Is Motherhood Safe?

Several years ago, I took a couple of my women/mama friends down to the Shenandoah Mountains area of Virginia, to have the opportunity to hear legendary activist and spiritual midwife, Ina May Gaskin speak. (Check out http://www.inamay.com/ and http://www.thefarm.org/midwives/index.html.)

I brought these particular women with me because all were pregnant and planning to give birth and all were hoping for a vaginal birth after only previously given birth by c-section. Ina May was just the person for them to meet for her inspirational wisdom and Knowing about birth.

When Ina May's time came to speak, we were seated in a small classroom at Shenandoah University. In this small, intimate setting we felt as if we were in her living room.

Ina May's talk was uplifting, enlightening and healing. Her impeccable research linearly pointed out what we all really Know deep within us; that normal, un-interfered-with birth is safest. That what makes birth risky, is the unnecessary use of interventions, for profit and/for convenience. Ina May is the perfect balance, to me, of book knowledge, deep intelligence, and eternal, intuitive wisdom and voice.

In the second part of her talk, Ina May brought to our attention the emerging yet still underground issue of maternal mortality. Basically, that means a woman who has died sometime before, during or a period after childbirth. Do you ever hear anyone talking about this in our country? I never did. I always thought that BIRTH was safe here in the US, and that women died "back in the old days" or in other countries were there might be inadequate health care.

Well, Mama May brought to our attention that US women do die in childbirth and that African American women die at a rate of 4x that of white woman, and Latina women die at the rate of 2x that of white women. It's completely tragic when any women dies during this period, equally unbelievable that there is a huge racial disparity. and of course the question is "why?"

It seems that the UK gives it citizens carefully detailed reports on incidences of maternal mortality numbers and reasons. This is an accountability measure that helps to determine what steps must be taken in order to improve maternal mortality rates. The definition of a maternal death related to childbearing includes deaths that have occurred up to a year after childbirth, as some childbirth related morbidity can exist and cause problems for the rest of a women's life. In contrast the US does not require that hospital or doctors gather statistics on maternal mortality, and regard a maternal death as something that only occurs up to six weeks after pregnancy.

To that end, Ina May decided to create a quilt to commemorate any women that she hears about that has suffered from maternal mortality, (http://www.rememberthemothers.net/) to bring awareness to this alarming trend, and so that their lives would not be forgotten. Each square of the quilt is embroidered with the name of the mother who has perished, her birth and death date.

She brought the quilt to show us and talked about the stories of some of the women, the complications that came up that caused each one of them their lives. Many of these deaths, if not all were related to complications occurring during interventions and interferences in the normal birth process, many of which birth advocates feel are extremely risky. It's no wonder we never hear of these stories, birth is a big business in this country, and the more interventions a doctor uses, the more the hospital profits. Although sometimes interventions are necessary, many times interventions are used unnecessarily.

Fast forward to about a year later. I receive a call from my Aunt Elaine, and as I hear her voice, I am so surprised and happy that I am gushing all over the phone. She calms me down in her sweet tone and lets me know that my Aunt Anne, whom I even more rarely speak too, is also on the line. Happy but a bit confused, I ask them "Why am I so blessed today to receive this call from both of you today?"

My sweet Aunties laugh nervously, and then my Auntie Elaine goes on to explain that Aunt Anne's youngest daughter and my childhood friend or "cousin", Leslie is dead. I'm in shock of course, Leslie was a wonderful women, young, recently married and had just given birth to a beautiful little girl.

Leslie went to have her baby expecting a normal vaginal delivery. She ended up with a c-section. Days after returning home, she began having trouble breathing. Repeated calls to the doctor resulted in an over the phone diagnosis of the flu. More days pass and Leslie finally goes back to the hospital as her condition has worsened. Shortly after being admitted, she dies. Doctors are puzzled at first, but later come up with a diagnosis of Peripartum Cardiomyopathy, (http://www.nlm.nih.gov/medlineplus/ency/article/000188.htm for more info) an uncommon and poorly researched complication of the postpartum period. My cousin had just become a statistic.

Her husband, her mom and her sister take over the care of Leslie's precious newborn even as they go through their own deep grieving process. It was oh so bittersweet to hear that Leslie was a breastfeeding mom. I thought of her baby girl, her family. I lived on, stunned with it all.

Spirit led me to contact Ina May. With the permission of Leslie's family, I related Leslie's story to Ina May, who let me know that she would give her information to one of her quilting volunteers (read: angel) who would make a square commemorating Leslie's life.

Fast forward to October 2005. I now live in LA, and I attend a CAPPA conference with Ina May as one of the keynote speakers. I greet her after her excellent talk. As usual, the "Safe Motherhood Quilt" is with her, a visual disclosure of the women who've died and whose names, lives and deaths have existed, until the quilt, in secret. She knows who I am, and walks me over to where the quilt is laid, and points out a square. It's purple-ish blue, black and gold, an African print (perfect!) with Leslie's name, birth and death dates, embroidered over an , tear-drop design. It's beautiful. I know Leslie must have helped the artist pick out the fabric and colors because it truly looks like her. Again, I am grateful...

Maternal morbidity and mortality are not pretty or fun subjects. Neither is infant mortality. They are heartbreaking, devastating and tragic facts of life. We cannot, however, stick our heads in the sand and think that we are safe from these things because we live in the US, or anywhere else. What angers me the most, is how corporate interests, health care as for-profit business, lack of access to quality health care, lack of access to safe birth practices, lack of accountability and the suppression of the women's' voice in life in general promote infant and maternal mortality.

Ina May has written an article in the March/April issue of Mothering Magazine on maternal mortality. I urge you to check it out. For more info on where to get Mothering go to http://www.mothering.com/. To see Leslie Ann Spencer's quilt square, go to http://www.inamay.com/, click on to The Safe Motherhood Quilt Project". After you enter that site, go to "Virtual Quilt" and look for Leslie's name.

For those of you who in serve in the birth field, or for those of you planning on having a baby, or know someone who is, check out http://www.motherfriendly.org/ for information on how to know if your doctor, midwife, center or hospital facility practices in way that promotes optimal outcomes for mother and baby. Also, Amnesty International is studying maternal mortality in this country. If you know of someone who died after giving birth or experienced a near-miss, please contact Rosa Cho at rcho@aiusa.org, or by phone at 212-633-4161.