15 August 2017

Feature: Word From the U.S

When Birth is More Important than Life

I think every country has their priority topics when it comes to election time, some countries focusing on immigration, others on raising or lowering taxes. In the US there is some kind of strange obsession with the place of the woman in society. And not just her place, also with the choices that she may or may not need to make concerning her body, and even more precisely, her womb. Yes, the topics of reproduction and abortion are often brought up by a bunch of men (and even some women) with the main intention of regulating them. What makes everything a little more confusing is that each state has its own regulations, which sometimes adhere to, but often clash with, federal regulations. Some states are more progressive than others (some downright oppressive), and even though the country is not supposed to be dominated by religion, it often is, in an underhand way. How many time have you heard or seen the phrase “God Bless America!”?? There are so many strains of Christianity in the US that it is hard to keep track of them, and so many fundamental Christian groups (think along the lines of Cromwell’s famed Puritans) seem to have an upper hand when it comes to what the government focuses on. I am constantly surprised at how the US is portrayed as advanced, but how often it wants to revert back into the past.

Abortion was only legalised in the US in 1973, with the Roe v. Wadecase, birth control legalized for every woman in 1972. And ever since then there have been people fighting to overrule these legislations. So-called “pro-life” groups (which I prefer to call “pro-birth” ) continue to lobby against Planned Parenthood (who provide affordable care for women, including abortions), and have a large enough following to be heard by politicians. And politicians are smart enough to see that if they also jump on the “pro-life” bandwagon their ratings and voter pool will increase significantly. Yes, apparently many states still live in the dark ages over here.
So, I often ask myself, if “life” is so important to all of these people, why does the US have the largest percentage of maternaldeaths in the developed world

Whereas other countries rates are consistently on the decline, the US rate is actually RISING, and currently sits at 26.4 deaths per 100,000 live births. In comparison, the UK is at 9.2 deaths per 100,000 live births and Finland at 3.8. These deaths don’t all happen immediately after childbirth in the hospital, but often after women are discharged. Complications can arise days or weeks after a pregnancy, and can be fatal if not detected immediately. Several news outlets and journalists have done extensive research into the matter, and it basically comes down to several different issues. But the main point is that care is focused on the infant, and the mother tends to fall by the wayside. Infant mortality rates are currently at an all-time low in the US, which is brilliant news, but why does it seem to be at the expense of mothers?

I have had three children in the US, and three different experiences. I have previously written about the healthcare situation here, and it remains fragmented at best. Each state has specific guidelines, and each hospital is different. It really requires a lot of research on the part of parents to be, and often, depending on your insurance, you don’t have a choice where you give birth. Home births are illegal (!!) in certain states, and midwife-led birthing centres often fill up fast as there are not enough of them. I have been lucky as I have been able to choose the hospital I deliver at (the pros of living in large cities), and I have also only lived in very progressive states. My experiences would have been very different if I had lived in the countryside in the south.

Prenatal care is excellent here. My first child was born with congenital heart defects, so with each subsequent pregnancy I was given a fetal echocardiogram to rule out heart defects, in addition to the usual anatomy scan. My doctors always took the time to listen to me. But I found when it came to labour, delivery, and post partum time everything changed. Labor and delivery depends on the hospital and doctor – I learnt that the hard way. After an unpleasant experience with my first child I did more research for the others and had the birthing experiences that I wanted, and felt fully supported. I also noticed that more care was provided to me with the last child, I was monitored as much as my newborn was. So either California is making better headway in maternal care, or things are slowly changing in general. I have a feeling it’s more of the former than the latter though.

The real issue lies in the support and care received after you are discharged from the hospital. After a vaginal birth you are usually kept for 48 hours (and can ask to leave after 24 hours if you and baby are OK). After a C section the general rule is 72 hours unless there are any complications. Women are pushed to get up and about as soon as possible, which is not necessarily a bad thing, and lactation consultants are usually on call for breastfeeding help. However, once you leave the hospital you are usually on your own. Apart from in certain small areas, there are no doctor or nurse home visits after you leave the hospital. You usually have one post partum appointment scheduled for six weeks after birth and that’s it. On the other hand you are responsible for taking your newborn in to his or her paediatrician's office within a few days for a check-up.  Even if you have an easy vaginal birth with minimal damage, hauling your newborn off to a doctor’s appointment three days after pushing him or her out is HARD. I can’t even imagine what it must feel like for someone who has had major abdominal surgery! You are discharged with a list of “symptoms” to watch out for, and a PPD questionnaire to answer, but how on earth can you answer these questions about depression when you have literally JUST had the baby? No, I don’t feel sad and despondent right now, but what happens if I do in 8 weeks? Who do I call?

Once you pop the baby out you basically have to just pick yourself up and get on with it. No wonder women are reluctant to talk about how hard the fourth trimester can really be, and that they are struggling – there is no TIME to struggle. Paid maternity leave is practically non-existent (unless you are lucky enough to work for a company that provides it for a few months), and there is no real safety net for women to fall into if they don’t feel they can cope. So much for all of these so-called “pro-life” groups – their focus seems to be solely aimed at pregnancy and abortion, and not at ensuring that mothers are given adequate support and help to even stay alive after birth. I’m sure everyone can agree that a healthy mother is much more important to a child than a dead one, no?

Maybe one day we can all stand together to rally for better post partum care for mothers AND infants, but in the meantime I fear that the maternal death rate is just going to continue to rise. Life goes a lot farther than just birth; I think we can all agree with that, whether we are pro-birth or pro-choice.

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