This week, activists around the country are meeting with their congressional offices to urge their elected officials to take action to reduce the unacceptable levels of women dying during childbirth here in the United States. These meetings will be even more effective if every member of Congress hears from his or her constituents by phone. Please call your Representative and both of New Jersey’s Senators and tell them
• Amnesty International urges Representatives and Senators to contact the Department of Health and Human Services to raise concerns exposed in Amnesty International‘s new report. The Department should take steps to stop women from dying from preventable pregnancy-related complications, including addressing issues of discrimination, systemic failures, and accountability.
• Amnesty International urges Representatives and Senators to support an increase in funding for the Federally Qualified Health Center program.
• Amnesty International urges Representatives and Senators to contact the health departments of their own states to improve maternal health data collection.
You can find out the name and contact information for your Representative by entering your zip code at www.house.gov.
You can call Senator Lautenberg’s office at (202) 224-3224. The number for Senator Menendez’s office is (202) 224-4744.
Larry Ladutke
NJ Legislative Coordinator, AIUSA
Monday, March 29, 2010
Friday, March 12, 2010
Time article on Amnesty's Deadly Delivery report on maternal morality in the US
You can do something about this by joining a delegation to lobby Congress and by taking part in the on-line action below!
www.amnestyusa.org\deadlydelivery
Too Many Women Dying in U.S. While Having Babies
By Jennifer Block Friday, Mar. 12, 2010
Daniel Allan / Photodisc / Getty Images
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Amnesty International may be best known to American audiences for bringing to light horror stories overseas such as the disappearance of political activists in Argentina or the abysmal conditions inside South African prisons under apartheid. But in a new report on pregnancy and childbirth care in the U.S., Amnesty details the maternal health care crisis in this country as part of a systemic violation of women's rights.
The report, titled "Deadly Delivery," notes that the likelihood of a woman dying in childbirth in the U.S. is five times greater than in Greece, four times greater than in Germany, and three times greater than in Spain. Every day in the U.S., more than two women die of pregnancy-related causes, with the maternal mortality ratio doubling from 6.6 deaths per 100,000 births in 1987 to 13.3 deaths per 100,000 births in 2006. (And as shocking as these figures are, Amnesty notes that the actual number of maternal deaths in the U.S. may be a lot higher since there are no federal requirements to report these outcomes and since data collection at the state and local levels needs to be improved.) "In the U.S., we spend more than any country on health care, yet American women are at greater risk of dying from pregnancy-related causes than in 40 other countries," says Nan Strauss, the report's co-author, who spent two years investigating the issue of maternal mortality worldwide. "We thought that was scandalous."
(See the most common hospital mishaps.)
According to Amnesty, which gathered data from many sources including the CDC, approximately half of the pregnancy-related deaths in the U.S. are preventable, the result of systemic failures including barriers to accessing care; inadequate, neglectful, or discriminatory care; and overuse of risky interventions like inducing labor and delivering via cesarean section. "Women are not dying from complex, mysterious causes that we don't know how to treat," says Strauss. "Women are dying because it's a fragmented system, and they are not getting the comprehensive services that they need."
The report notes that black women in the U.S. are nearly four times more likely to die from pregnancy-related causes than white women, although they are no more likely to suffer certain complications like hemorrhage.
(See the top 10 medical breakthroughs of 2009.)
The Amnesty report comes on the heels of an investigation in California that found maternal deaths have tripled there in recent years as well as a maternal-mortality alert issued in January by the Joint Commission, a group that accredits hospitals and other medical organizations, which noted that common preventable errors included failure to control blood pressure in hypertensive women and failure to pay attention to vital signs following c-sections. And just this week, a panel of medical experts at a conference held by the National Institutes of Health recommended that physicians' organizations revisit policies that prevent women from having vaginal births after having had a cesarean. Such policies, designed in part to protect against litigation, have contributed to the U.S. cesarean rate rising to nearly 32% in 2007, the most recent year for which data is available.
The Amnesty report spotlights numerous barriers women face in accessing care, even among those who are insured or qualify for Medicaid. Poverty is a major factor, but all women are put at risk by overuse of obstetrical intervention and barriers in access to more woman-centered, physiologic care provided by family-practice physicians and midwives.
Amnesty is calling on Obama to create an Office of Maternal Health within the Department of Health and Human Services to improve outcomes and reduce disparities, among other recommendations. The report also calls on the government to address the shortage of maternal-care providers.
