Saving mothers' lives: Breaking barriers
As we approach Mother's Day, we're taking a look at some of the steps we can take to help prevent deaths due to pregnancy and childbirth. This is part 1, reducing barriers to care.
United Methodists have long advocated for societies where each person is afforded health, wholeness and human dignity.
Take Dr. John Stewart for example. He is a retired OB-GYN and a United Methodist. He volunteers with Doctors Without Borders in South Sudan and says he went to medical school to learn how to deliver babies.
But that’s not all he does.
“When I am in South Sudan,” he said, “there are skilled birth attendants who deliver babies. Part of my job is to disassemble babies that have died in the birth canals of girls too young to give birth.”
Many people believe pregnancy is no longer risky. That’s just not true. Since 1990, deaths of mothers and children under the age of 5 worldwide have been cut by more than half, but 830 women still die each day as a result of complications during pregnancy or childbirth.
Several factors can lead to these deaths, things like gestational diabetes, high blood pressure and not enough time between pregnancies.
Many of these deaths are preventable. Several low-cost, high-impact interventions, including contraception to prevent early and unplanned pregnancies and skilled care before, during and after pregnancy, could save 100,000 or more women each year.
The United Methodist Church says, “Motherhood is sacred.” If motherhood is sacred, we have to treat pregnancy and childbirth as parts of that sacredness and ensure that women have access to affordable, high-quality care.
Recognizing the barriers
Stewart says, there are three delays in getting needed help for mothers experiencing complications of childbirth in the developing world: delay in recognizing there is a problem; delay in obtaining transportation to a health facility; and, delay in getting the level of care needed.
There is also a lot of misinformation about reproductive health care and a lack of access to contraception. Many people believe untrue things like birth control encourages promiscuity or causes cancer.
Language, education, racism, health literacy and cultural practices can also create barriers. Women living in rural areas and among more impoverished communities are more likely to die in childbirth.
Too many of our sisters live in communities where there are not providers for pregnancy-related complications and emergencies. For example, The last OB-GYN retired in McDowell County, West Virginia, in 2017, and now there is no care for emergency services including deliveries. Worldwide, about three-quarters of women giving birth in 2016 had the help of a skilled attendant, but there are regions, like Sub-Sahara Africa, where half of the women and girls giving birth have no one trained to assist them.
Dr. Jennifer Roncone, a doctor serving the Wellness on Wheels program of OhioHealth Medical System, explains, “What people don’t understand is that we can have a doctor’s office, but we have women who may not have a car to get there. Or she may not have anyone to watch her children so that she can all to the appointment.”
OhioHealth is a United Methodist-related health care system. The Wellness on Wheels program puts Christ’s call to care for our neighbors into practice by operating a doctor’s office on wheels at five sites.
The mobile clinic seeks to break down barriers to care. Sonia Booker, a registered nurse and director of the Wellness on Wheels, says OhioHealth created the program after a 1992 study found that “too many women were delivering without prenatal care. And, as a result, a lot of those babies were going to the [Neonatal Intensive Care Unit].” Roncone added, “Not only do we take anyone at any gestational age, but we will provide them transportation.”
Booker emphasizes that the Wellness on Wheels team “…[doesn’t] penalize [patients] for not coming to visits; we incentivize them to come.”
Some of their patients have addictions; others are experiencing intimate partner violence. Yet, Roncone says, “We honor the integrity of our patients. We practice under ethical guidelines. We don’t judge people.”
She added, “I think the women have a fear of being exposed and consequently losing their baby…We try to make them understand that we’re here to support them and help them take better care of themselves, their new baby and, sometimes, even the family, the children, they already have. We can tell it works because they refer their friends.”