The United Nations has designated Sierra Leone as the most dangerous place to have a baby. In fact, it has the highest maternal mortality rate in the world at 1,360 deaths per 100,000 live births. On average, most women have at least six babies in Sierra Leone.
In a previous post I mentioned the Aminata Maternal Foundation that helps pregnant women in Sierra Leone. An Australian organization, it was started by a woman, Aminata Conteh-Biger, who became a sex slave during the Liberian Civil War. Now, she is giving back to expectant mothers after so many years away from her home country.
This video shows the work of the Aminata Maternal Foundation and how it oftentimes becomes difficult for young pregnant girls to receive permission from family and elders to deliver in a hospital or health center. It also shows the frustration of healthcare workers who try to teach entire villages about the importance of proper maternal healthcare.
One of the leading causes of maternal mortality in the United States is hemorrhaging. In fact, according to the CDC hemorrhaging accounts for 11.2% of pregnancy-related deaths. Based on these increasing numbers since 1986 the Joint Commission, the country’s leading accreditation organization for hospitals, has created 13 new standards for perinatal safety for hospitals to properly care for women who hemorrhage during or after delivery. These standards were designed specifically to prevent, recognize and treat, as well as evaluate patients for transfer to critical care for not only hemorrhage but also severe hypertension/preeclampsia.
I write about maternal health a lot on Social Good Moms and sometimes I don’t write enough about newborn health. I saw some interesting information this month about the best and worst states to have a baby and thought the data was interesting to share. The data was compiled by Wallet Hub.
They compared the 50 states and the District of Columbia across four key dimensions:
Additionally, across these four dimensions, they evaluated 30 additional metrics including infant mortality rate, maternal mortality rate, Cesarean deliveries, preterm birth and low-birth weight infants.
The best and worst states are listed in the table below. One of the most important things for all parents to check for is their newborn health screenings. You can find yours based on your state at Baby’s First Test. And in North Carolina, mothers can sign up for an additional two free tests ( fragile X syndrome and spinal muscular atrophy (SMA))at EarlyCheck.org. The tests are led by RTI International.
Best vs. Worst
Mississippi has the lowest average annual cost for early child care, $3,192, which is 4.9 times lower than in the District of Columbia, the highest at $15,515.
Alaska has the lowest share of childbirths with low birth weight, 6.19 percent, which is 1.9 times lower than in Mississippi, the highest at 11.60 percent.
The District of Columbia has the most obstetricians and gynecologists (per 100,000 residents), 25, which is 25 times more than in Oklahoma, the fewest at 1.
Massachusetts has the highest parental leave policy score, 160, while 9 states, such as Alabama, Michigan and South Dakota, tie for the lowest at 0.
As I have written many times before postpartum hemorrhage (PPH) or excessive uterine bleeding after childbirth is the leading cause of maternal mortality in low-and-middle income countries. The recommended drug to prevent PPH according to the World Health Organization (WHO) is oxytocin. When administered in its recommended dose it causes little to no side effects. Oxytocin, the WHO’s current gold standard therapy, however, must be refrigerated and administered by skilled health workers posing two obstacles to its wider use in low resource, tropical settings.
Some countries have approved misoprostol, an oral drug, to prevent PPH, but there are several concerns that its use can be misappropriated for abortions instead of used solely for PPH. The World Health Organization has listed misoprostol as an alternative to oxytocin if it is not available.
Now, another PPH preventative drug, carbetocin, has been added to the latest updated 2019 WHO Essential Medicines List. The announcement was made last week. Unlike oxytocin, even at high temperatures carbetocin remains effective. The recommendation is that carbetocin can be used when oxytocin is not available or if its quality is uncertain. Additionally, the cost must be comparable to oxytocin.
After recently receiving a press release about a pregnancy docuseries on Facebook Watch I have been hooked! As a maternal health advocate, it takes a lot to stop me in my tracks, but 9 Months With Courteney Coxhas really opened my eyes on the realities of pregnancy in America. After all, it has been twenty years since I had my last child, so things have definitely changed!
My proclivity these days is to focus on vulnerable communities when it comes to maternal health and mortality and yet there are so many women who have to deal with pregnancy complications and care, health issues, and disparities, as well as fertility options and disappointments when it comes to carrying a baby full-term. The most important thing for all of us to remember is that women the world over have personal struggles with pregnancy. Those experiences are certainly different from one country to the next, and most certainly from one woman to the next. They all are valid for those who are carrying a baby or are desperately trying to.
9 Months With Courteney Coxhas honestly shone a brilliant light on pregnancy in the United States in its docuseries from a mother who found out she was pregnant and had cancer at the same time, to a couple who have tried for years to get pregnant, only to miscarry time and time again, to a mother who couldn’t imagine ever delivering a ninth child to add to her already eight children. These are just a few of the couples’ experiences of the ten that are laid bare in this riveting Facebook Watch show.
Want to watch? Start on episode one and enjoy. I will admit, I wish the episodes were longer because I really want to know what happens, but they are timed perfectly for busy people. Each episode is about 15 minutes.