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August 24th, 2017 by Mayri Sagady Leslie

Compassion and Fear: The Focus on Maternal Mortality

I am awed by the enormous media response to the rising maternal mortality rate in the U.S. Public awareness and compassion are important components of solution-making. This is an extremely serious situation we must improve. As a country, holding the highest maternal mortality rate among industrialized countries is nothing to be proud of. Under analysis, maternal mortality is a complex problem to unravel with multiple influencing factors. Some maternal deaths are unpredictable and inevitable. But many may have been prevented by earlier actions. This chart from the CDC paints a clear picture of where we stand.

Trends in Pregnancy-Related Mortality in the United States, 1987-2013. This line graph represents the number of pregnancy-related deaths per 100,000 live births per year: 1987, 7.2; 1988, 9.4; 1989, 9.8; 1990, 10.0; 1991, 10.3; 1992, 10.8; 1993, 11.1; 1994, 12.9; 1995, 11.3; 1996, 11.3; 1997, 12.9; 1998, 12.0; 1999, 13.2; 2000, 14.5; 2001, 14.7; 2002, 14.1; 2003, 16.8; 2004, 15.2; 2005, 15.4; 2006, 15.7; 2007, 14.5; 2008, 15.5; 2009, 17.8; 2010, 16.7; 2011, 17.8; 2012, 15.9; 2013, 17.3.

Excellent resources exist on what we can do and ways to improve outcomes. But this post is not about that. This post is about the unwanted impact of increasing public awareness on maternal mortality.

As I flip around to my various news apps, I see this effort to increase public awareness has begun to take on its own ‘personality’. Beyond the facts, beyond the evidence, a downstream effect is emerging and that is fear. Intended or not, those who read the media on this issue are hearing the horror stories of childbirth. Reporters are seeking out personal stories which are illustrative and compelling. But, depending on the quality of the news source, this has resulted in a collection of traumatic stories, which, taken together, paint a picture of pregnancy and childbirth as life-threatening events.

Propublica and NPR and other sources have responsibly brought the reality of losing a mother by storytelling of family members who have lost someone and by mothers who narrowly escaped death. I applaud this. But what I have noticed in the increasing number of news stories and personal testimony is the emerging dominant image of childbirth as a terrifying, mortal threat to the mother’s life. I worry that thousands of women seeing these stories will experience increased fear about having a child.

Let’s put this in perspective. In 2013 (above) the maternal mortality rate was 17.3 per 100,000 live births per year. This is saying that of every 100,000 live births, 0.017% of mothers died. This is less than two tenths of a percent. Turning this around, 99.083% do not die.

OF COURSE it matters that any mother dies as a result of childbirth and we should do everything we can to reduce its occurrence. But the vast majority of women do not die in childbirth. In fact, the vast majority of women have safe, healthy births.

We need storytelling about healthy and safe births. Where are the mothers who view their birth experience as powerful, significant and empowering? We need you to speak up as well. One very important solution to reducing maternal mortality is having mothers in good health receiving excellent care in pregnancy and birth. If you are one of these, please speak up.

Fear of giving birth will not reduce maternal mortality. Awareness, compassion and action will. But the awareness should include the perspective that more than 99% of women do not die in childbirth.


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