"Access is only one factor," cautions Maureen Corry, executive director of Childbirth Connection, a research and advocacy organziation that recently convened more than 100 stakeholders, including the American College of Obstetricians and Gynecologists and the NIH, in a large symposium on transforming maternity care. "We need to make sure that we reduce the overuse of interventions that are not always necessary, like C-sections, and increase access to the care that we know is good for mothers and babies, like labor support."
Read more: http://www.time.com/time/health/article/0,8599,1971633,00.html?xid=rss-topstories#ixzz0hyL7H9Nw
www.amnestyusa.org\deadlydelivery
Too Many Women Dying in U.S. While Having Babies
By Jennifer Block Friday, Mar. 12, 2010
Daniel Allan / Photodisc / Getty Images
Print Email Digg Facebook Yahoo Buzz Twitter MORE
Add to my:
del.icio.us Technorati reddit Google Bookmarks Mixx StumbleUpon Blog this on:
TypePad LiveJournal Blogger MySpace
49
Share
Amnesty International may be best known to American audiences for bringing to light horror stories overseas such as the disappearance of political activists in Argentina or the abysmal conditions inside South African prisons under apartheid. But in a new report on pregnancy and childbirth care in the U.S., Amnesty details the maternal health care crisis in this country as part of a systemic violation of women's rights.
The report, titled "Deadly Delivery," notes that the likelihood of a woman dying in childbirth in the U.S. is five times greater than in Greece, four times greater than in Germany, and three times greater than in Spain. Every day in the U.S., more than two women die of pregnancy-related causes, with the maternal mortality ratio doubling from 6.6 deaths per 100,000 births in 1987 to 13.3 deaths per 100,000 births in 2006. (And as shocking as these figures are, Amnesty notes that the actual number of maternal deaths in the U.S. may be a lot higher since there are no federal requirements to report these outcomes and since data collection at the state and local levels needs to be improved.) "In the U.S., we spend more than any country on health care, yet American women are at greater risk of dying from pregnancy-related causes than in 40 other countries," says Nan Strauss, the report's co-author, who spent two years investigating the issue of maternal mortality worldwide. "We thought that was scandalous."
(See the most common hospital mishaps.)
According to Amnesty, which gathered data from many sources including the CDC, approximately half of the pregnancy-related deaths in the U.S. are preventable, the result of systemic failures including barriers to accessing care; inadequate, neglectful, or discriminatory care; and overuse of risky interventions like inducing labor and delivering via cesarean section. "Women are not dying from complex, mysterious causes that we don't know how to treat," says Strauss. "Women are dying because it's a fragmented system, and they are not getting the comprehensive services that they need."
The report notes that black women in the U.S. are nearly four times more likely to die from pregnancy-related causes than white women, although they are no more likely to suffer certain complications like hemorrhage.
(See the top 10 medical breakthroughs of 2009.)
The Amnesty report comes on the heels of an investigation in California that found maternal deaths have tripled there in recent years as well as a maternal-mortality alert issued in January by the Joint Commission, a group that accredits hospitals and other medical organizations, which noted that common preventable errors included failure to control blood pressure in hypertensive women and failure to pay attention to vital signs following c-sections. And just this week, a panel of medical experts at a conference held by the National Institutes of Health recommended that physicians' organizations revisit policies that prevent women from having vaginal births after having had a cesarean. Such policies, designed in part to protect against litigation, have contributed to the U.S. cesarean rate rising to nearly 32% in 2007, the most recent year for which data is available.
The Amnesty report spotlights numerous barriers women face in accessing care, even among those who are insured or qualify for Medicaid. Poverty is a major factor, but all women are put at risk by overuse of obstetrical intervention and barriers in access to more woman-centered, physiologic care provided by family-practice physicians and midwives.
Amnesty is calling on Obama to create an Office of Maternal Health within the Department of Health and Human Services to improve outcomes and reduce disparities, among other recommendations. The report also calls on the government to address the shortage of maternal-care providers.
"Access is only one factor," cautions Maureen Corry, executive director of Childbirth Connection, a research and advocacy organziation that recently convened more than 100 stakeholders, including the American College of Obstetricians and Gynecologists and the NIH, in a large symposium on transforming maternity care. "We need to make sure that we reduce the overuse of interventions that are not always necessary, like C-sections, and increase access to the care that we know is good for mothers and babies, like labor support."
Read more: http://www.time.com/time/health/article/0,8599,1971633,00.html?xid=rss-topstories#ixzz0hyL7H9Nw
Tuesday, March 09, 2010
Hoped-for drop in childbirth deaths not happening
As you may know, Amnesty's report on maternal mortality in the US is going to be released on March 23rd. We will have a week of lobbying around this issue starting March 29th!
