I recently spent the weekend upstate at a beautiful old house built in 1898. It was surrounded by trees and just a hundred yards away from a gorgeous, crystal clear lake. It had a lovely massive porch in front that looked absolutely perfect for sipping lemonade, reading, and, brace yourself, giving birth. The owner of the house showed me photos taken almost four years ago of her sister giving birth to a lovely little girl out on the porch, surrounded by family and friends. I’m sure it looked very similar to that very first birth in the house over a hundred years ago.
When I was doing my pediatric residency in the West Village, the birthing center just a few blocks away was the bane of my existence. So were all the trendy West Village home births. Our hospital was where all the home births and birthing center births gone bad came to to get resuscitated. I remember the baby that was accidentally dropped in the birthing pool and took its first breaths of bloody bath water. The water was too soiled to find the baby quickly and it supposedly was under for 10 or 15 seconds as they searched for the little girl. I saw too many bad outcomes and became convinced that the hospital was the only safe place to give birth.
But then The Lancet, one of the most respected medical journals of all time, published a study this week that found:
"The United States is one of just eight countries in the world where deaths related to pregnancy and childbirth rose between 2003 and 2013, a new report says. That puts it in the company of countries such as Afghanistan, Belize and El Salvador."
This falls right in line with the other wide scale studies reporting the abysmal performance of our nation’s healthcare system. The most popular one being the World Health Organization ranking the US healthcare system 37th in performance.
But why would our maternal mortality increase be on par with Afghanistan’s increase? Could it be that women have just as difficult a time accessing high quality care in America as women in Afghanistan? That’s one possibility. But I think the far more likely reason is that American women have too much access to an increasingly unsafe healthcare industry marred by an addiction to unnatural and brutal c-section births (ever seen one?) in environments teeming with a high risk of hospital-acquired infections.
It’s been 14 years since the Institute of Medicine released their startling report finding that roughly 100,000 people die every year because of contact with the United States Healthcare Industry. Since that report was released, those numbers haven’t changed. Our nation’s healthcare industry is responsible for 100,000 deaths and our nation’s highways are responsible for roughly 34,000.
I have 3 years of personal anecdotes from real life situations of home births gone bad. But, as a doctor on the front lines working in a pediatric ER or neonatal intensive care unit, you see a disproportionate amount of bad things. It’s the nature of our business. Sick people come to us and it colors our world because we tend to forget about all the health and all the good out there in the world. For every botched home birth, there are many more that go marvelously well safe from the world of hospital-acquired infections and unpleasant high tech machines designed to pick up the first sign of an excuse to c-section.
So now I’m in a bind. I’ve got my experience that says natural pregnancies and births are unsafe for mom and baby. But now we’ve got legitimate, believable hard data saying that our healthcare system is increasingly unsafe for mothers. I don’t practice medicine anymore, but I’m still asked for advice. As a good doctor, I should point others to reliable, evidence-based information. Going forward, I’m afraid I’m going to have to point expectant mothers toward this study. It’s an important one and hopefully sparks a conversation where expectant mothers and fathers demand safer, cleaner, and less risky environments to bring babies into this lovely world.