What is maternal health?
The World Health Organization (WHO) defines maternal health as, “the health of a woman during pregnancy, childbirth, and the postpartum period.” For many women, pregnancy and childbirth are a joyous and anticipatory experience. For others, however, this period can be marked with adversity, mental or physical health issues, and death—even in the United States. In fact, WHO reports:
From 1990 through 2013, the maternal mortality rate in the U.S. increased from approximately 12 to 28 maternal deaths per 100 000 births.
Currently, The United States has a higher rate of maternal deaths than other high-income countries and countries like Iran, Libya, and Turkey.
According to WHO, nearly half of all maternal deaths in
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Mary Jane Minkin, a clinical professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at Yale and a private practice physician in New Haven, CT, began medical school at Yale School of Medicine in 1971. She delivered her first baby during her obstetrics rotation in 1973. With more than four decades of experience with women throughout pregnancy and childbirth, Minkin has seen some changes in maternal healthcare.
Minkin says the first, significant advancements for obstetrics, gynecology, and maternal health occurred in the early 1970’s. One of the primary areas of progress Minkin mentions is in early pregnancy detection. “When I started medical school, we literally had to wait for the rabbit to die to see if someone was pregnant,” she recalls.
The phrase “the rabbit died” was created between the 1920’s and 30’s. To see if a woman was pregnant, physicians would inject urine from their patient into a rabbit. If the urine contained the pregnancy hormone hCG, it would cause the rabbit to ovulate and verify if a woman was pregnant. Unfortunately, this method came with a tremendous cost to the rabbits—their lives! The rabbit’s ovaries couldn’t be seen without a fatal surgery dissecting its insides. Eventually, this practice was replaced with home test kits like First Response, which allows a woman to tell if she’s pregnant six days before her missed
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“In the last ten years, we have started regularly practicing to react for emergencies that rarely happen, so that we are better prepared and have better outcomes when the time comes,” they stated. Furthermore, Moxley and Fernandez aim to cut down on unnecessary c-sections, which increase the maternal risk of having complications during childbirth. They state, “The statistics indicate after the first C-section, repeat births will be done via C-section 90% of the time. Since the risk of complications increases with C-sections, we want to make sure that the C-section is medically needed. We follow the guidelines that were created in 2014 by the American Congress of Obstetricians and Gynecologists (ACOG)—the guideline that made the biggest change was allowing more time for the labor to progress.” Regarding how healthcare providers are working to enhance a woman’s maternal experience, Minkin furthers the conversation by stating, “The most important advances in maternal and child health actually pertain to getting ready for pregnancy. We know that smoking, alcohol, and drug ingestion—such as cocaine—are very toxic to the fetus. So, we encourage all of our patients to stop taking drugs, stop drinking alcohol, and stop smoking before pregnancy, or limit these as best as
Even though mice reproduce so rapidly, it is still not 100% certain that pregnancy will occur
Upon viewing “More Business of Being Born” (Epstein, 2011), I learned a lot about the different pros and cons of Vaginal Birth After Cesarean (VBAC). Women are often deprived of the choice of the method of delivery of their children after they’ve previously had a cesarean birth. The cause of this is that there exists medical fright about a rupture of the uterus which often leads to death of mother and baby (Epstein, 2011). In the mid twentieth century, it became a common saying that “once a cesarean, always a cesarean” came about. This saying perpetrated the fear and understanding that women have to go about having another cesarean, depriving them of choice (Epstein, 2011).
Drug and alcohol use in pregnancy poses a threat to the neonate’s development and the obstetric provider has an obligation to screen for substance use. Substance use in pregnancy can place the developing fetus at risk for in-utero opioid dependence, fetal-alcohol syndrome, preterm labor, and other consequences of maternal alcohol, tobacco, and illicit drug use.(6) Within the past three years La Crosse County has seen a marked increase in the amount of heroin use.(7)
The Centers for Disease Control and Prevention suggestion that a pregnant woman should not drink alcohol during pregnancy (Advisory on alcohol use in pregnancy 2005) has been widely criticized as being unnecessarily paternalistic, but the CDC goes further into explaining that, “Alcohol consumed during pregnancy increases the risk of alcohol related birth defects, including growth deficiencies, facial abnormalities, central nervous system impairment, behavioral disorders, and impaired intellectual development” (Advisory on alcohol use in pregnancy
Neonatal Abstinence Syndrome (NAS) is a group of problems a newborn experiences when exposed to addictive drugs that the mother consumes during pregnancy. NAS is a growing concern in the United States and can have significant adverse effects on newborns. Shortly after birth, the infant can display many physical symptoms of withdrawal. In addition, substance abuse during pregnancy can cause premature birth, low birth weight, seizures, birth defects, Sudden Infant Death Syndrome (SIDS), and possible long-term cognitive and behavioral problems. The 2010 results from the National Survey on Drug Use and Health: Summary of National Findings reported incidence of substance abuse among pregnant women within the United States....
...o find a balance between interventional and non-interventional birth. With this being said, I also understand that there are strict policies and protocols set in place, which I must abide to as a healthcare provider, in any birth setting. Unfortunately, these guidelines can be abused. Christiane Northrup, MD, a well recognized and respected obstetrician-gynecologist has gone as far as to tell her own daughters that they should not give birth in a hospital setting, with the safest place being home (Block, 2007, p. xxiii). Although I am not entirely against hospital births, I am a firm believe that normal, healthy pregnancies should be fully permissible to all midwives. However, high-risk pregnancies and births must remain the responsibility of skilled obstetricians. My heart’s desire is to do what is ultimately in the best interest of the mother, and her unborn child.
