Women's childbirth deaths increase over 10 years in US, Canada...

[old mark]

The number of women who die in childbirth increased increased in the US and Canada from 12 per 100000 in 1998 to 17 per 100000 in 2008, while substantially decreasing in most other nations.
Read article here: http://www.medscape.com/viewarticle/720152


Health care? We don't want no Obama socialist healthcare!


mark

[Warpy]

1. Well, I know why they've increased here

Poor women lack access to prenatal care and rich women get cut open too frequently.

I have no idea why Canada's rates are increasing unless they've also increased their C-section numbers.

[Donnachaidh]

9. not all c sections are done on rich women -- but insurance companies

sure like to kick women out of the hospital even *if* they've had a c-section as quickly as possible. I would not be surprised if that little gem of a rule didn't factor in somewhere in the mortality rates.

"You've had invasive surgery? Too bad - we want you to leave on day 3".

[mainer]

2. Might it be the rising obesity rates in both US and Canada?

The causes mentioned for most deaths are embolism and hypertension-related illness. Both would be more common in obese patients.

[GreenPartyVoter]

3. I had PIH, and my cousin nearly died of HELLPS. Not all women who

develop those conditions are overweight, but I know in my own case I was.

[fasttense]

4. Yes, but simply having those conditions, even if caused by obesity,

are not death sentences. With regular check ups and careful monitoring a woman with these conditions can give birth to a healthy baby and remain alive to see the child graduate from college. These conditions are only life threatening to the mother if left uncontrolled. It's the lack of access to health care, that make these conditions deadly to pregnant women.

I think Canada needs to look at how they care for their poor pregnant women.

[polly7]

6. Our poor, pregnant women have the exact same

care as anyone, I know from experience. Up to 7 per 100,000 I imagine may include the problem of actual access to that care.. ie. lacking beds, specialists in isolated communities or transport to get them there. My BIL was posted at semi-northern communities for his first 8 years and the weather alone many, many times prohibited entering or leaving these areas. Registered Nurses are in charge of medical care quite often with only a small office and bed. I don't know how much of a factor that is in the study for sure, but yes, we do have to improve on it. Our northern communities are and have been neglected for decades. I'd really like to see what the statistics were based on, because I do believe every woman has the right to the best care.

[BlancheSplanchnik]

5. could it have anything to do with more, poorer, younger women having less access to BC

and abortion?

we have the highest teen preg. rates in the world.

[SidDithers]

7. Virtually unchanged in Canada...

not sure why the two countries are lumped together.

The maternal mortality ratio (MMR) for Canada was 5.5 (95% CI: 4.2–7.2) per 100,000 live births in 2002–2004. This rate was not statistically different from the same rate in 1999–2001 (4.2, 95% CI: 3.2–5.7). Even though the point estimate of the MMR in 2002–2004 was higher than in previous years, this is unlikely to be of significance especially since there were no striking increases in any of the specific causes of maternal death (page 103). A similar non-significant increase in the MMR was observed in the United Kingdom as well (11.4 per 100,000 maternities in 1997–1999 and 13.1 per 100,000 maternities in 2000–2002.

http://www.phac-aspc.gc.ca/publicat/2008/cphr-rspc/behaviours-comportements-eng.php

For Full report from the Public Health Agency of Canada:
http://www.phac-aspc.gc.ca/publicat/2008/cphr-rspc/index-eng.php


What the statistics do show, however, is that women are generally having babies later in life, with the associated increased risks that follow.

Sid

[polly7]

8. I got 7 per 100,000 figure here in Canada from an article I can't find now.

grrrrr. Thanks for your links.

Eta ... found mine:

http://www.washingtonpost.com/wp-dyn/content/article/2010/04/13/AR2010041303989.html

[Festivito]

14. Thank you for that. Odd that they combine US and Canada.

Seems like an attempt to make Canadian health care look bad when not bad.

[SidDithers]

15. I found it odd too...

the info from Public Health Canada is a bit older than the Lancet article out earlier this week. The Lancet has Canada at 7 per 100,000 in 2008.

