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A soaring maternal mortality rate: What does it mean for you?

October 16, 2018

About the Author

photo of Neel Shah, MD, MPP, FACOG

Neel Shah, MD, MPP, FACOG, Contributor

Dr. Shah, MD, MPP, FACOG, is an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, and director of the Delivery Decisions Initiative at Harvard’s Ariadne Labs. As an obstetrician-gynecologist at Beth Israel … See Full Bio
View all posts by Neel Shah, MD, MPP, FACOG


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Nona Djavid
November 30, 2018

I am hoping I misunderstood your intentions. Just using common sense, eating poorly and excess responsibility and all the struggles that come post-natal, can not be related to maternal mortality.

Can I get your research on : ” However, very few deaths counted in maternal mortality statistics occur during childbirth. Rather, four out of five of these deaths happen in the weeks and months before or after birth. ” please?

Jason H Collins MD,MSCR
November 25, 2018

Maternal mortality is reported relative to ethnic groups. What is the status of Asian moms and compared to other groups?

Stacie Bingham
November 19, 2018

In my area of California, Central Valley near Bakersfield, birthing people are sent home 24 hours after a vaginal birth and 48 hours after a cesarean birth (some physicians will let folks go 24 hours after a cesarean birth if that’s what the parent requests). As a doula and a Lamaze Educator I have seen this before in the past — when there begins to be too many negative incidents, the pendulum swings back and people are kept the more traditional 48/72. It feels pretty helpless to stand by and wait for an increase in maternal and infant mortality and morbidity to see an unwise practice change…all in the name of overcrowded hospitals.

October 18, 2018

The list omitted EMPLOYERS. It’s employers who oppose paid maternal or paternal leave, for the most part, and state legislators and the US Congress (& chief Exec) that either oppose or simply ignore the issues of maternal health (other then seeking to control women’s bodies). It’s health insurers who won’t pay for longer hospital stays for women, or home health maternal & child care for the first week after a woman returns home from the hospital.

I am tired of hearing how the general public needs to “step up”. Too many members of the public, or other family members, are already struggling to meet their own needs & other family members needs.

What the US needs is a broad societal shift, so that pre & post natal maternal health matters as much in the US –and maternal wellbeing is as well supported–as it is in nations like Sweden. Parents are entitled to 480 days of PAID parental leave in Sweden—pre & post natal care (and assistance in care of infants) is provided primarily by trained midwives–and the care is provided at state expense (i.e., you get something very useful for your taxes) or for a small fee if you are not a citizen. There is nothing like that in the US except for the very wealthy.

October 23, 2018

Totally agree! I live in Germany and the system here, while not perfect, gives women 6 weeks paid leave before the due date and 8 weeks postnatal. Then, mother and father can divide between them 14 months of paid parental leave (at 65% of their last pay, capped at 1800 Euros) and we have a midwife coming home for postnatal care as long as is deemed necessary.
This makes a huge difference! And it is a shame the US can’t get it together for for it’s mothers.

October 18, 2018

Not one woman I have known or known of, nor even heard about, in these 20 years or so of child bearing years has died from pregnancy / childbirth related issues. In my particular religion, community, life situation I am around and meet fellow married women in this age group that have lots of babies way more than the average person. I’ve lived in more affluent areas and have had insurance but poorer areas get the same care at the hospital and maternity care right? I do wish we had the same extra luxeries other countries have but with my 3 pregnancies, I felt take care of.

October 19, 2018

” but poorer areas get the same care at the hospital and maternity care right?” No, they don’t.

November 20, 2018

I am happy for you and your fortunate friends. I also belong to a well-off, well-educated group of people. In the last TWO years I have personally known one woman who had hypertensive crisis and seizures two days after discharge, one woman who had uterine hemorrhage a week after delivery, and one woman who had deep venous thrombosis and (thankfully non-fatal) pulmonary embolus. There were two with serious post partum depression, one of whom needed hospitalization.
These are the daughters of my friends, and my daughter’s friends. you and I are looking at a small sample of women.

Elizabeth Ward, MS, RD
October 17, 2018

As the mother of three, I agree that women lack postpartum support from society and the medical community, and in a big way. However, I wonder how preconception health affects the risk of post-delivery death. More than ever, women are entering pregnancy overweight and obese, and developing complications because of their weight. In addition, many women are clinically depressed prior to pregnancy, which exacerbates the risk of postpartum depression. Women may also have poorly managed preexisting conditions that contribute to poor health before during, and after pregnancy, such as prediabetes, hypertension, and iron deficiency anemia.

October 23, 2018

I agree with you and we now know that epigenetic Stress before conception also effects baby and mum health.

October 11, 2018

I have been reading these news for a while now over the last few years ,
So knowing that this is an issue here more so than in other ‘modern’ countries.
It is interesting to read this , though yes it would have helped all the poor single moms that did not live long after giving birth to have someone by their side at all times but take into consideration that unless
there were absolute exceptions in this America, woman do not leave a hospital after a few days .
If that was the case , that would already help,
Also you dont go into how there Just isn’t enough care for the Mothers compared for the Babies.

Kristin Hinton
October 3, 2018

I am writing to commend Harvard Vanguard OB/Gyns Cristina Diaz and Sandra Fleming. These women saved my life when I delivered my baby nearly six years ago, and I do not think I would have had the same results with just any other doctors. Dr. Diaz diagnosed me with HELLP Syndrome after only hearing that I had a nagging pain in my ribs and what I thought was a crick in my neck. She delivered my baby that evening and thankfully he was perfectly healthy, though a little small. The next morning, Dr. Fleming watched me like a hawk as my liver continued to swell until it did rupture. I credit the quick thinking and actions of these two women for saving my life so that I did not become one of these statistics and I am so grateful.

Melanie Scharrer
October 3, 2018

I am suspicious of any doctor who ends an article with “is as simple as that”. While I am all for reaching out and supporting each other, the increase in maternal mortality is a multi-factoral public health problem -which demands systemic, not just individual response. Working towards repairing harms from generations of injustice towards underrepresented and impoverished women is not “just as simple as that”. Paid maternity and paternity leaves would probably be a step in the right direction…

Gita Prasad
October 17, 2018

Amen to that, Melanie!

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