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I'm a Minnesota Girl, living in the south. I tell my friends I try not to talk and think like a Yankee, but sometimes I slip up!

Saturday, March 27, 2010

Maternal Health

You heard some musings, as healthcare reform passed, about the nation finally taking a step against discrimination against women when it comes to healthcare. No woman who was in a position to vote wanted to make it the central issue, but most of them were aware of the incredible gap in women's healthcare when it comes to maternity.

First, there is the jaw dropping problem of being turned away from an insurance plan if you have given birth before by C-section:


The national U.S. cesarean section rate was 4.5% and near this optimal range in 1965 when it was first measured (Taffel et al. 1987). In more recent years, large groups of healthy, low-risk American women who have received care that enhanced their bodies' innate capacity for giving birth have achieved 4% cesarean section rates and good overall birth outcomes (Johnson and Daviss 2005, Rooks et al. 1989). However, the national cesarean section rate is much higher and has been increasing steadily for more than a decade. With the 2007 rate at 31.8%, about one mother in three now gives birth by cesarean section, a record level for the United States.

Since this is a relatively new insurance scheme to turn away participants, the furor has only begun to grow across the nation. Then, there is the recent report by Amnesty International on Maternal Health in America:

Amnesty International: U.S. Maternal Health Is in "Crisis"

Those brave members of Congress who believe the biggest problems in health care are government-funded abortions, death panels, and lawsuits might want to take a look at
this problem:
The report, titled "Deadly Delivery," notes that the likelihood of a woman's dying in childbirth in the U.S. is five times as great as in Greece, four times as great as in Germany and three times as great as in Spain. Every day in the U.S., more than two women die of pregnancy-related causes, with the maternal mortality ratio doubling from 6.6 deaths per 100,000 births in 1987 to 13.3 deaths per 100,000 births in 2006.
"In the U.S., we spend more than any country on health care, yet American women are at greater risk of dying from pregnancy-related causes than in 40 other countries," says Nan Strauss, the report's co-author, who spent two years investigating the issue of maternal mortality worldwide. "We thought that was scandalous."
The report from Amnesty International found
a number of systemic problems with health care for pregnant women, including:

Obstacles to care are widespread, even though the US A spends more on health care than any other country and more on pregnancy and childbirth-related hospital costs, $86 billion, than any other type of hospital care.

Nearly 13 million women of reproductive age (15 to 44), or one in five, have no health insurance.

Minorities account for just under one-third of all women in the US A (32 percent) but over half (51 percent) of uninsured women.

One in four women do not receive adequate prenatal care, starting in the first trimester. The number rises to about one in three for African American and Native American women.

Burdensome bureaucratic procedures in Medicaid enrollment substantially delay access to vital prenatal care for pregnant women seeking government-funded care.

A shortage of health care professionals is a serious obstacle to timely and adequate care, especially in rural areas and inner cities. In 2008, 64 million people were living in "shortage areas" for primary care (which includes maternal care).

Many women are not given a say in decisions about their care and the risks of interventions such as inducing labor or cesarean sections. Cesarean sections make up nearly one-third of all deliveries in the USA – twice as high as recommended by the World Health Organization.
The number of maternal deaths is significantly understated because of a lack of effective data collection in the USA

The report concludes that these problems -- most of which are preventable -- aren't just a health care issue; they're a human rights issue.

The report recommends seven ways to address this crisis:
Ensure access to quality health care for all
Ensure equitable access to health care without discrimination
Remove barriers to timely, appropriate, affordable maternal health care
Ensure access to family planning services and information for all women
Ensure access to adequate, appropriate, quality maternal health care provision
Ensure that all women receive adequate post-natal care
Enhance and improve accountability
Fully recognize the human right to health and integrate a human rights perspective

Food for thought. Is healthcare a right or a privilege? If it's a privilege, then women of child-bearing age are a whole lot less privileged than anyone else in the nation. If it's a right, is it important to the future of the nation that our women of childbearing age and the children they bear have access to decent healthcare...or is that just socialism?

1 comment:

Kelly said...

Interesting material here, Quid...