Maternal Mortality in the Golden State

According to California Watch (a project of the center of investigative reporting) the mortality rate of women in California who die from causes directly related to pregnancy has almost tripled in the past ten years. Though I am sure you have read all over the Internet that its safer to give birth in Kuwait or Bosnia, the state of California has yet to go public with this information claiming the report needs some more revisions.

So what exactly did the research find? Plain and simple California has seen the largest spike in pregnancy related deaths since the 1930s.  Some researches chalk this up to the fact that now there is just a better counting of deaths and that there hasn’t really been an actual increase.  Others believe that the actual numbers are on the rise and that changes in population, obesity in mothers, and fertility treatments are not the sole culprits. 

What adds to this disturbing reality is that this problem may be occurring nationwide.   It has been suggested that if other states took a closer look they might notice a similar phenomenon.  In response on January 26 the Joint Commission sent out an alert to hospitals stating; “unfortunately, current trends and evidence suggests that maternal mortality rates may be increasing.”

Ok-but why? In this technologically advanced age-why would women be dying at an increased rate? Or is it the technology itself that is playing a role?   Many researchers are now investigating what it is that doctors are doing differently-what has changed? Dr. Elliott Main has noted, “it’s hard to ignore the fact that C-sections have increased 50% in the same decade that maternal mortality increased. “  The task force concluded that changing clinical practice could indeed prevent a number of these deaths.  As troubling as it is nearly one in three babies today is born surgically.  It has been noted by scientists, researchers, and others working the in the industry that at some point if the Cesarean rate continues to rise the risks will outweigh the benefits.   This percentage is so far off from what is deemed healthy by the World Health Organizations which suggest the best outcomes for mothers and babies occur with cesarean section rates of 5% to 10%. Rates above 15% seem to do more harm than good.  I am deeply troubled by just how off we are and wonder how we can go back?

To be fair there are other factors that can and probably contribute to the rise in deaths but it makes sense to start with those factors that can be controlled.  For instance, inductions.  Having an induction almost doubles a woman’s chances for a surgical delivery.   According to the California Watch report Dr. David Lagrew noticed that the occurrence of elective inductions was also on the rise-with no medical reason.  He made it a rule (in his hospital in Orange county) that minus a few exceptions there would be no elective inductions before 41 weeks. As a result the operating rooms were open and the mothers and babies were experiencing fewer complications.  Lesson learned?

There are faces to these numbers, faces and families who have obviously suffered a great loss.  Doctors and nurses are eager to become part of the solution.  According to the report “the California task force isn’t waiting to determine the ultimate cause of these deaths.  It has started pilot projects to improve the way hospitals respond to hemorrhages, to better track women’s medical conditions, and to reduce inductions.”

Though it’s not entirely clear who is at most risk it should be noted that despite the increase in the mortality rate-PREGNANCY AND BIRTH REMAINS SAFE, NORMAL AND NATURAL FOR MOST WOMEN!!!  These statistics are frightening no matter how you look at it, how you review the research, or which risk factors you account for.  It is my hope that this and similar studies will bring awareness to the greater population-will bring attention and resources to the health and well being of mothers and their babies.

P.S. Having a doula at your birth significantly decreases your chance of having a Cesarean .  Keep that in mind. 

Original Article:

http://californiawatch.org/health-and-welfare/more-women-dying-pregnancy-complications-state-holds-report