Thursday, August 30, 2007

Death By Cesarean

This article appeared in my local paper, The Kansas City Star, last Saturday. Read it and weep. This is where the out of control cesarean rate is taking us. Oh well, look at the bright side. When enough women die the medical establishment will stop looking at cesareans are 'cure alls.'

Posted on Sat, Aug. 25, 2007
Experts: U.S. childbirth deaths on rise
By MIKE STOBBEAP Medical Writer
U.S. women are dying from childbirth at the highest rate in decades, new government figures show. Though the risk of death is very small, experts believe increasing maternal obesity and a jump in Caesarean sections are partly to blame.
Some numbers crunchers note that a change in how such deaths are reported also may be a factor.
"Those of us who look at this a lot say it's probably a little bit of both," said Dr. Jeffrey King, an obstetrician who led a recent New York state review of maternal deaths.
The U.S. maternal mortality rate rose to 13 deaths per 100,000 live births in 2004, according to statistics released this week by the National Center for Health Statistics.
The rate was 12 per 100,000 live births in 2003 - the first time the maternal death rate rose above 10 since 1977.
To be sure, death from childbirth remains fairly rare in the United States. The death of infants is much more common - the nation's infant mortality rate was 679 per 100,000 live births in 2004.
Maternal deaths were a much more common tragedy long ago. Nearly one in every 100 live births resulted in a mother's death as recently as 90 years ago.
But the fact that maternal deaths are rising at all these days is shocking, said Tim Davis, a Virginia man whose wife Elizabeth died after childbirth in 2000.
"The hardest thing to understand is how in this day and age, in a modern hospital with doctors and nurses, that somebody can just die like that," he said.
Some health statisticians note the total number of maternal deaths - still fewer than 600 each year - is small. It's so small that 50 to 100 extra deaths could raise the rate, said Donna Hoyert, a health scientist with the National Center for Health Statistics. The rate is the number of deaths per 100,000 live births.
In 2003, there was a change in death certificate questions in the nation's most populous state, California, as well as Montana and Idaho. That may have resulted in more deaths being linked to childbirth - enough push up the 2003 rate, Hoyert said.
Some researchers point to the rising C-section rate, now 29 percent of all births - far higher than what public health experts say is appropriate. Like other surgeries, Caesareans come with risks related to anesthesia, infections and blood clots.
"There's an inherent risk to C-sections," said Dr. Elliott Main, who co-chairs a panel reviewing obstetrics care in California. "As you do thousands and thousands of them, there's going to be a price."
Excessive bleeding is one of the leading causes of pregnancy-related death, and women with several previous C-sections are at especially high risk, according to a review of maternal deaths in New York. Blood vessel blockages and infections are among the other leading causes.
Experts also say obesity may be a factor. Heavier women are more prone to diabetes and other complications, and they may have excess tissue and larger babies that make a vaginal delivery more problematic. That can lead to more C-sections. "It becomes this sort of snowball effect," said King, who is now medical director of maternal-fetal medicine at Riverside Methodist Hospital in Columbus, Ohio.
The age of mothers could be a factor, too. More women are giving birth in their late 30s and 40s, when complications risks are greater.
Other characteristics of the maternal mortality rate include:
-Race: Studies have found that the maternal death rate in black women is at least three times greater than is it is for whites. Black women are more susceptible to complications like high blood pressure and are more likely to get inadequate prenatal care.
-Quality of care: Three different studies indicate at least 40 percent of maternal deaths could have been prevented.
Sometimes, there is no clear explanation for a woman's death.
Valerie Scythes, a 35-year-old elementary schoolteacher, died in March at a hospital in New Jersey - the state with the highest Caesarean section rate. She had had a C-section, as did another teacher at the same school who died after giving birth at the same hospital two weeks later.
However, Scythes died of a blocked blood vessel and the other woman died from bleeding, said John Baldante, a Philadelphia attorney investigating the death for Scythes' family.
"I'm not sure there was any connection between the two deaths," Baldante said.
Also mysterious was the death of Tim Davis' 37-year-old wife, Elizabeth, who died a day after a vaginal delivery at a Danville, Va., hospital in September 2000.
She had a heart attack after a massive blood loss, Davis said. It's not clearly known what caused the heavy bleeding. There was no autopsy, he said, a decision he now regrets.
Two previous births had gone well.
"Nothing led us to believe anything was wrong with this pregnancy. She was like a picture of health," he continued, noting she had been a YMCA fitness instructor.
A lawsuit against the hospital ended in a settlement. Davis also sued the obstetrician, but a jury ruled in the doctor's favor.
The child born that day, Ethan, starts second grade next week. "He's a happy kid," Davis said. "He's just never had a mom."
© 2007 Kansas City Star and wire service sources. All Rights Reserved.


