Why are so many women dying in childbirth?

Womens' bodies are designed to give birth.  It's not a medical event.  In biological terms, it's one of those things we do to propogate the species.  We live in a time when there are generally better options available than to give birth in the dirt, even in many developing nations.  So, why are maternal mortality statistics still shockingly high? 

You may have heard that the numbers of women dying in childbirth worldwide are decreasing.  That is true.  However, according to a recent Time magazine article, The Perils of Pregnancy: One Woman's Tale of Dying to Give Birth, "every day, one woman per minute dies while giving birth or soon after. An additional 10 million to 15 million women suffer complications or injuries resulting from the act of giving life." One woman per minute.  One or more babies every minute who grow up without their mother to nurse, raise and love them.  In numbers, that translates to 1440 women per day, and 525,600 per yea.   The worst part?  Many of these deaths are preventable. 

In the United States, where we supposedly have access to the best health care in the world, the number is actually rising.  Amnesty International's report, "Deadly Delivery: The Maternal Health Care Crisis in the USA" , indicates that "Maternal mortality ratios have increased from 6.6 deaths per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006."  In California alone, the rate of "women who die from causes directly related to pregnancy has nearly tripled in the past decade", according to a California Watch report.  The rise in c-section surgeries, obesity and "advanced maternal age" are some of the contributing factors to the spike in mortality rates.  However, I think it's fair to say that access to good care during pregnancy and labor is sorely lacking. 

This is certainly an issue in developing countries, where adequate prenatal care may be absent and emergency medical care is inadequate (see the Time photo essay of a Sierra Leone woman who died as a result of post-partum complications.  Warning: contains graphic imagery.) 

Don't think that just because you have "good" medical insurance and access to modern hospital facilities that the risk of sub-standard care is minimized.  I am a walking miracle, someone who almost died after hemorrhaging out half the blood in my body following an emergency c-section.  (A c-section can be categorized as an "emergency" simply for failure to progress, not because of any immediate danger to mother or baby.)  I bled out for hours because a routine hematocrit test to check blood count levels post-surgery was never performed. 

The nurses who continually changed the blood-soaked absorbent pads on my bed shrugged when I expressed concern.  (Lesson learned: always trust your instincts!)  My full birth story is posted on the International Cesarean Awareness website, where I turned for answers in order to try to come to terms with my near-death experience. I wasn't in some podunk hospital.  I was in a modern university hospital with a high-risk neonatal center.  The attending OB who performed my c-section is the Division Director of Gynecology and Obstetrics.  I have excellent medical insurance.  I had a birth doula, and practiced yoga and meditation for years.  My only real risk factor was being over 35, but I had what would be considered a healthy pregnancy.  I even traveled for work - including a two week trip to India - until 7 months into my pregnancy.  Here's a photo of me taken by my husband a day after my post-partum hemmorhage.  I cried the first time I saw it. My hair is matted.  The skin on my face is sallow and drawn from blood loss.   Both arms (and legs) have edema from multiple IVs pumping fluids, blood, antibiotics and narcotic painkillers.  I was very weak, in tremendous pain and could not hold my daughter for long periods of time.  Hardly the mother-baby birth photo I'd hoped to cherish.  I've rarely shown anyone this photo, but I want to do this to underscore my point. 

If I nearly died - someone with all the information and access to supposedly the best care available - then what are the odds for millions of other women who have less available to them? We're baby-obsessed and yet most women are treated like disposable incubators.  That really scares me.  It should scare you too.