Pregnancy and childbirth.
What romanticized and fetishistic notions we have of them.
Many women in the world have no access to medicine and help and others are over medicalized.
From an article from the UN News Service;
The initiative is being carried out in collaboration with more than 20 regional and international agencies, including the UN Population Fund (UNFPA), the UN Children’s Fund (UNICEF) and the World Bank.
They are fighting what is widely viewed as an “invisible epidemic” in poor countries, where the risk of dying in childbirth is over 100 times higher than in rich nations. WHO says these figures do not tell the whole story because as many as half of all maternal deaths go unreported. Over 60 States don’t even track statistics on the problem.
“If dead women are not even counted, then it seems they do not count,” Joy Phumaphi, WHO’s Assistant Director-General on Family and Community Health, said at a meeting today in Nairobi.
The manual delves into the question of why women die from complications related to childbirth, and spells out how to avoid them through methods which can be used in even the poorest settings.
The main causes of maternal deaths are well-known: haemorrhage, infection, hypertensive disorders, obstructed labour and unsafe abortion. But WHO and its partners are trying to remind the world that the crisis continues because care for pregnant women is either unavailable, inaccessible, or inadequate.
There may be something worse than death, however, fistulas
“Big eyes, with a question mark: ‘When is it my turn?’ ” he said later in his office, filled with medical books, suture-filled suitcases and damp socks and T-shirts hung on chairs to dry. He held up his hands. “The eyes are following you everywhere you go. I tell them it is one man, two hands and many women.”
What brings the girls to Dr. Waaldijk – and him to Nigeria – is the obstetric nightmare of fistulas, unknown in the West for nearly a century. Mostly teenagers who tried to deliver their first child at home, the girls failed at labor. Their babies were lodged in their narrow birth canals, and the resulting pressure cut off blood to vital tissues and ripped holes in their bowels or urethras, or both.
Now their babies were dead. And the would-be mothers, their insides wrecked, were utterly incontinent. Many had become outcasts in their own communities – rejected by their husbands, shunned by neighbors, too ashamed even to step out of their huts.
Until this decade, outside nations that might be able to help effectively ignored the problem. The last global study, in which the World Health Organization estimated that more than two million women were living with obstetric fistulas, was conducted 16 years ago.
You can help lessen the impact by donating to charities such as the The Worldwide Fistula Fund.
In the developed world over care is often a problem. Doctors tend to see pregnancy and birth as something to be controlled and “cured” in a study on midwifery it was concluded that
After controlling for social and medical risk factors, the risk of experiencing an infant death was 19% lower for certified nurse midwife attended than for physician attended births, the risk of neonatal mortality was 33% lower, and the risk of delivering a low birthweight infant 31% lower. Mean birthweight was 37 grams heavier for the certified nurse midwife attended than for physician attended births. CONCLUSIONS: National data support the findings of previous local studies that certified nurse midwives have excellent birth outcomes. These findings are discussed in light of differences between certified nurse midwives and physicians in prenatal care and labour and delivery care practices. Certified nurse midwives provide a safe and viable alternative to maternity care in the United States, particularly for low to moderate risk women.
Midwives tend to use a more hands on approach, receiving information directly from the mother rather than relying on machines and monitors. A more personal approach can often calm and reassure women going through the pain of birth. Women who use midwives and doulas tend to use fewer drugs and often have shorter birth times.
According to WHO cesarean rates should hover around 10-15% yet many regions report rates as high as 25-30%. Although c-sections can be life saving it is unlikely that such high rates are justified and as a c-section is major abdominal surgery doctors should be more judicious in their use of this procedure.
# A cesarean section poses documented medical risks to the mother’s health, including infections, hemorrhage, transfusion, injury to other organs, anesthesia complications, psychological complications, and a maternal mortality two to four times greater than that for a vaginal birth.
# An elective cesarean section increases the risk to the infant of premature birth and respiratory distress syndrome, both of which are associated with multiple complications, intensive care and burdensome financial costs. Even mature babies, the absences of labor increases the risk of breathing problems and other complications.
Domestic violence often increases or starts when a woman is pregnant.
* over a third of domestic violence starts of gets worse when a woman is pregnant
* one midwife in five knows that at least one of her expectant mothers is a victim of domestic violence
* a further one ins five midwives sees at least one woman a week who she suspects is a victim of domestic violence
* domestic violence is the biggest unborn baby killer
One US study showed that 37 per cent of obstetric patients were suffering abuse, and that 30 per cent of domestic violence actually started during pregnancy. Domestic abuse was identified as a major health issue for pregnant women: a Yale study revealed that abused women were 15 times more likely to suffer a miscarriage.
Women living in poverty also have greater likelihood of complications due to lack of nutrition and/or poor living conditions.
It is a proven fact that when a woman receives good prenatal care and nutrition her baby will not only be born healthier but have better health outcomes over a lifetime.
Yet many women cannot afford good food and many without health insurance in the states do not receive prenatal care.
It is unfortunate that so much energy is being giving to trying to keep pregnant those who do not want to be, and so little is being giving to those who do but need help or to those who have no access to medical care.
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