Can some help update this assignment?
ddelva88
InfantandMaternalMortality.docxDeanna Earl Seminar in Medical Humanities -MHU 4813 Professor: Abraham Graber
20
Deanna Earl
Seminar in Medical Humanities -MHU 4813
Professor: Abraham Graber
Infant and Maternal Mortality Rate
Deanna Earl
University of Texas San Antonio
Infant and Maternal Mortality Rate
In developed nations with a vibrant economy, current technology, and availability of modern care systems, the likelihood of infant and maternal deaths occurrence is minimal compared to countries that are not as developed. However, there are higher pregnancy and delivery risks in the United States than in other developed nations such as Canada, France, Australia, Spain, and Germany, to name a few. The Centers for Disease Control and Prevention (CDC) estimates 700 mothers to die because of pregnancy and childbirth-related complications in the United States. Most infant and childbirth deaths are preventable, and obstetrician doctors need to develop ways to help predict and prevent obstetric complications using antenatal care and train traditional birth workers. OB doctors should lead community awareness to create awareness on infant and maternal deaths.
Across the world, at least 300,000 mothers die in a year due to issues arising from pregnancy and childbirth. More particularly, almost 700 women die each year in the U.S. The World Health Organization (WHO) revealed that an estimated 830 expectant mothers die daily globally. Health care workers record maternal death rates as how many mothers die for every 100,000 live births. The U.S. has approximately annual 4 million births. In 2015 there were more than 17 childbirth deaths for every 100,000 live births (World Health Organization, 2019). Most of these women (99%) are from the low-income population living in "deeper" poverty in 3rd world nations. The rate of women losing lives due to pregnancy is as high as one in fifteen.
World Health Organization (WHO) reported declined mortality rates between 2000 and 2017. During this period, the number of maternal deaths in every 100,000 live births decreased by almost 38% globally. In 2017, approximately 295,000 women lost their lives during their pregnancy and childbirth. In Texas, the mortality rates increased between 2011 and 2012 (World Health Organization, 2019). The Centers for Disease Control (CDC) assessed the causing factors of the maternal mortality deaths to be high blood pressure, heart disease, inadequate access to quality care, hemorrhage, low transport, and inadequate housing. However, risk factors were diabetes, race, hypertension, untreated infections, and chronic heart disease.
In 2018, the maternal mortality rate (MMR) in the United States, healthcare institutions recorded 20.7 deaths per 100,000 live births. However, from 2010 to now, the rates have declined by 15%, as CDC reports (World Health Organization, 2019). Some of the risk factors for childbirth deaths are a family background of congenital disabilities, maternal age of more than 35, prenatal exposure to drugs and alcohol, and certain medications. An abortion surveillance report from the CDC indicated that women's deaths are associated with complications from abortion. In 2014, the report showed that six identified women have died due to complications from legal induced abortion.
There are many reasons why individuals may choose to have an abortion. The reason may include not feeling financially adequate to take care of a child or religious and cultural reasons. For example, in the state of Indiana, the U.S., the Faith Assembly of God is a religious sect with all its well-fed, extremely educated, and wealthy members. Their Christianity beliefs do not allow them to rely on current medical services irrespective of whether it is an emergency need or not. From the healthcare data, the revelation was that medical specialists who researched maternal deaths among these people of sample size 2,000 from 1975 to 1982 indicated high maternal death rates (MacDorman et al., 2017). MMR in the Faith Assembly members was 872 deaths in every 100,000 live births. The researchers realized that MMR for the Faith Assembly could be compared with third-world countries in Asia and Africa (Gingrey, 2020). The researchers' report suggests that when women in the U.S. or any other country avoid obstetric care, they put themselves at significant risk of maternal death.
OB Doctors can collectively help formulate numerous counteraction procedures to assist with managing complications. Obstetrician doctor is aware of maternal deaths resulting from complications, although most are unpredictable and challenging to prevent. A pregnant woman can develop complications at any time during pregnancy, at delivery, or in the postpartum period (Damian, Njau, Lisasi, Msuya, & Boulle, 2019). Thus, such a patient is at greater risk. OB doctors cannot predict or prevent most obstetric complications leading to infant and maternal deaths, but they can treat such complications.
The leading five causes of death include hemorrhage, pre-eclampsia and eclampsia, infection, obstructed labor, and complications of unsafe abortion. It is not possible to predict or prevent bleeding because it can occur at any time in pregnancy. As for eclampsia, most eclamptic incidences occur even without showing signs during or after delivery (Petersen, Davis, Goodman, Cox, Mayes, Johnston, & Barfield, 2019). However, according to WHO, antenatal care has limited capacity to prevent deaths and disability from infection.