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AP – This Oct. 2007 family photo provided by Clare Johnson shows Linda Coale holding her son Benjamin in Crownsville, … .By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer – Tue Mar 9, 3:04 am ET
WASHINGTON – Eleven days after her son Benjamin's birth by C-section, Linda Coale awoke in the middle of the night in pain, one leg badly swollen. Just as her doctor returned her phone call asking what to do, she dropped dead from a blood clot.
Pregnancy-related deaths like Coale's appear to have risen nationwide over the past decade, nearly tripling in the state with the most careful count — California. And while they're very rare — about 550 a year out of 4 million births nationally — they're nowhere near as rare as they should be. The maternal mortality rate is four times higher than a goal the federal government set for this year.
"It's unacceptable," says Dr. Mark Chassin of The Joint Commission, the agency that accredits U.S. hospitals and which recently issued an alert to hospitals to take steps to protect mothers-to-be. "Maybe as many as half of these are preventable."
Two years after Coale's death near Annapolis, Md., her sister says topping that list should be warning women about signs of an emergency, like the clot called deep vein thrombosis, or DVT, that can kill if it breaks out of the leg and moves to the lung.
"All she wanted to do was have her own family, and when she finally gets that privilege, she's no longer with us," says Clare Johnson, who says her sister's only risk was being pregnant at age 35.
Maternal mortality gets little public attention in the U.S., aside from last year's worry over the swine flu that killed at least 28 pregnant women. Among the leading preventable causes are hemorrhage, DVT-caused pulmonary emboli and uncontrolled blood pressure.
It's not clear what's fueling the overall increase, although better counting is playing some role. But there are some suspects: A jump in cesarean deliveries that now account for almost a third of births. One in five pregnant women is obese, spurring high blood pressure and diabetes. More women are having babies in their late 30s and beyond.
"It can be a death here, a death there," says Dr. Elliott Main of the California Maternal Quality Care Collaborative, whose research is helping to uncover the rise. "Any one doctor or any one hospital hasn't really seen this change."
When he shows the statistics at medical meetings, "everybody sits up."
More startling, black women are at least three times more likely to die from pregnancy complications than white women, and research is too limited to tell why.
Then there are the near-misses. For every death, 50 additional women suffer serious complications of pregnancy or delivery, notes Dr. Jeffrey King of the University of Louisville, a spokesman for the American College of Obstetricians and Gynecologists.
At issue are deaths directly related to pregnancy or childbirth, up to 42 days after delivery. In 2006, the latest year for which data were available, there were 13.3 maternal deaths for every 100,000 births. A decade ago, the rate hovered around 7 — and by this year, the U.S. government had hoped to lower it to 3.3 deaths. California in 2006 charted 16.9 maternal deaths for every 100,000 births, up from a rate of 5.6 in 1996.
How pregnancy-related deaths are coded and counted changed during that time period, but Main says only about 30 percent of the increase may be due to that.
At the request of California health officials, Main is finishing an in-depth study of maternal deaths that already has prompted a project to reduce hemorrhage in 30 of the state's hospitals.
"Jumping on it early is very important," says Main, who worries that hospitals can lose track of bleeding that happens a bit at a time until "before you know it, you've bled a lot."
Among other safety steps:
_Seek early prenatal care to control underlying disorders and check for DVT risk. Pregnancy makes everyone's blood clot more easily. At extra risk are women who've already had a clot or whose relatives have, who are obese or who have varicose veins, says Dr. Geno Merli of Thomas Jefferson University Hospital. They may need blood-thinning medication.
C-sections, like any major surgery, also add to the risk.
Andrea Darling of Skillman, N.J., suffered a DVT in her first trimester in 2002 and endured months of treatment and anxiety before her son was born healthy. Darling already was being treated for a genetic clotting disorder but says patient education helped her take extra steps to avoid a C-section.
_Hospitals should consider using compression boots on C-section patients, says King. They help keep blood from settling in the lower legs.
_C-sections can be lifesaving but women should understand how to reduce their chances of needing one — because next pregnancies tend to end in C-section, too, and repeat C-sections increase hemorrhage risk. Coming to the hospital before you're properly dilated or seeking induction before the cervix is ready unnecessarily increases the C-section risk, Main says.
There often aren't clear explanations for these deaths, and Maryland's Clare Johnson tries not to wonder if anything could have saved her sister, because that's impossible to know.
Still, she urges better education about DVT as the family watches her nephew Benjamin, now 2, grow.
"He is truly our blessing in all this," Johnson says. "He's truly what gets us through."
