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Mother deaths prompt protest, call for midwives

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Even for Andrea McPherson, who is accustomed to looking at international statistics on maternal deaths, the numbers seemed shocking.

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Betsy Alger (right) stands with a group promoting natural childbirth holding a rally to call attention to Augusta's very high maternal death rate.  TODD BENNETT/STAFF
TODD BENNETT/STAFF
Betsy Alger (right) stands with a group promoting natural childbirth holding a rally to call attention to Augusta's very high maternal death rate.

“I’m used to seeing these stats for Third World countries, not at my front door,” said McPherson, who was among about a dozen women and children protesting Friday outside the Richmond County Health Department to call attention to the area’s high maternal mortality rate.

The rally was prompted by an Augusta Chronicle analysis published in June that found the East Central Health District in Augusta had the highest maternal mortality rate in Georgia in 2011 – 93.3 per 100,000 births, three times the state rate and more than six times the national average.

One sign the protesters carried asked, “Did you know birth is safer in Iraq than Augusta?”

Georgia is trying to get to the bottom of why that rate has shot up in recent years and formed a Maternal Mortality Committee in December 2012 to review each death and come up with recommendations for the state, said Dr. Ketty Gonzalez, the director of the East Central Health District and a member of the review committee.

There is probably not one reason, but likely a number of factors, she said.

“What we know is it is closely tied to infant mortality and low birth weight,” Gonzalez said. “It is closely tied to the women’s health status before they get pregnant. That is an issue for us.”

There are higher rates of obesity, diabetes and hypertension, some of it undiagnosed, among women who then get pregnant, she said.

“It creates a major stress to your kidney, your heart, your liver, etc.,” Gonzalez said.

Richmond County is hoping to help address the problem by creating a Centering Pregnancy program. It involves grouping pregnant women by due date and following their care through a nurse practitioner who sees them as a group weekly. The women weigh themselves, check their blood pressure and discuss issues ranging from nutrition to domestic violence, Gonzalez said.

“They have someone looking at the process, but they allow the patients to engage in their own care,” she said.

For the women at Friday’s rally, many of whom have delivered using midwives and at home, the solution is having more mid-level practitioners such as doulas and nurse-midwives.

Laura Selvidio pointed to the midwife-led Birth Centers prevalent in other states that resulted in much lower cesarean rates, and the potential complications involved with that, and zero maternal deaths among the 15,574 women followed in one study.

In Washington state, which encourages midwives and out-of-hospital births, the state saved an estimated $3.1 million a year, said Betsy Alger, who has delivered three children at home and is expecting another in a month.

“It is a significant savings,” she said, adding that it should appeal to Georgia’s fiscal conservatives. “They should be all over this.”

According to a Cochrane Database Systematic Review of 11 clinical trials involving more than 12,000 women, midwife-led care resulted in less anesthesia use and fewer episiotomies and gave women a feeling of greater control during labor.

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Augustaisdying
526
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Augustaisdying 07/13/13 - 12:51 am
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Yeah, but...
Unpublished

Do midwives accept EBT as payment?

Riverman1
86785
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Riverman1 07/13/13 - 03:35 am
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Nonsense...But....

This is all nonsense. It's obvious the life the woman lives after the birth of the child is what matters. It's also obvious it's going to be about the same life she lived before giving birth...with added responsibility. Demographics. These nurse midwives, bless their hearts, may have hit on something, though. They stay in touch with the women, communicating as equals after the births. That could have a real beneficial effect. Someone to talk to.

allhans
23995
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allhans 07/13/13 - 07:19 am
1
1
Are these stats realistic?

Are these stats realistic? It is difficult to find someone who knows first-hand of a death of this kind.

seenitB4
90642
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seenitB4 07/13/13 - 08:29 am
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Drugs

Sometimes we forget what role that plays....huge.

thauch12
6848
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thauch12 07/13/13 - 02:34 pm
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2
I'm suspicious...

The statistics are highly questionable...99.3/100000 is a 0.093 probability or less than 1 in 1000, a figure which I highly doubt is statistically significant.

All that aside, the heart of this matter seems to be shameless self-promotion from a bunch of underworked midwives, using a health dose of scare tactics to further their agenda.

Little Lamb
46854
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Little Lamb 07/13/13 - 04:13 pm
1
1
Lists

From the story:

. . . analysis published in June that found the East Central Health District in Augusta had the highest maternal mortality rate in Georgia in 2011. . . .

Well, as I have pointed out before, when you make a list someone has to be at the top, someone has to be on the bottom, and someone has to be in the middle. Half of them are above average and half of them are below average. It's just the nature of lists.

corgimom
33940
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corgimom 07/13/13 - 05:43 pm
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As long as Augusta is the

As long as Augusta is the medical center for high-risk pregnancies for a hundred miles north, south, and west, and even some from the east, yes, there will be a high number of deaths.

Factor in a 23% poverty rate, lots of teenage births, and an unhealthy population in the stroke belt, then yes, you will see a lot.

And then people want to close places like Planned Parenthood, which are responsible for finding and identifying many of these at-risk women. Sure, let's have more women die, that'll show a respect for life like no other.

Little Lamb
46854
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Little Lamb 07/13/13 - 08:41 pm
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Extra Statistics

Corgimom got me thinking. Here is the subject of the story:

. . . an Augusta Chronicle analysis published in June that found the East Central Health District in Augusta had the highest maternal mortality rate in Georgia in 2011. . . .

The study went on to define "maternal mortality rate" as the mothers dying during childbirth or within one year of giving birth. If you look at all the women who died during their abortion procedure or within one year of having an abortion, the statistics would be much higher.

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