Death Due to Birth
The events of pregnancy, childbirth, and new motherhood can be filled with joy, stress, love, pain, and other unique, indescribable emotions. Unfortunately for many mothers in the United States, the problematic health care system and hospital culture devastate these already hectic experiences for a woman and her family with the increasing rates of childbirth complications and deaths of the mothers. When this medical violence occurs uniquely to women, especially for black women, those in poverty, or those under the age of consent, it is salient to question how these institutions are able to systematically harm them.
Four million women give birth in the United States every year, and an astonishing quantity of those suffer from potentially fatal complications, especially when compared to other industrialized and wealthy nations. According to the Centers for Disease Control and Prevention, the rate for these complications has doubled between 1993 and 2014, adding up to about 50,000 cases a year. There has been a 60 percent rise in emergency hysterectomies, a surgical operation to remove parts or all of the uterus, which is five times more likely to occur than in Britain or Sweden. Cases where the mother requires a breathing tube has increased by 75 percent, three times more than for British and Swedish mothers. The United States also sadly has the highest rate of maternal mortality among industrialized nations, in which 700 to 900 die each year from pregnancy or childbirth, or from complications that occur afterwards. For each woman that dies, up to 70 more can suffer from hemorrhages, where blood escapes from a ruptured blood vessel, organ failures, and other problems.
While these alarming, high numbers represent women across many ages, ethnicities, and socioeconomic backgrounds, further investigation reveals that black women die due to childbirth three to four times more than white mothers, no matter their economic status. In fact, black mothers with a college education are more likely to suffer complications than white women who never graduated high school. This indicates that while economic hardships can affect maternal health as will be discussed later, systematic racism remains a huge factor in why black women specifically are dying at higher numbers. For example, the hospitals they stay in to give birth may be in historically segregated areas and therefore provide lower-quality healthcare. There is also a higher rate of caesarean section for black women, a procedure that can lead to more complications than vaginal delivery. Finally, black women are also twice as likely to suffer from postpartum depression and less likely to receive adequate mental health treatment.
Inequities in health care coverage and maternity care are a major contributing factor that affects women of low socioeconomic background. For example, women in rural and low-income communities have an increased likelihood in having asthma, hypertension, diabetes, and substance use. Some of these conditions, especially hypertension and diabetes, cause a woman to be three times more likely to experience life-threatening impacts from childbirth. If Medicaid covers their health care, it only pays up to two months after delivery, thus discouraging women from coming in with postpartum symptoms or issues. Similarly, there is an increased pressure for C-sections, because although it’s riskier, the procedure takes less time and is therefore more cost-effective for both hospitals and insurance providers.
State laws also unjustly impact women’s health in regards to teen mothers receiving pain relief during childbirth. In states like Ohio, people under 18 cannot consent to elective procedures to help with their labor, such as asking for an epidural to ease the pain. Since there is no legal emancipation process for teens in Ohio either, the young women are left to suffer unnecessarily without the consent of their parents. In this way, the state takes away the autonomy and agency of a young woman over the care of her own body.
The way hospitals and the U.S. government contribute to these startling health issues among mothers can be expressed by the thoughts of Michel Foucault in his piece on “Docile Bodies”. While criticizing the manipulation of the body by the state, Foucault theorizes that institutions can achieve discipline by enclosing bodies into their own individual spaces, categorizing them by diseases and symptoms to acquire a useful space that is easy to supervise. Foucault’s ideas are evident in hospital culture, where women’s bodies are objects on a schedule rather than autonomous humans with individual needs. Since obstetric emergencies are unusual, many hospitals lack treatment protocols for what to do before complications become life threatening. Studies also show that many nurses don’t inform women enough on postpartum care, which consequently harms them if they don’t know which symptoms to look for once they are released from the hospital. Medical institutions also manipulate bodies for their convenience by providing too much care, such as when doctors try inducing labor with drugs, or perform unnecessary C-sections to speed the delivery of the baby.
Although advocates like the patient safety group Alliance for Innovation on Maternal Health make guidelines for doctors in hopes of improving the well-being of mothers during childbirth, it remains evident that the systemic violence against women in hospitals will continue to put their lives at risk. Until that can be deconstructed and brought down, the lives of thousands of mothers will sadly still be impacted.
