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Maternal Mortality: One of the hidden costs of being a woman may be your life

In our medical malpractice practice, we sometimes see trends in the types of calls we get and cases being brought. Whether it’s from doctors lagging behind and not keeping up with particular standards of care, or patients being educated by what’s in the news, or something more anecdotal, similar types of malpractice cases seem to come in waves.

One of the trends I’ve seen, both in the calls we’re getting and in the general public consciousness, is a rising rate of birth injuries. Our firm is handling more birth injury cases (including injuries to newborns and new moms alike) than ever before. The interest of the public in this cases in on the rise as well.

Although we obviously don’t discuss our clients’ confidential information with the press, our firm has received multiple calls from reporters wanting to speak to us about birth injury cases we have handled. Articles have cropped up in newspapers about our cases and others across the state and across the country.

Something about this particular plight has caught the public’s attention. The interest is perhaps not surprising given that, even though US infant mortality is at its lowest point in history, maternal mortality is actually increasing. This sets the US apart from every other wealthy nation in the world, and not in a good way. American women are three times more likely than Canadian women to die in the maternal period (from the beginning of pregnancy to one year post-delivery) and six times more likely to die as Scandinavians. Even worse, 60% of these maternal deaths were preventable.

Scientific developments in NICU treatment have led to better survival rates for extremely premature infants and infants with other developmental or birth injuries. Unfortunately, the same attention is not being given to the health and safety of new and delivering moms.

Even very well-known and highly dangerous conditions such as preeclampsia (a type of high blood pressure in pregnant women that can cause seizures, stroke, and death), are not consistently diagnosed and treated in the United States. Britain has developed a systematized method of diagnosis and treating preeclampsia that has reduced its mortality rate to 1 in a million (0.0001%), while in the US it still accounts for about 8% of maternal deaths all on its own.

The exact reason that the US is lagging behind other modern countries is not clear, but a lack of oversight and reduced access to healthcare likely plays a role. Unlike other nations, there is no federal body that reviews these bad outcomes with a view towards creating solutions. This task is left to the states, who may or may not have such a body: when they do are often underfunded (or unfunded) and largely ineffective. Uninsured women who become pregnant are also subject to worse outcomes due to preexisting untreated chronic conditions and difficulty obtaining postnatal care.

The focus on babies, at the expense of mothers, occurs at all levels of the healthcare, from researchers, to obstetricians, to hospital discharge instructions. When new moms are discharged from the hospital after delivery, they are given a great deal of information about the care and keeping of their infant (on breastfeeding, how to tell if the infant is sick, etc.) but not enough information on caring for themselves. The signs and risks of blood clots, hemorrhage, and infection need to be understood if young mothers (who are understandably preoccupied with the care of their new infant) are to be able to recognize the difference between “normal” post-delivery symptoms and what constitutes a medical emergency. Poorly educated patients may not seek the help that they need or may seek unnecessary treatment, leading ER doctors to discount the complaints of the next seriously ill young mother that comes in.

No woman should lose her life as a result of preventable medical error during one of the times when her health will be more closely monitored than ever before. A woman who is going to the doctor every two weeks during pregnancy, and who is having her vitals constantly monitored during labor and delivery, should be able to know that her doctors and nurses are looking out for her health just as much as her baby’s.

Anything less is unconscionable.