The U.S. is a pretty great place to live. Freedom, bounty, all that. We Americans tend to think we’re the TOP country: the strongest, the richest, the homest of the freeest and the bravest; just the best in general. It’s true that we rank at the top of the list when it comes to stuff like military spending, average number of cars per person, number of hours of daily TV watching, and other important indicators of clear superiority.
We’re also #1 in the Western world in maternal mortality. In other words, of all the wealthy countries in the world we are the WORST when it comes to taking care of pregnant women. And it’s not just wealthy countries that are better than us at keeping moms alive: If you are a pregnant woman, you are more likely to die if you live in the U.S. than if you live in Lithuania. Or Bahrain. Or Bulgaria. The U.S. number of maternal deaths per 100,000 women is the same as in Iran and Hungary. If you are a pregnant woman, you are twice as likely to die if you live in the U.S. than if you live in Macedonia or Cyprus. Three times more likely than if you’re from Qatar or Israel. Seven times more likely than if you’re in Greece or Singapore. If you are pregnant, you have a better chance of surviving your pregnancy if you are in one of 48 other countries in the world. Ok, I’ll stop, you get the point.
What are you, the pregnant lady, supposed to do about it? Just this: demand better care. There is NO reason a country in which people have more access to calories and movies than any other country can’t also have access to high-quality healthcare. There is no reason for American women to be dying from childbirth at rates only marginally better than those in Saudi Arabia and Uzbekistan.
(I know, I know, I said I’d stop with the comparisons… it’s just so counterintuitive – in so many ways we are one of the most medically advanced countries…)
Back to what you can actually do about it: question, question, question. Question everything your OB-GYN tells you you need to do. Even if she sounds very confident about it. And if she doesn’t appreciate the questions, if she gets offended when she sees you really want to understand your medical treatment and know about all your options, tell her the U.S. has a really high maternal mortality rate, that you strongly believe in taking an active role in your own health and medical care, and that you’d prefer not to die, thank you very much, so could you please answer the question or get back to me when you have an answer. Ask for data. Ask for the research. Ask for proof. Ask for alternatives. Ask what the risks are. Ask what would happen if you chose another course of action.
Then: don’t take their word for it. Do your own research. Many doctors will not like this, not one bit. And I get it. They’re the ones who went to med school, studied, see patients every day, blah blah blah.
Well, that’s the same medical training and practices that are putting us at the glorious ranking of 49th in the world in maternal mortality. So honestly I don’t think they have a very strong argument when they cite their credentials and experience. Nothing but real, hard facts, studies, and research should convince you to accept medical advice.
I visited an OB-GYN exactly once during my pregnancy. I asked her what the C-section rate was in her practice – in other words, what’s the percentage of women under her care who end up delivering by Caesarian rather than vaginally. She tried to maintain a pleasant expression as she answered: “Oh, that’s a case-by-case basis.” And then quickly changed the topic. HUH? I ask for a RATE, an AVERAGE, and she tells me it’s case by case? She either didn’t know how often her practice resulted in women giving birth by C-section, or she didn’t want me to know (I found out on my own that it was near 50%, waaaay higher than the 10% recommended by the WHO). Either way, pretty pathetic, and very unprofessional. I didn’t go back after that first appointment. I was lucky enough to find a midwife-run birth center that had a patient-centered philosophy (and whose C-section rate was much closer to the WHO’s recommendation).
Just remember: the doctor works for you. You hire, and you can fire. They perform a service. If you don’t like the way they treat you, you owe it to yourself to find another person to perform the service. A lot of us feel a little shy around our doctors; a little in awe of their status. We don’t want to displease them or appear rude. But we need to learn to be assertive and to reclaim our place right at the top of the list of people who make decisions about our bodies and our health. People are probably pickier with choosing who cleans their toilets than with who gets to stick things in their hooo-ha and helps them bring their child into the world.
So just remember: this is not paranoia, it’s not rejecting science and modern medicine, and it’s not saying all doctors and nurses are evil people (most of them are doing what they have been told is the right thing – even if that means totally violating their patients’ rights…). It’s looking at the facts and acting on them. It’s realizing that things are not as they should be, that the system we take for granted as good and functioning has serious issues that result in real women and babies dying needlessly; it’s refusing to go along with the crowd,
it’s taking a small step to change the status quo. It’s deciding that your health and your baby’s health are worth stepping outside of your comfort zone, worth making waves and ruffling some feathers. You and your baby deserve the highest-quality, most supportive, and safest health care system in the world.