This month, Mothering Magazine published a fascinating (and sad) article by Ina May Gaskin called "Masking Maternal Mortality." The article explores the deaths of several women from postpartum hemorrhage in the days following the births of their babies and other who died of complications from their cesareans. In the US, there is no national procedure for tracking an accurate maternal death rate, whereas in Britain a comprehensive, 400 page report is published every 4 years on "Why Mothers Die." (The maternal mortality rate is lower in Britain as well, which becomes even more concerning when you consider that the CDC in the US admits that there is "so much misclassification in the US system of maternal death reporting that the actual number could be as much as three times greater than the number officially published each year.")
Also, the article reports that according the CDC, "There has been no improvement in the maternal death rate since 1982, when it was reported to be 7.5 deaths per 100,000 live births. Our current maternal death rate is four times as high as it should be, and this statement, remember, is based upon our underreported figure. According to the Department of Health and Human Services, the rate should not exceed 3.3 deaths per 100,000 live births, whereas the rate in 2004 was more than 13 deaths per 100,000 births." (Note that the cesarean rate has also doubled since 1982.)
Vocal opponents of homebirth and midwifery claim that babies should be born in hospitals for "safety" and that if even one death can be prevented by cesarean or by "mandatory" hospitalization for birth, then it is worth it. I think of our four times higher than it should be maternal mortality rate and the fact that these mothers lost their lives after their "safe" hospital births and wonder...
The article also makes the point that several of the mothers who died after their hospital discharge, would likely NOT have died if they had had postpartum follow up care (such as that provided by midwives). Instead, the women were completely ignored, with fatal consequences.
Read more about Ina May's Safe Motherhood Quilt Project here.