___
EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
---------
AP – This Oct. 2007 family photo provided by Clare Johnson shows Linda Coale holding her son Benjamin in Crownsville, … .By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer – Tue Mar 9, 3:04 am ET
WASHINGTON – Eleven days after her son Benjamin's birth by C-section, Linda Coale awoke in the middle of the night in pain, one leg badly swollen. Just as her doctor returned her phone call asking what to do, she dropped dead from a blood clot.
Pregnancy-related deaths like Coale's appear to have risen nationwide over the past decade, nearly tripling in the state with the most careful count — California. And while they're very rare — about 550 a year out of 4 million births nationally — they're nowhere near as rare as they should be. The maternal mortality rate is four times higher than a goal the federal government set for this year.
"It's unacceptable," says Dr. Mark Chassin of The Joint Commission, the agency that accredits U.S. hospitals and which recently issued an alert to hospitals to take steps to protect mothers-to-be. "Maybe as many as half of these are preventable."
Two years after Coale's death near Annapolis, Md., her sister says topping that list should be warning women about signs of an emergency, like the clot called deep vein thrombosis, or DVT, that can kill if it breaks out of the leg and moves to the lung.
"All she wanted to do was have her own family, and when she finally gets that privilege, she's no longer with us," says Clare Johnson, who says her sister's only risk was being pregnant at age 35.
Maternal mortality gets little public attention in the U.S., aside from last year's worry over the swine flu that killed at least 28 pregnant women. Among the leading preventable causes are hemorrhage, DVT-caused pulmonary emboli and uncontrolled blood pressure.
It's not clear what's fueling the overall increase, although better counting is playing some role. But there are some suspects: A jump in cesarean deliveries that now account for almost a third of births. One in five pregnant women is obese, spurring high blood pressure and diabetes. More women are having babies in their late 30s and beyond.
"It can be a death here, a death there," says Dr. Elliott Main of the California Maternal Quality Care Collaborative, whose research is helping to uncover the rise. "Any one doctor or any one hospital hasn't really seen this change."
When he shows the statistics at medical meetings, "everybody sits up."
More startling, black women are at least three times more likely to die from pregnancy complications than white women, and research is too limited to tell why.
Then there are the near-misses. For every death, 50 additional women suffer serious complications of pregnancy or delivery, notes Dr. Jeffrey King of the University of Louisville, a spokesman for the American College of Obstetricians and Gynecologists.
At issue are deaths directly related to pregnancy or childbirth, up to 42 days after delivery. In 2006, the latest year for which data were available, there were 13.3 maternal deaths for every 100,000 births. A decade ago, the rate hovered around 7 — and by this year, the U.S. government had hoped to lower it to 3.3 deaths. California in 2006 charted 16.9 maternal deaths for every 100,000 births, up from a rate of 5.6 in 1996.
How pregnancy-related deaths are coded and counted changed during that time period, but Main says only about 30 percent of the increase may be due to that.
At the request of California health officials, Main is finishing an in-depth study of maternal deaths that already has prompted a project to reduce hemorrhage in 30 of the state's hospitals.
"Jumping on it early is very important," says Main, who worries that hospitals can lose track of bleeding that happens a bit at a time until "before you know it, you've bled a lot."
Among other safety steps:
_Seek early prenatal care to control underlying disorders and check for DVT risk. Pregnancy makes everyone's blood clot more easily. At extra risk are women who've already had a clot or whose relatives have, who are obese or who have varicose veins, says Dr. Geno Merli of Thomas Jefferson University Hospital. They may need blood-thinning medication.
C-sections, like any major surgery, also add to the risk.
Andrea Darling of Skillman, N.J., suffered a DVT in her first trimester in 2002 and endured months of treatment and anxiety before her son was born healthy. Darling already was being treated for a genetic clotting disorder but says patient education helped her take extra steps to avoid a C-section.
_Hospitals should consider using compression boots on C-section patients, says King. They help keep blood from settling in the lower legs.
_C-sections can be lifesaving but women should understand how to reduce their chances of needing one — because next pregnancies tend to end in C-section, too, and repeat C-sections increase hemorrhage risk. Coming to the hospital before you're properly dilated or seeking induction before the cervix is ready unnecessarily increases the C-section risk, Main says.
There often aren't clear explanations for these deaths, and Maryland's Clare Johnson tries not to wonder if anything could have saved her sister, because that's impossible to know.
Still, she urges better education about DVT as the family watches her nephew Benjamin, now 2, grow.
"He is truly our blessing in all this," Johnson says. "He's truly what gets us through."
___
EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
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