Sid

[w8liftinglady]

10. i remember one Christmas a few years ago

I had 5-yes,5-pregnant women in my adult ICU,all with flu/pneumonia.We lost 2 on Christmas eve,2 on Christmas, and one on the day after Christmas.I remember the nurses chipping in to buy Christmas presents for the small children of these women,as the spouses were too grief stricken by their illnesses.Proper prenatal care and regular visits may have helped these women,as their immune systems were suppressed(lupus or the like).The spouses all had jobs without benefits(welcome to Texas,a right-to-work state).It sucked.

[old mark]

11. I was drawn to this article because one of my neighbor's daughters

just announced to him she is pregnant. She is barely 16, lives at home with dad and 4 other sibs - mom is out being an aging crack addict with various males. Most of the kids are not related to "dad", but he spends every dime and all his life on them - he is on disability with a back injury. Mom occasionally stops by to steal things - his pain meds, cash when he gets his SSDI check, various items to sell, even the kid's dog - to sell- and the kids all have problems. The girl's boy friend is about 18, has no real job or place to live and I don't see him staying around for the reality.
Also, one of the other neighbors talked the girl into having and keeping the baby because to abort it would be murdering a child and the baby is god's will.
She is stubborn, thinks her BF will be a great dad and all will be well.
Maybe the increase in deaths is due to fundamentalists and others having kids at home, etc, relying on god to see it all works out right.


mark

[Echo In Light]

12. How on Earth will the Professional Trivializers downplay this?

[SidDithers]

13. By pointing out that the information in the OP was inaccurate...

Canada's maternal mortality in 2008 was 7 per 100,000.

Sid

[Echo In Light]

16. I knew one of em would come through! lol

[SidDithers]

17. Lancet: Sharp drop in maternal deaths worldwide...

http://www.google.com/hostednews/ap/article/ALeqM5j-phKb8xCQcxd8xanFFF7f1IN3oAD9F2UIVO0
http://www.nytimes.com/2010/04/14/health/14births.html

Chicken Little doom and gloomers can sensationalize even a good news story.

Sid

Edit: added NY Times link

[Echo In Light]

18. Way to stick to it, buddy

[muriel_volestrangler]

19. HIV may be the major problem

Here's the Institute's page on this: http://www.healthmetricsandevaluation.org/resources/news/2010/maternal_deaths_fall_0410.html

Researchers found that progress in reducing maternal mortality has been slowed by the ongoing HIV epidemic. Nearly one out of every five maternal deaths – a total of 61,400 in 2008 – can be linked to HIV, and many of the countries with large populations affected by HIV have had the most difficulty reducing their maternal mortality ratio.

Nearly 80% of all maternal deaths are concentrated in 21 countries, and six countries account for more than half of all maternal deaths.

Eight low-income countries have seen annual increases in the MMR over the period 1990 to 2008, including Afghanistan and Zimbabwe, as have several high-income countries, such as the United States, Canada, and Norway. At least part of the increase in high-income countries appears to be due to changes in the way maternal deaths are reported. Mothers in the US now die at a higher rate than in most other high-income countries, four times the rate of Italy and three times the rate of Australia.

There's a spreadsheet of the levels (all rounded to a whole number per 100,000) and also the annual percentage change for each country (which indicates the background data is more precise, eg Germany and Japan both change from 12 to 7, but Germany falls at 3.6% per annum, and Japan at 3.0%).

The countries with the worst increases in death rates are southern African, where HIV/AIDS is a huge problem:

Country		MMR 90	MMR 08	Annual % change 90-08
United States	12	17	2.0
Malawi		743	1140	2.3
Mozambique	385	599	2.4
Cτte d'Ivoire	580	944	2.7
Namibia		354	586	2.8
South Africa	121	237	3.7
Swaziland	359	736	4.0
Botswana	237	519	4.4
Lesotho		363	964	5.4
Zimbabwe	232	624	5.5

Is the HIV/AIDS rate in women substantially higher in the US than most other developed countries?

[ecstatic]

20. Is it due to the increase in C-sections?

Abdominal surgery seems more risky than natural vaginal birth. Some women need them, but others are just trying to avoid labor pain.