Saving mothers' lives: Quality care
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 2, increasing the quality of care.
Jesus commanded us to heal the sick. Providing health care was a key component of the ministry of the early Christian church. And even today, denominations like The United Methodist Church work to make sure everyone gets the care they need.
As we mentioned in part one of this series on saving mothers’ lives, 830 women die each day around the world from issues stemming from pregnancy and childbirth. In that article, we talked about the need to break down barriers to accessing care.
But, even with access to health care, sometimes the care is inadequate. In addition to breaking barriers, we must ensure the care received by mothers and mothers-to-be is high quality.
When it comes to prenatal, childbirth, and postnatal care, health care professionals say that three things that can improve care: intensive screenings, childbirth interventions and postpartum care.
OhioHealth is a United Methodist-related health care system. A mobile doctor’s office is one of its programs. Dr. Jennifer Roncone, an OB-GYN with the clinic said they use a lengthy intake process for new patients, including screenings for diabetes, high blood pressure and preterm labor.
She also said they’ve started measuring the length of the patient’s cervix, an early indicator of the potential for preterm labor.
Following the intake interview, OhioHealth has the new patient meet with a social worker. Roncone says the social worker “will provide emotional support. She’ll introduce them to a smoking cessation program and encourage the mom to quit for two, her and the baby. If they don’t have insurance, or there’s a health literacy issue, she’ll help them get linked up with all the resources that they need.”
In parts of the world where immunizations are less frequent, these screenings can also offer a chance for mothers to receive their shots. Testing and treatment for sexually transmitted infections can also improve the health of both the mother and baby. For example, the World Health Organization has developed guidelines that dramatically reduce the rate of transmission of HIV from mother to baby.
Death rates related to childbirth are going down throughout most of the world. The U.S. is one of 13 countries, and the only developed country, where the rate is increasing.
Some states have defied that trend. California, for example, has implemented two interventions that have increased the survival rate.
Cesarean sections are often necessary when vaginal delivery risks the life of the mom or baby. But the California Quality Maternal Care Collaborative found that many c-sections were unnecessary. By cutting the number of c-sections, the number of mothers hemorrhaging because of placenta accreta has also decreased.
Similarly, California hospitals have created hemorrhage carts (similar to code blue cards) so that the medical team has the tools to keep a woman from bleeding to death at their fingertips.
Postpartum care is critical for new moms. But many are missing out.
Roncone of OhioHealth says a lot of women get prenatal care because they want to take care of their baby. After birth, they come for their baby’s appointments, but the highest rate of missed appointments is postpartum.
But, she says they try, "to send the message that we’re helping the mom and the baby. So, this is for your health and well-being as well as your baby.”
Sonia Booker, a registered nurse and director of the Wellness on Wheels at OhioHealth, explains their two primary goals for postpartum care are decreasing close interval pregnancies and screening and treatment for postpartum depression.
Close interval pregnancies are dangerous to women and babies. It is recommended that women space their pregnancies by at least 18 months. The Mayo Clinic says research shows poorly spaced pregnancies are related to an increased risk of:
- Premature birth.
- The placenta partially or completely peeling away from the inner wall of the uterus before delivery (placental abruption).
- Low birth weight.
- Congenital disorders.
OhioHealth works to connect women with long-acting reversible contraceptives, like intrauterine devices, to prevent pregnancies which risk the mother’s life.
Postpartum depression affects an estimated 1 in 7 women each year. OhioHealth screens women for depression and connects them with programs and councilors if they need it.
Taken together, focusing on increasing the quality of care women get before, during and after childbirth will decrease the number of women who die because of pregnancy and childbirth.
Medical professionals know what works. How will we as people of faith advocate for the political will to invest in and implement these life-saving protocols and guidelines?
As we prepare to celebrate Mother’s Day, let us put our faith into action for the sake of all mother’s and families.