- The Washington Times - Sunday, July 27, 2008

My husband and I recently watched the Oscar-winning 1939 movie, “Goodbye, Mr. Chips.” The movie has a tragic scene in which the shy professor’s new wife dies in childbirth. In one horrible moment, his true love and child are swept away, leaving him alone again, except for his beloved school and students.

Dying in childbirth is a subject that always affects me. Without modern medicine, I and my firstborn would have perished in 1987.

In America today, death in childbirth is “a relatively rare event,” according to the National Center for Health Statistics (NCHS). In fact, our low maternal mortality rate was once hailed as “one of the greatest miracles of the 20th century,” by Janice Shaw Crouse, who studies women’s issues for the Beverly LaHaye Institute at Concerned Women for America.

However, U.S. maternal mortality lately has been trending up, not down. In addition, as the July 11 World Population Day reports made clear, dying in childbirth remains a frightening likelihood for many women in the world.

Maternal mortality refers to dying during pregnancy or within 42 days of childbirth.

In 1915 America — about 15 years after the fictional Mrs. Chipping died in her English bedroom — about 600 mothers died per 100,000 live births.

The U.S. rate plummeted in the late 1930s, after it was discovered that if doctors washed their hands between patients, fatal infections fell among new mothers.

Antibiotics, blood transfusions and other medical advancements helped reduce the U.S. maternal mortality rate to about seven deaths per 100,000 births — not far from the Healthy People 2000 (now 2010) goal of 3.3 deaths per 100,000 births.

In recent years, though, the U.S. maternal mortality rate has crept back up and is now 15.1 deaths per 100,000 births, according to 2005 death figures.

In actual deaths, there were 623 deaths in 2005, 540 deaths in 2004, and 495 in 2003.

The primary reason for the increases are new reporting rules that capture “more indirect deaths,” said Donna L. Hoyert, a health scientist at NCHS. Except for the reporting changes, she said, the maternal death rate is staying about the same, not gaining ground and not losing ground.

In America, the leading causes of pregnancy-related deaths are bleeding, blood clots, high blood pressure, infection, stroke, amniotic fluid in the bloodstream and heart muscle disease.

Having a Caesarean-section delivery raises risks for bleeding and complications; having multiple C-sections raises the risk even more.

Poor prenatal care is a risk factor. So is being obese. So is giving birth later in life — I was shocked to hear that being pregnant at age 35 automatically made me a “high risk” pregnancy.

Several of these risk factors are on the rise, so medical professionals and public health officials will have their hands full trying to talk American women into staying fit and at a normal weight; getting married and bearing children in their 20s and early 30s; getting good prenatal care; and avoiding C-sections, especially “elective” ones.

If Americans begin to take their own lives seriously, value family relationships over material pursuits, and rediscover the logical seasons of life, our nation ought to see death in childbirth go from “relatively rare” to “extremely rare.”

As we fix our own cultural maladies, we might be able to help other nations tackle their own unhealthy practices, such as approving of births to girls in their early teens, approving of annual births to women, approving of unsanitary birthing practices, allowing prenatal and birth care to be poor or nonexistent, allowing husbands and other family members to remain ignorant or oblivious about the details of pregnancy and birth, and allowing malnutrition to spread.

These problems are not intractable. They just take men and women to decide that, as the United Nations Population Fund says, “no woman should die giving life.”

Cheryl Wetzstein’s column “On the Family” appears Tuesdays and Sundays. She can be reached at cwetzstein@ washingtontimes.com.

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