May, 2010 browsing by month


Why is the Maternal Mortality Rate in the U.S. So High?

Thursday, May 27th, 2010

In the richest nation on earth, with an advanced health care system, and the technology available to monitor and treat mothers and their babies, you’d expect the United States to have among the lowest rates of maternal mortality. So it’s distressing to learn that, although it’s still relatively rare for mothers to die as a result of pregnancy and childbirth, it happens here more often than it should. The U.S. is ranked 41st in maternal deaths among 171 nations analyzed by U.N. experts. That’s a worse record than virtually any other developed country — even worse than a good number of under-developed countries. What’s even more distressing: the death rate is rising.

The question is why? Why is pregnancy so risky in such a rich nation?

Often, the reason is a pre-existing disorder that complicates pregnancy, such as obesity, high blood pressure, or diabetes. The lack of access to good quality care among the uninsured also puts women at risk, leaving them without diagnosis and treatment for conditions that can cause problems until the condition gives rise to a full-blown emergency.

But there’s one contributor to maternal death that might surprise you. Our wealth, itself, could be contributing to the risk, because it encourages the prevalence of Cesarean-on-demand.

According to the CDC, in 2007, 31.8 percent of births were by Cesarean section. The rates of births by C-section have risen every year for at least eleven years.

While C-sections can be, and often are, life-saving, it’s difficult to justify that high a rate. The World Health Organization estimates that the U.S. rate is twice what would be medically necessary.

Cesarean births are now treated as routine, but major surgery is never routine. Major surgery comes with the risk of complications, including hemorrhage. And the C-section, as common as it has become, is still major surgery.

Childbirth is usually very safe, but it could be safer. Giving all women access to pre-natal care and preventive medicine is an important start. But it’s also important to remember that a woman’s body was designed to deliver babies the old-fashioned way. And choosing unnecessary surgery instead could be inviting trouble.

– Yvonne S. Thornton, MD, MPH

When New Moms – or New Dads – Get the Pregnancy Blues

Friday, May 21st, 2010

Most women are familiar with the term post-partum depression.  Start with all the stresses of adding a new member to the family – not just the financial burden, but the schedule upheaval, the sleep deprivation, and the demands of a tiny person who can only make his or her needs known by wailing. Add the wild surge of hormones flooding a woman’s body, and is it any wonder that she might not be the picture of serenity and assurance? Estimates vary on the prevalence but as many as 25 percent of new moms may experience some level of depression either before or after delivery.

That’s bad enough, but now a study suggests that new fathers, just like new mothers, can find themselves overwhelmed when baby makes three (or more).

“The study, published in the Journal of the American Medical Assn., found that 10.4% of men experienced serious depression at some point between his partner’s first trimester and one year after childbirth, more than double the depression rate for men in general. American men were more likely to experience prenatal or postpartum depression compared with men in other countries, 14.1% in the U.S. compared with 8.2% internationally.”

What can you do when the guy you depend upon to keep you sane is going through his own blue period?

Your most important step –the one you should take if either you or your partner starts to feel sadness, agitation or hopelessness – is to talk to your doctor. Don’t try to tough it out. Reach out for help at the first signs that something isn’t quite right. It’s possible that all you need to get back to your cheery old selves is a good night’s sleep, but sometimes, you need more. The good news is that help is available. But first, you have to be aware of the signs of depression.

Post-partum depression can be debilitating if you let it go, so take steps immediately to get yourself and your new family back into the swing of enjoying things together again.

– Yvonne S. Thornton, MD, MPH

The Ditchdigger’s Daughters film is back

Sunday, May 9th, 2010

In 1997, a movie version of my memoir, The Ditchdigger’s Daughters, aired on The Family Channel. And while the film covers only a fraction of the book, it was still a thrill to see the actors playing the roles of my family members and me.

The film was never released commercially on DVD and seemed all but forgotten. Imagine my surprise when I discovered that BET network was broadcasting my story – and lots of people on Facebook are talking about it. I caught the film version last weekend as a movie premiere on BET, which makes me think that it might be broadcast again, so you should check the schedules.

Of course, Hollywood likes to focus on the conflict, so the movie was more about the struggles between my father and my older sister, Jeanette and less about what made the book a bestseller: how my father and mother overcame incredible obstacles to build a better life for their daughters.

It’s fun to watch but if you really want the whole story, I hope you’ll read the book.

And if you want to know what happens after that book ends, please keep an eye out for my next memoir, Something to Prove, scheduled to be published in December.

– Yvonne S. Thornton, MD, MPH