Many women today are doing more C-sections, also known as cesarean, than they are natural. Whether the reasons being because it’s more convenient or that some moms did not really have a choice, the percentage is still growing. “The cesarean delivery rate increased from 26% to 36.5% between 2003 and 2009; 50.0% of the increase was attributable to an increase in primary cesarean delivery (National Partnership for Women & Families, 201.)” There are many things to consider when deciding which is the right or safer choice. With both choices comes risks for the baby like, possible respiratory problems with a C-section. The mom has many risks to worry about for herself as well, like possibly hemorrhaging. There is also the recovery and the long-term effects that a woman has to put into consideration. They both have their pros and cons that should not be taken lightly.
In 2006, 49% of all pregnancies in the United States were reported unintended on a national survey.1 The highest rate of preventable birth defects and mental retardation is due to alcohol use.2 In this paper, I will further discuss FAS, the potential effects of binge drinking during the embryonic stage of gestation, and what actions need to be taken in order to reduce the incidences of alcohol-related birth defects. Alcohol Consumption During Pregnancy Alcohol is an ethanol containing substance that is a common beverage in many social and private settings. Alcohol is also a teratogen, therefore alcohol consumption and binge drinking potentially pose a substantial risk to the embryo or fetus. In 2013, the Centers for Disease Control conducted a telephone survey of women in the age range of 18-44 years regarding alcohol use.3
All drugs, legal or illegal, are considered to be harmful to the fetus and should be taken with caution and under the doctor’s direct orders only. Drugs can be anything as simple as a cigarette to a major substance like heroin and cocaine. Most mothers who do drugs during their pregnancy don’t think about the detrimental effects they could be causing to their baby. Any amount of these forbidden substances can leave an everlasting effect on the precious defenseless baby. Most women know that when you are pregnant your hormones vary greatly, but when a woman is pregnant it also ...
Between five to ten percent of all infants are born more than two weeks before their due date due to several factors that include infections, illness, poor nutrition, or complications during the pregnancy. Fetal monitors are used in the cases of C-sections because there is a much higher risk of detecting the infant’s distress and therefore can go in more quickly to remove the baby from the uterus. When the mother is under general anesthesia, which is rare in the United States, the mother is not aware of any kind of pain or even the birth of her child. When the mother has spinal anesthesia she has no feeling from the waist down. Sometimes, the best indication that the baby is in distress is the mother- an unfamiliar pain occurs or something else could be a sign of problems.
Worldwide, the rate of cesarean section is increasing. According to the CDC, in 2012 the rate of cesarean sections comprised 32.8% of all births in the United States (CDC, 2013). Between 1996-2009 the cesarean section rate has risen 60% in the U.S (CDC, 2013). According to the World Health Organization (WHO), more than 50% of the 137 countries studies had cesarean section rates higher than 15% (WHO, 2010). The current goal of U.S. 2020 Healthy People is to reduce the rate of cesarean section to a target of 23.9%, which is almost 10% lower than the current rate (Healthy People 2020, 2013). According to a study conducted by Gonzales, Tapia, Fort, and Betran (2013), the appropriate percentage of performed cesarean sections is unclear, and is dependent on the circumstances of each individual birth (p. 643). Though often a life-saving procedure when necessary, the risks and complications associated with cesarean delivery are a cause for alarm due to the documented rate increase of this procedure across the globe. Many studies have revealed that cesarean deliveries increase the incidence of maternal hemorrhage and mortality and neonatal respiratory distress when compared to vaginal deliveries. As a result, current research suggests that efforts to reduce the rate of non-medically indicated cesarean sections should be made, and that comprehensive patient education should be provided when considering an elective cesarean delivery over a planned vaginal delivery.
“To determine pregnancy, the doctor will have to perform a urine test which uses mathematical principles to determine the level of pregnancy hormones” (Doctors Use Math in the Field of Medicine. " N.P., 28 Feb. 2014. Web. 04 Jan. 2016.). In being pregnant and becoming pregnant math has set up a formula in calculating due dates for mother.
Over the years birthing methods have changed a great deal. When technology wasn’t so advanced there was only one method of giving birth, vaginally non-medicated. However, in today’s society there are now more than one method of giving birth. In fact, there are three methods: Non-medicated vaginal delivery, medicated vaginal delivery and cesarean delivery, also known as c-section. In the cesarean delivery there is not much to prepare for before the operation, except maybe the procedure of the operation. A few things that will be discussed are: the process of cesarean delivery, reasons for this birthing method and a few reasons for why this birthing method is used. Also a question that many women have is whether or not they can vaginally deliver after a cesarean delivery, as well as the risks and benefits if it. Delivering a child by a c-section also has a few advantages and disadvantages for both the mother and child; this will also be discussed in more depth a bit later.
Chambers, C. D., Polifka, J. E., & Friedman, J. M. (2008). Drug safety in pregnant women and their babies: ignorance not bliss. Clinical Pharmacology & Therapeutics, 83(1), 181-183.
This journal was useful for me because it gave me the background details on why women are opting for delayed motherhood by the age of 30 or 40. Accordingly, I was able to build up my points on how it will affect the health conditions of both baby and mother and also the risk of taking that challenge.