Anonymous said...

I really can imagine that a c-section would be a lot more risk. I do not have anything diagnosed in the way of blood clots, but with spider veins since 19 on my legs, and funny eye things that are not related to high blood pressure, I often wonder if I have "sticky blood" at times. I actually do not bleed much after my vaginal births, and this despite good hydration.

My cousin is an OB nurse and watched a woman die during a c-section because her epidural was somehow wrong. She saw the woman's lips turn blue and eyes open wide, they took the baby out as she died, tried to shock her heart, cracked open her chest but nothing revived her. It was a mistake somewhere, and she died leaving a baby all alone with his daddy.


Mimi said...

I read that article, it's shameful.

mm said...

Finally someone is admiting to the "risks" to this all too common surgery!
Frightening isn't it!
I don't think it is the absolute only reason... but I'm sure that it is a great factor in this problem.

sash said...

that is so sad...

Anonymous said...

Just came across your blog and was so touched. My baby is turning 1 this week and I still look back at her birth day with anger.
My water broke but I had no contractions. An hour later, I was on an IV, to start contractions, with internal monitor...the works.
Then the baby pooped...panic. The baby is not as active as we would we may need a C-section. Some time later the baby perked up.
I refused the epidural. When the "doctor" arrived she was not pleasantly surprised that I was not numb from the waist down. She looked at me as if I was crazy for not accepting shot to the spine. “I can’t help you now”, she said in the most annoying voice. The baby was out in three pushes. I felt rushed and bullied and I tore, fine, it happens. “That’s why I love my epidurals”, she said to the eager intern at her side. Not even once a word of encouragement, I thought my husband was going to strangle her. If I have another baby I am looking for a midwife.

Laborpayne said...

I feel your anger in your words. How telling that she said she loved 'her' epidurals. Its not your body or your decision how to handle your pain- she views you as 'her' body and can be annoyed because you are not following 'her' game plan. This is an excellent example of how providers are really looking for folks who are on board with THEIR philosophy and why women need to be doing the same.

Housefairy said...

Sick and scary.

I have had 2 c-sections and they were like nothing in this world. SO odd, so anitclimactic, so horrible...

and then to come home to complete isolation, after surgery, and have to not only take care of a newborn and my other children, but then to start to absorb the impact over and over and over again of the friends (some) and family (all) tellng me how GOOD it was that I had a C-Section.

Laborpayne said...

I have often thought, if women saw what I saw (an a nurse) during a cesarean, they would never allow this to happen to them unless it was a matter of life and death.

Bupil said...

I totally agree with what your saying and doing! I love what you stand for. Unfortunately I had my 1st child at 16 that ended in c0section and then had a vbac and 3 additional c-sections. My dream was to always give birth in the home. being I was 16 when i started things didn't go my way. I am thankful for the c-section as I would have died if it wasn't available. Now I am here at 4 c-sections one vbac and wanting more babies ( 1 to be exact) And was told that i could no longer have them due to the risks and my uterus being thin. However the Dr that did my 3rd section said my uterus was beautiful and had no scar tissue any could have 3 more if wanted. So how could 1 pregnancy change everything so much. And a v-bac now is totally out of the question per my doctors. Any advice is VERY much welcome.....

Anonymous said...

Unfortunately some women can't choose not to have a c-section. I had undiagnosed diabetes and a really large baby who, even after 10 hrs of labor, was not about to come out vaginally. If not for the c-section we both would have died. All I can say is that by the grace of God and modern medicine, my family of five exists.

Bobbie said...

I really loved your article.
I had a step-granddaughter that had her 3rd. baby by c-section. She did fine with the first 2 also by c-section. But she died with the third one. 4 days after giving birth to the little girl she wanted so much. They said she had staph.

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