Response to Every Mother Counts “The Walk”

Here is a video we saw during the 2013 ING NYC Marathon. It makes me sad that a group, so dedicated to educating and training midwifes in impoverished areas of the world, portrays childbirth in an American hospital in such an ideal way.

The message of the video is definitely harrowing, and the ad certainly gets the non-profit’s voice heard. But being a group that seeks to save women’s and babies’ lives, surely it would have been beneficial to portray a safer, cheaper, and more attainable level of maternity care than a fluorescent-lit hospital bed. Yet Every Mother Counts chose to romanticize the Western birth by demonizing the walking African woman and her (presumably) more natural birth.

The problem? Both stink!

The needs of a birthing woman in Africa and the needs of a birthing woman in Manhattan are truly not that different. Both need an educated, practiced, wise, patient, kind, gentle, and loving midwife/doctor to support the mother throughout the both the emotional and physical process of childbirth. For that 1% of (actual) complications, one needs access to an experienced obstetric.

There is no such sharp contrast between “good” and “bad” care, “rich” or “poor” care in a healthy delivery in either part of the world.

While the overall MMR of the US is nowhere near the miserable rates of Chad, Somalia, or the Central African Republic, it is the highest out of all industrialized countries (21 deaths per every 100,000 live births), and the second-worst for infant mortality (6 deaths per 1,000 live births), comparable to Uruguay, Slovak Republic, and Qatar. (Luxembourg, Iceland, and Norway lead with the lowest IMR.) (Source: World Bank) So although the cost of a pregnancy in the US is the highest in the world, it is a tragic national embarrassment, not something to be glorified or contrasted with an unimaginable difficulty in getting care in a developing country.

Despite this, Every Mother Counts has a noble cause and deserves credit for outlining the reasons behind poor MMR rates in poorer countries and taking actions to train midwives. As outlined on their site, transportation, lack of qualified workers, lack of equipment, and lack of funds all contribute to the extremely tragic maternal and infant deaths in those regions.

Obviously, no laboring mother should have to walk over a day to get to a sub-par health worker, but neither should a woman in American be subjected to (oftentimes unnecessary) interventions such as C-sections, episiotomies, hourly exams, nurse disputes, and overuse of antibiotics and epidurals. So as African women have little access to any care, American women have too much care.

The solution is not exporting the AMA, thousands of American OB/GYNs, and hundreds of American hospitals to Africa. It is recognizing that quality maternal care demands well-trained midwives and doctors who are able to work both with their hands and technology to ensure the healthiest outcome. It means recognizing that every person who deals with birth need a capacity to provide love and patience, and trust a woman to successfully deliver her child whether in her home or hospital. But personally, I think hospital beds are for sick people.

And birth is not a disease.

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