Increase in maternal mortality due to inconsistent health care?

I just got back from Texas where I was taking my mother to various doctor’s appointments.  I discovered, not for the first time, that Texas really is like a whole other country because the lady just got there three weeks ago and she’s already seen at least four specialists and a GP. One medical complex we went to last week had computerized records and what must be the forerunner to the iPad where instead of printing papers to sign and filling out the same forms repeatedly everything popped up to be verified and she initialed the screen instead of a dead tree. Efficient and accurate.

Needless to say I was blown away since, in my experience in New York, it takes two months to get your first appointment with a primary care doctor if you’re a new patient and if it’s an emergency they tell you to go the ER rather than fit you in to their overcrowded office where you fill out reams of paperwork every time you step in the door. My point is there is a massive discrepancy in the quality of health care in our country depending on your zip code. One horrifying result is the increase in maternal deaths in California.

A new report out of California found the number of women who died in the state after giving birth has nearly tripled over the past decade, from 5.6 deaths per 100,000 to 16.9 per 100,000 in 2006. The report was commissioned by the California Department of Health but has not yet been publically released. ABC News first learned of its existence from a watchdog group called “California Watch.”

Death after childbirth is still rare, but experts say many of those deaths could have been prevented. “We’ve been able to double-check the data so we can truly say there is a rise,” said Dr. Elliott Main, chairman of the California Maternal Quality Care Collaborative, which worked on the report.

“Most women died from hemorrhage, from deep vein thrombosis or blood clots, and from — this is the surprise — from underlying cardiac disease,” added Main.

via Preventing Maternal Mortality – ABC News.

The woman profiled in this story, Valerie Scythe, died after a stroke due to a blood clot reaching her brain. Scythe had a c-section and didn’t get out of bed for 30 hours. Her husband claimed her legs were “hard to the touch.” The article points out that Scythe was not outfitted with compression boots after the surgery due to the high cost of the machine. (I’m also guessing she didn’t have nurses or her doctor encouraging her to stand up and walk around if she was bed ridden for that amount of time.)

After my c-sections at St. Vincent’s (now on the verge of bankruptcy) and NYU – both in Manhattan – I was almost immediately fitted with the compression boots. It was a routine matter that Valerie Scythe’s hospital did not see as routine, and now she’s dead.

According to the World Health Organization, the U.S. ranks behind more than 40 other countries when it comes to maternal death rates, with 11 deaths per 100,000 pregnancies when measured in 2005. More women die in the U.S. after giving birth than die in countries including Poland, Croatia, Italy and Canada, to name a few.

via Preventing Maternal Mortality – ABC News.

Passing health care reform will not automatically improve the quality and consistency of care in our nation’s hospitals, but improving communication and record keeping is a big step in preventing mistakes that lead to these unacceptable statistics.  Preventative care and labor support would also help women avoid c-sections, if that is indeed what seems to be pushing the mortality rate higher.

It boggles my mind – and I can’t imagine what Valerie Scythe’s family must be feeling – that something as simple as keeping the blood flowing after major surgery to prevent blood clots is not a given. How is our health care system not broken?

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2 Responses to Increase in maternal mortality due to inconsistent health care?

  1. Pingback: Scared To Death Of Giving Birth? A Tokophobe Tells Her Story - Caitlin Kelly - Broadside - True/Slant

  2. jake brodsky says:

    I don’t think there is any disagreement that the health care system is in poor shape and needs improvement. What we need is something like the safety programs used in other fields, so that medical staff understand what the risks are better and they can take appropriate action.

    There is no standardized feedback to illuminate problems before they get dangerous. The only recourse we have is the legal system. By the time this stuff gets in to the courts, it’s too late. The ignorant will pass judgment on whether someone was incompetent. Nobody will come out smelling clean.

    To fix this, we need ways to collect better data without rancor or retaliation, and to use that data to improve procedures. Right now, these methods are mostly haphazard one of approaches.

    The medical industry needs to do better.

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