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Letter: American obstetric practices increase maternal death rate

American obstetric practices increase maternal death rate

Recent news stories have passed over the real reason behind the unconscionable rise in deaths among child-bearing women in the United States – American obstetric practices. As a board-certified obstetrician-gynecologist, I see firsthand that pregnant women are subjected to multiple unscientific physician and hospital protocols – inductions prior to 42 completed weeks; continuous electronic fetal monitoring; refusal of food and drink in labor; drugs and procedures to speed up labor; cesarean delivery for “non-reassuring fetal tracings” and labor that “takes too long”; and vaginal birth after cesarean section policies that discourage or deny women the right to a vaginal birth.

All of this, forced on women despite copious scientific evidence that it does not help babies but harms their mothers, has led to an insane cesarean section rate and the increasing maternal death rate and rate of “near misses” (women who don’t die but come close).

The American College of Obstetricians and Gynecologists and its peer review journal, Obstetrics & Gynecology, initially denied the rise, then blamed it on women (who are too old, too fat, too unreasonable) and now blame it on regressive politics, pre-existing conditions such as heart disease and the opioid epidemic.

Great Britain has a maternal mortality rate that is a fraction of ours in the United States. Britain has the same problems with diet, obesity and opioids, but it does not have a 25 percent induction rate or a 40 percent cesarean section rate.

If you travel 20 minutes north of Buffalo into Canada, you will find a population with all of the ills cited as justification of the terrible U.S. maternal mortality rate – obesity, pre-existing conditions such as diabetes and heart disease, drug use and a diverse population – but its maternal mortality rate is substantially lower than ours. Canada’s induction and cesarean section rate is also far less than ours.

No amount of hand-wringing by the ACOG changes this reality. Until the real culprits are identified and obstetric practice changed to benefit women and babies rather than physicians and hospitals, the maternal mortality rate will continue to climb.

Katharine Morrison, M.D., FACOG


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