Amnesty International Releases Report on U.S. Maternal Mortality

Amnesty International released a report on maternal mortality in the U.S.: Deadly Delivery: The Maternal Health Care Crisis in the USA. Both the rate and absolute number of maternal deaths in the U.S. more than doubled between 1987 and 2006. Amnesty International called this rate “shocking” and attributed the surge in maternal deaths to our “maternal health care crisis”, which the group called “not just a public health emergency” but a “human rights crisis”. The 12-page summary maps out the problems, but contained within the 150-page report itself are solutions, such as the individualized, family-oriented, minimally interventionist care provided by midwives and at birth centers.

Among the report's 50 recommendations for reducing U.S. maternal mortality is recommendation #43: "The U.S. government should direct the Department of Health and Human Services to initiate inclusive discussions about alternative and potentially more cost-effective models of care for low-risk pregnancies that could help improve the availability, accessibility, acceptability and quality of maternal health care services in the USA. Federal and state governments should revise the current legal restrictions on appropriately trained and qualified midwives. Public and private insurance should include payment for services that women may choose through qualified midwives or birth centers."

Washington Post Article on Breech Deliveries and a Response

On January 5, 2010, the Washington Post Science and Health section ran an article describing the debate among obstetricians (OBs) on how to deliver breech babies. Most obstetricians, backed by a firm stance of the American College of Obstetricians and Gynecologists (ACOG), routinely deliver breech babies by cesarean section. However, the article profiles a few OBs in the U.S. who practice this dying art. The article also notes the adoption by a Canadian group of obstetrics and gynecologists of new guidelines that recommend vaginal delivery of breeches in select cases. Interestingly, the article follows a woman seeking vaginal delivery of her breech baby, who finds what she is looking for with a midwife. This midwife delivered the woman's second breech child vaginally without complications.

Seasons of Life Women's Health and Birth Center supporter Lois Wessel read the article and was moved to respond. Here is her response that was published in the January 12, 2010 Opinion section of the Post.

Doctors Are Losing the Ability to Manipulate Breech Babies before They Are Born
As a former labor and delivery nurse, I was able to attend several breech births at Georgetown University Hospital ["Doctors debate how to deliver breech babies," Jan. 5]. There are more ways breech babies can be turned than were described in the article. The art and skill of external cephalic versions, or ECVs [in which a doctor manipulates the fetus from outside], are being lost, as fewer physicians are doing them, and rising OB-GYNs are not learning how to do them. An ECV can be done in a controlled hospital setting where a mom can then be induced and deliver vaginally, or wait for labor to begin on its own.

As the mother of two breech children, I had one external cephalic version performed by a midwife and an OB-GYN, and went into labor naturally two days later. For my second pregnancy, I diligently practiced Ina May Gaskin's technique of spending time upside down in a swimming pool. (Gaskin is a famous midwife and the author of Spiritual Midwifery.) Being inverted shifts the baby and creates the space it may need to move a hand or a foot to turn around. After a session of about 20 handstands in a pool, my daughter turned on the way home from the pool and I went into labor two days later.