I think us choice advocates focus more on abortion than any other reproductive health issue because it’s the one that is most commonly and most vehemently attacked. But there’s no denying that the state of women’s health care across the spectrum, be it in abortion rights or otherwise, deserves a good hard look.

Amnesty International sheds light on the U.S. maternal health care crisis in a report entitled Deadly Delivery: THE MATERNAL HEALTH CARE CRISIS IN THE USA. According the the report, 2-3 American women die every day from complications in pregnancy and childbirth. Our country “spends more than any other country on health care, and more on maternal health than any other type of hospital care. Despite this, women in the USA have a higher risk of dying of pregnancy-related complications than those in 40 other countries.” Additionally, barriers to financial and informational support adds increased risk to women of color. Maternal-fetal outcomes in African American women have not improved in 20 years, leaving these women nearly four times as likely to die of pregnancy-related complications than white women.

While I am a white woman, I can vouch for the racial disparity in quality maternity care. My very first doula client was a young African American woman on Medicaid. She was under the care of one of two “all Medicaid” obstetricians in our city. These obstetricians work almost exclusively with Medicaid patients and work within the system to ensure they do not have to pay a dime out of pocket for their prenatal and childbirth costs. Unfortunately, this means they are not only overrun with patients, but also that they are almost always forced to use medical interventions that pose great risks to the mother and baby alike. Due to his busy schedule (not to mention affinity for micro-managing birth), her particular OB schedules nearly all his patients for labor inductions up to one week before their due date, resulting in increased likelihood of underdeveloped babies and higher rates of transfer to the NICU.

While occasionally necessary for complications such as placental insufficiency and postmature fetuses, Pitocin (synthetic labor inducing/augmenting hormone) has become one of the most commonly administered interventions in childbirth, and its effects can be detrimental to both mother and baby. Pitocin is rarely medically indicated, but instead used so that a labor and delivery unit can get women in and out of the bed as quickly as possible. For this reason, women who cannot afford to overstay their insurance-paid recovery period (generally 36 hours for women on Medicaid) are far more likely to be given the drug to ensure they may recover at the hospital within the allowed time limit.

Even if a woman has the resources to purchase her right to the birth she wants to have, legislative barriers continue to pose a threat to choice in childbirth. While shot down in a Senate committee, the Mississippi state legislature recently proposed legislation that would ban Certified Professional Midwives (CPMs) from working in the state. If passed, the law would have severely restricted a woman’s right to a home birth, despite not only its safety but also a woman’s right to make that decision for herself. Women all over the country continue to face obstacles to choosing a vaginal birth after cesarean (VBAC), again despite repeat studies on safety. And if you don’t have $1500 just lying around, legislative barriers are the least of your concerns; few states offer Medicaid reimbursement for home births despite how it could cut costs, and liability issues surrounding VBAC means women are less likely to find a Medicaid-eligible practitioner for her vaginal birth after cesarean. When you consider that almost one-half of women birthing in the U.S. are eligible for Medicaid, there is no question that finances, not personal desires, are making women’s decisions for them.

As the health bill “reconciliation” process begins on Capitol Hill, and debates regarding the place of government in health care affordability rage on, women’s health has been whittled down to nothing more than a bargaining chip to gain support from anti-choice politicians. But the headlines and soundbites about abortion care, maternal health, and government intervention cannot possibly do justice to the fact that the end result will affect women’s lives, and it will affect them profoundly. Health reform has too often been spoken of in sweeping generalizations, in dollars and cents, in attempts to advance one’s political career; the debates tend to lack any consideration of our health care system’s true-life impacts, the impact of sub-par health care on actual people, on women and their families. In that sense, the Amnesty report could not have come at a better time.

You can take action using this form from Amnesty International to tell HHS Secretary Kathleen Sebelius that all women deserve unbridled access to the best evidence-based maternity care available. Indeed, the well-being of future generations depends on access to adequate care in-utero and in life’s beginnings.

This entry was posted on Thursday, March 18th, 2010 at 5:26 pm and is filed under Birthing Options, activism, economic justice, health, legislation, pregnancy, race. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.