OB doctors can ensure that delivery kits are clean and health education is provided to reduce infection rates. The vital factors giving rise to unclean delivery are poverty-related and lack of facilities. As for obstructed labor, prediction, or prevention cannot play any critical role in alleviating a pregnant woman's suffering from complications (Damian et al., 2019). The treatment recommendations involve a Caesarean section that must be accessible to all expectant mothers if mortality rates among women and infants have to decline.
Complications resulting from unsafe abortion are treatable provided the hospital is well-equipped and staffed. According to a Lancet study of 1980, Aberdeen researchers in the United Kingdom revealed that most antenatal hospital admissions other than delivery resulted from complications that had arisen irrespective of routine antenatal care (Petersen et al., 2019). Gynecological visits had neither detected nor prevented the complications from taking place. Healthcare institutions have backed traditional birth workers' training for a long time. This overwhelming training support's main reason is that many expectant mothers in third-world countries do not access quality healthcare services for many years before modern medicine. As a result, they deliver at homes. Their delivery is facilitated by traditional birth workers such as a birth Doula that help during delivery time. In most modern countries, if not an OB doctor, license professionals such as a Midwife, in most cases, are specialists who get paid by the patient and her family. Thus, such treatment services do not present a burden to the overall national healthcare budget. Since the method is reliable and cost-effective, most pregnant mothers prefer it. For example, hiring a Birth Doulas has proved to be effective in combating infant and maternal deaths because they provide emotional support and medical skills associated with midwives or nurses at delivery units. Physicians who see mothers that had experienced this kind of support, especially when faced with life-threatening complications, have seen that having a birth Doulas contributes to decreasing mortality rates.
Doulas have a code of ethics, according to the DONA international that they are to maintain fairness to all mothers and babies and provide adequate care. Women who obtain doula services have lower rates of preterm birth and low birth weight. Doulas are beneficial, especially for women in disadvantaged areas that require support. Some states and agencies help provide these services to individuals who cannot afford a birth worker. Some states allow for Medicaid insurance to pay doulas a fixed salary to be more accessible. Doulas also provide home visitation that contributes to improving maternal and child health and have been shown to reduce infant mortality, preterm births, and emergency room utilization (NCSL; NCSL; HRSA). Furthermore, Birth workers have skills that assist in delivery procedures that involve breathing and pushing techniques on the abdomen to hasten delivery. Thus, there is a need for more birth workers that can able them to detect obstetric complications and the best ways of referring to further obstetric services.
Some pregnant women with delivery complications are likely to die if there are not available equipped-hospitals to offer life-saving services. As a result, preventing maternal deaths can be attained through community awareness. These mobilization events can be best under OB doctors who can educate community members, especially women, on safe delivery procedures and processes. The topics to cover can involve explaining to community members the different options such as home-based delivery under a midwife and enlightening them about current care services available for pregnant mothers.
Further, community pregnancy campaigns can warn women against substance abuse, such as alcohol drinking during pregnancy. In many countries, such as the United States, community awareness has helped provide emergency obstetric services at grassroots levels where transport challenges can lead to loss of pregnant women's lives. It means that obstetrician doctors need to plan and implement effective community awareness campaigns on healthy delivery among women and strategize on disseminating information about pregnancy risk factors such as diabetes and inadequate housing (MacDorman, Declercq, & Thoma, 2017). Similarly, the community needs to plan to assist in funding the transport of women under labor pain to a nearby hospital or establish a community kit to take care of a vulnerable population that cannot afford to cater for hospital expenses.
In conclusion, the infant and maternal mortality rate can get reduced by focusing on preventable measures. Obstetrician doctors can predict pregnancy complications through antenatal care, equip traditional birth attendants with new delivery skills, and plan for community mobilization campaigns to educate members on healthy delivery procedures and pregnancy practices. Government agencies on health must ensure that every hospital can offer emergency obstetric care (EmOC) services and that these healthcare institutions get support from the functional referral system.
References
Damian, D. J., Njau, B., Lisasi, E., Msuya, S. E., & Boulle, A. (2019). Trends in maternal and neonatal mortality in South Africa: a systematic review. Systematic reviews, 8(1), 76.
Gingrey, J. P. (2020). Maternal Mortality: A US Public Health Crisis.
Petersen, E. E., Davis, N. L., Goodman, D., Cox, S., Mayes, N., Johnston, E., ... & Barfield, W. (2019). Vital signs: pregnancy-related deaths, United States, 2011–2015, and strategies for prevention, 13 states, 2013–2017. Morbidity and Mortality Weekly Report, 68(18), 423.
Pierre, A. S., Zaharatos, J., Goodman, D., & Callaghan, W. M. (2018). Challenges and opportunities in identifying, reviewing, and preventing maternal deaths. Obstetrics and gynecology, 131(1), 138.
World Health Organization (2019). World health statistics. Maternal mortality. https://apps.who.int/iris/bitstream/handle/10665/329886/WHO-RHR-19.20-eng.pdf?ua=1
