Women in the U.S. have a greater risk of dying from pregnancy-related complications, including hemorrhage, than women in 46 other countries. You had your own close call experience; how would you describe feeling so at risk in birth in a country that is supposed to have one of the most advanced healthcare systems in the world?
It was extremely scary. I was fortunate enough, however, to know that skilled, trusted medical professionals were taking care of me. While it was an incredibly frightening experience, there was never a point where I thought that I wouldn’t survive. I had a strong healthcare team. I had health insurance. I felt cared for and listened to. There are too many other women who don’t get to feel that level of certainty.
It was later that I realized just how close a call that was and how many other women simply die for lack of skilled care. Since I’ve always traveled and know women and mothers all over the world, the realization that many of them don’t have access to that level of care was jarring. It motivated me to switch gears in my life in a way that has ultimately created Every Mother Counts (EMC; everymothercounts.org).
For you, Every Mother Counts is very personal.
If a potentially life-threatening childbirth complication can happen to me, it can happen to anyone. I was fortunate to have high-quality, compassionate healthcare when I needed it most. If I’d been a woman in many of the countries where
healthcare is limited or denied, I would not be here today answering these questions. I’d be among the almost 300,000 women who die every year from preventable pregnancy and childbirth-related conditions.
By sharing my story, some women understand what has also happened to them is a fairly universal experience. It makes them realize they’re not alone but that our shared, common experiences represent a bigger problem. My career enables me to shine a light on this bigger problem that affects so many women in the world. I hope it will help generate significant change.
Of which victories with Every Mother Counts are you most proud?
There are many. We’re beginning to see a groundswell of interest and concern about the welfare of women and mothers in the world. When I had my childbirth complication 10 years ago, there was very little attention being paid to the problem of maternal mortality and poor maternal health conditions.
Because of our supporters, we’ve been able to fund projects that are making a direct impact on maternal health in some of the most in-need countries in the world like Haiti, Uganda, Malawi, Indonesia and the United States. I’m also very proud that people are beginning to look closely at women’s and maternal health conditions right here at home, and understanding that we need to do more, and do things differently, to take care of our own mothers.
Currently, 1 in 3 babies born in the U.S. are birthed surgically through cesarean. Federal health experts advise that the incidence of cesarean should be more like 1 in 6-7 births. Cesarean is major abdominal surgery, and can leave a woman at risk for health problems in future pregnancies. Is EMC doing anything to address the prevalence of cesarean in countries where rates are higher than they should be?
We’re addressing the c-section crisis in the U.S. in 3 ways: First, we consider the education of women, families and healthcare providers to be the most powerful tool we can use to change our healthcare system. We use our blog and social media platforms to write original content and to share content from other resources about maternal health issues.
We’re funding a program in Florida that exemplifies the challenges and solutions many American women face in accessing high-quality healthcare and prenatal education. Third, we regularly engage in conferences and conversations that promote examination of what is and is not working in the American maternal healthcare system. We’re talking with your organization, the Association of Women’s Health, Obstetric & Neonatal Nurses (AWHONN), the American College of Obstetricians & Gynecologists, the American College of Nurse Midwives, and many others.
For every death, there are exponentially more life-changing injuries. How is EMC making a difference in this regard?
For every woman who dies due to childbirth complications there are 20+ who suffer lifelong disabilities, such as obstetric fistula. We don’t see many incidences of fistula in the U.S. because even women who lack prenatal and antenatal care can usually access emergency room services to treat complications like that.
Instead, women are suffering short- and long-term complications related to our high-intervention, high c-section rate model of care. We’re seeing increasing problems with hemorrhage, placental complications with subsequent pregnancies and infections. The way to change that is to directly address the issues that contribute to poor maternal healthcare including lack of health insurance and overuse of unnecessary interventions and surgeries.
Americans perceive the U.S. healthcare system as a leader. How do we not export the mistakes we make here in labor and birth?
The U.S. is currently ranked 47th in safe motherhood, so I would say that we are far from being a “leader” in world health. While 99% of deaths that result from pregnancy and childbirth complications occur in the developing world, 800 women die every year right here in the U.S. That’s 2 or 3 every single day.
We are very concerned about exporting our mistakes. We’re seeing evidence in many parts of the world that some hospitals are following in our footsteps in terms of implementing too many unnecessary interventions. At the same time, many of these countries and hospitals are still facing extreme lack of access, staff, supplies and skills. We need to address all of these issues while also keeping our eyes open for the mistakes that are so prevalent here at home.
Which leads us to ask about Every Body Counts?
Every Body Counts explores how women’s overall health and wellbeing contributes to maternal health. Our goal is to get people thinking about maternal health from a wellness angle, offering our audiences ways they can educate themselves and others about nutrition, exercise, mindfulness, spirituality, mental health issues and lifestyle factors. Every Body Counts is a natural theme for us to explore because improved physical and mental health contribute to a healthy pregnancy, and ultimately, healthy babies.
How can women actively partner with their doctors, midwives and nurses to ensure that their desires and health needs are met? What barriers do you see that still need to come down to improve outcomes for moms
It starts with education and ownership of our own health and continues with changing the culture of healthcare women receive in the U.S. and around the world. Many women go into their pregnancies assuming their healthcare providers will make all the decisions. They essentially hand over their health to someone else. When women aren’t actively involved in making their own healthcare decisions though, they have no real say in how they’re medically treated.
When women and their partners educate themselves about what’s normal and healthy in pregnancy and about the potential complications they might face and when they know their options, then they have a more equal partnership with their healthcare provider.
Ultimately, we need to change the way many people still see healthcare. They see the doctor as in charge and the patient as having to do as they’re told. Instead, we need to understand that as patients, we are hiring our healthcare providers to provide us with the information we need to make our own choices. When we trust our doctors, midwives and nurses, and engage in a give-and-take relationship, that’s where the best healthcare decisions can be made.
What will mother/baby health and wellness look like when you can say, “Our work here is done?”
Pregnancy and childbirth will be safe for every mother, and there will be no more preventable deaths. Mothers and their children will thrive and girls will see their future lives as mothers as hopeful, safe and supported.
Carolyn Davis Cockey, MLS, LCCE, is editor of Healthy Mom&Baby and a Lamaze-Certified Childbirth Educator.