putting safe protocols into practice isn’t impossible, as the team from USA Today concluded. The exception to their research showed that California has actually seen a decline in maternal fatality by standardizing some simple practices that help with quick intervention, as Vox reported. Medical societies nationwide point to the state, which has seen death rates fall by half, as the standard for care, as USA Today reported.
California, Nevada, and Massachusetts seem to be doing well with the issue, reporting less than 10 fatalities per 100,000 live births according to the American College of Obstetrics and Gynecology. Georgia, Washington DC, and New Jersey are among the states with the highest maternal mortality rates, at more than 35 deaths per 100,000 live births, according to the ACOG.
The research team from USA Today was able to obtain more than half-a-million pages of internal hospital records, as the publication reported. They focused on cases of more than 150 women and contacted 75 hospitals to determine what kind of birthing safety procedures were in place. And the results were shocking: Fewer than half the patients they studied were treated quickly for high blood pressure and some hospital records revealed less than 15 percent of new moms received intervention for their problems, according to USA Today.
Joy Victory wrote about her problem with dangerously high blood pressure during pregnancy for Cosmopolitan. As she shared with the magazine, she was at home when she began vomiting during early labor. Though she assumed that could happen during labor, she still called the midwife associated with the hospital who told her to come in right away. And that simple instruction probably saved her life.
Part of the problem lies with the fact that hospitals are left to set their own protocols. There is no national system of requirement, according to Cosmopolitan, nor of tracking maternal deaths, which is any oversight. USA Today noted in its report that Medicare and Medicaid have made efforts to demand better care for the elderly by requiring hospitals to disclose information as a precursor to payment. Now it’s possible to find information online on complications from joint replacements or whether heart attack patients received proper care.
A Joint Commission that sets safety standards for hospitals nationwide could require something similar for birthing patients, as USA Today reported, but the group said they are still studying the issue. One physician researchers spoke with said a requirement that would protect moms against hemorrhage is “promising,” but that they are still researching how to deal with the problem of high blood pressure.
Sadly, until these practices become standard protocol it seems is up to patients to advocate for top-notch care. When giving birth — or helping someone who is — don’t be afraid to ask questions and speak up if something seems amiss. If medical personnel don’t seem to be responding to concerns, then seek out a patient advocate. Quick interventions may be the best interventions, and for now they have to become one more item on the hospital checklist for new moms and dads.