Maternal Mortality: A National Embarrassment

Americans spend more money on childbirth than any other country, but we’re not getting a good return on our investment.

Less than a century ago, approximately one mother died for every 100 live births — an occurrence so common that nearly everyone belonged to a family, or knew of one, that was devastated by such a loss. Fortunately, in most nations, those tragedies have declined over the years. In fact, in the decade between 2003 and 2013, only eight countries saw their maternal mortality rates rise.

Unfortunately, the United States was one of those eight countries, joining a club that also includes Afghanistan and South Sudan. Within the 31 industrialized countries of the Organization for Economic Cooperation and Development, an American woman is more likely to die as a result of pregnancy than a citizen of any other country besides Mexico. Among developed countries, the United States has one of the highest maternal mortality rates — and those rates are only getting worse.

Graph: CDC

U.S. maternal mortality has attracted the attention of organizations whose oversight you wouldn’t expect. Amnesty International, which most Americans associate with the fight against human rights abuses in far-flung authoritarian regimes, considers our high maternal mortality rates to be a violation of human rights. Additionally — and pathetically — one of the biggest sources of funding for maternal health in the United States comes not from taxpayers but from the pharmaceutical company Merck. The Economist quoted a Merck spokesperson as saying, “We expected to be doing all our work in developing countries.” Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 23: Preconception Counseling for a Healthy, Informed Pregnancy

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.

pregnancyFew moments in life are as important and complex as when a woman makes the decision of whether and when to have children. There are many considerations to take into account when planning to conceive, many of which can affect not only the baby, but the mother as well.

Preconception counseling, a service of Planned Parenthood Arizona, can provide those who wish to conceive with valuable information about their own health, suggestions about how to best manage their wellness for pregnancy, and education about a range of outcomes (including the possibility of miscarriage). Preconception counseling can assist you in creating an environment focused on optimal health for both you and your future child.

These counseling services include:

  • targeted medical history with focus on teratogenic exposures, ethnic background, and family history
  • social history with focus on risk factors for sexually transmitted diseases (STDs), tobacco, alcohol, and street drug use
  • history of chronic illnesses
  • physical exam
  • labs as indicated (STDs, diabetes screening, etc.)
  • genetic counseling referrals as indicated
  • immunization review
  • folic acid utilization
  • review of current medications and possible hazardous exposures

The above list might seem long and detailed, but upon closer examination, you might not know what all of these things mean. What are teratogenic exposures? What does folic acid have to do with a healthy pregnancy? Let’s look at some of these topics in more depth. Continue reading