Giving Birth in California More Dangerous Than in Kuwait or Bosnia?

As reported by Nathanael Johnson of California Watch, over the past decade, the mortality rate of women in California who die from pregnancy-related causes has nearly tripled. The Department of Public Health has been refusing to release to the public a report outlining this trend but California Watch has confirmed that this is the biggest spike since the 1930’s. Kuwait and Bosnia are now safer places to give birth than California!

This appears to be a nationwide problem. Both the Joint Commission (the country’s leading health care accreditation group) and the U.C. Centers for Disease Control (2007) agree that maternal mortality has been on the rise. High blood pressure, diabetes, obesity, older mothers, and hemorrhaging after C-sections may all be contributing factors.

These risk factors, however, cannot fully account for the increase in deaths. Investigators from California’s Department of Health have found that simply changing clinical procedures and practices could prevent a large number of these incidents. The fact that the rate of C-sections performed has increased by 50 percent in the same time period must also be taken into consideration. Almost one out of every three babies born is now delivered by C-section.

Out of 500,000 live births in 2006, 95 Californian women died due to a cause directly related to pregnancy. According to the U.S. Department of Health and Human Services, the number of deaths should have been closer to 28 when compared to the level incurred by other countries.

"For every maternal death, there are 10 near misses; for every near miss, there are 10 severe morbidity cases (such as hysterectomy, hemorrhage, or infection), and for every severe morbidity case, there is another 10 morbidity cases related to childbirth," writes Catherine Camacho, deputy director of California’s Center for Family Health. She concludes that the rise in deaths is symptomatic of a bigger problem.

Dr. David Lagrew noticed that an alarming number of patients at the Women’s Hospital at Saddleback Memorial Medical Center in Orange County were being induced before term with no apparent medical excuse. Since induction doubles the chance of having a c-section, he ceased allowing elective inductions before 41 weeks. This occurred in 2002 and as a result, the hospital had fewer babies admitted to the neonatal intensive care unit, fewer hysterectomies and less maternal hemorrhaging. An additional result was a loss in revenue. Improved care does not always yield an increase in profitability so the first hospitals to put controls on early elective inductions were nonprofits.

Childbirth Connection, an advocacy group, states that "Six of the 10 most common procedures billed to Medicaid and to private insurers in 2005 were maternity related." A Cesarean section commands about twice as much revenue as a normal vaginal birth and is now the most common surgical procedure in the U.S.

Although the state has been reluctant to release the report on its findings on maternal mortality, officials do agree that there is a problem with current standards of care and that change is necessary in order to fight this "cesarean section epidemic." It sounds as if the rise in C-sections, inductions and other medical interventions (which add to the revenue of the hospitals) are largely responsible for these deaths and complications. This coupled with older mothers, high blood pressure and other health issues has nearly tripled the mortality rate of birthing mothers.

It makes you wonder why many medical professionals question the safety of homebirths. Homebirths are safe. The British Medical Journal found that Planned Homebirths are as safe as low risk hospital births.

The full story can be read here:
http://www.alternet.org/story/145524?page=entire