Maternal mortality highest
among industrialized nations
By Trévon
Austin
25 August 2017
An estimated 700 to 900 women die in the US every year from
pregnancy- and childbirth-related causes, the highest rate among industrialized
nations. Another 65,000 nearly die, according to the Centers for Disease
Control and Prevention (CDC).
A study released
last week published in MCN: The American Journal of Maternal/Child Nursing indicates
that postpartum nurses are not being properly educated on the dangers mothers
face after giving birth. Lacking sufficient education, the nurses are unable to
play the critical role in identifying potential warning signs of postpartum
complications and taking precautionary measures.
A recent CDC Foundation
analysis of data from four states found that close to 60
percent of maternal deaths were preventable. By failing to properly alert
mothers to postpartum risks, nurses may be missing an opportunity to reduce the
abysmal maternal mortality rate.
MCN researchers surveyed 372 postpartum nurses around the United
States. According to the study, only 15 percent of respondents were aware of
the current maternal mortality rate and 12 percent accurately reported the
correct percentage of deaths occurring during the postpartum period.
Eighty-eight percent of nurses could not identify the three leading causes of
maternal mortality: postpartum bleeding (15 percent), complications from unsafe
abortion (15 percent), and hypertensive disorders of pregnancy (10 percent).
On the day that mothers were discharged, 67 percent of respondents
reported spending less than 10 minutes focusing on potential warning signs,
such as painful swelling, headaches, heavy bleeding and breathing problems that
could indicate potentially life-threatening complications. Furthermore, 19
percent of nurses believed maternal mortality was declining. “If [nurses]
aren’t aware that there’s been a rise in maternal mortality, then it makes it
less urgent to explain to women what the warning signs are,” says study
co-author Debra Bingham, who heads the Institute for Perinatal Quality
Improvement and teaches at the University of Maryland School of Nursing.
The importance of postpartum education is stressed by both experts
and the nurses surveyed. The data reported that 95 percent of RNs reported a
correlation between postpartum education and mortality. However, only 72
percent strongly agreed it was their responsibility to provide this education.
Nurse respondents who were over the age of 40 were significantly more likely to
report feeling very competent when providing education on all the postpartum complication
variables measured, indicating a decline in the quality of education for
nurses.
This post-delivery education is particularly important because a
mother typically doesn’t see a doctor for four to six weeks after she leaves
the hospital. A statement from the American College of Obstetricians and
Gynecologists says that up to 40 percent of new mothers, overwhelmed with
caring for an infant and often lacking in maternity leave, child care,
transportation and other kinds of support, never go back for their follow-up
appointments.
This revelation is obviously correlated with the decline in access
to adequate health care for all Americans. Approximately 11.3 percent of adults
in the US are without any form of health care. Throughout the United States, researchers
have pointed to heart problems and other chronic medical conditions such as
diabetes, to explain the rise in pregnancy-related deaths. The rise in these
conditions coincides with a decline in the quality of health care and its
accessibility, especially among low-income families.
This trend is reflected in Texas, the state with the highest
maternal mortality rate and the highest uninsured rate in the United States. In
the previous legislative session, Texas lawmakers rejected a federally-funded expansion
of Medicaid that would have covered 1.1 million more Texans. More than half of
all births in Texas are covered by Medicaid, indicating the irresponsible and
disastrous nature of lawmakers’ decision to defund Medicaid, but increase funds
for border patrol.
Actions of the Trump administration and
Congress will only exacerbate this situation. The Wall Street
Journal reported this week that the president is preparing to
roll back an Obamacare rule requiring all employers to provide insurance
coverage of all contraceptive methods without co-pays.
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