Moms in India are dying in preventable ways. How are they being saved?
Most deaths resulting from pregnancy-related complications can be prevented. Here's how Merck's doing its part.
For three months, Pennsylvania-based Scott Wright left his regular day job as a global communications expert to work in direct collaboration with Jhpiego, an international nonprofit health organization in India.
"How often do you get to say that you were part of a global initiative to reduce maternal mortality and save ... lives?" he tells us, beaming.
What's the state of maternal health in India?
It's getting better. The number of lives lost to pregnancy-related complications has been reduced by 65% since 1990.
That's great news, right? Impressive results, all around. In less than 25 years, the number of women in India who died from complications due to pregnancy and childbirth has dropped significantly, from 152,000 to 45,000.
A selfie with over 20 nurses during a field visit and interview at a mission hospital, with all enrolled in MNH quality-of-care training. They deliver over 700 babies a month.
Unfortunately, though, that means tens of thousands of women in India still die each year from complications with pregnancy and childbirth.
"Two leading causes [of maternal mortality] are preeclampsia [high blood pressure] and postpartum hemorrhaging [bleeding]," Scott says. "In many cases, the deaths that occur from these conditions are entirely preventable."
There's still a lot more work to be done, and while assistance initiatives like the Janani Suraksha Yojana and Rashtriya Swasthya Bima Yojna have increased access to quality care, there is now a need to reap the benefits by focusing on ensuring that access.
So, how do you begin to address the still-staggering number of deaths?
That's what organizations like Merck (known as MSD outside of the U.S. and Canada) — through its Merck for Mothers initiative — are committed to figuring out.
Merck for Mothers is a 10-year, $500-million commitment to improve maternal health around the world.
Launched in 2011, Merck for Mothers works with more than 75 partners on more than 50 programs to increase access to, and the quality of, maternal health care for women in more than 30 countries, including India, Senegal, Uganda, Zambia, and the United States.
Ambitious? Absolutely.
"You can make a difference, but having a difference that lasts? That's what matters."
Scott was part of the Merck Fellowship for Global Health program (known as the MSD Fellowship for Global Health outside of the U.S. and Canada), where employees have opportunities to share their skills with selected nonprofit organizations around the world, many of which are Merck for Mothers’ partners.
Between 2012 and 2015, 101 fellows like Scott from 16 different countries worked for 27 nonprofit organizations. Their goal? To support meaningful and systematic improvements in health service delivery for people with the greatest needs.
On the flip side, the fellows bring back experiences and insight that can contribute to the company’s success and ability to deliver innovative health solutions to people around the world.
Scott’s work centered on helping to communicate and perform higher quality of care standards for maternal health by private maternity health care providers in India.
Children need their mothers. With the right quality of care training, no woman needs to die giving life.
Why does a focus on private maternity health care matter?
According to the India's National Sample Survey Office, 40-50% of all births occurring within medical institutions in India are happening in the local private sector.
Jhpiego's project involves training private maternity providers on the standards of quality care, and Scott’s work was largely focused on two critical fronts: developing a strategy with private maternity providers to adopt and implement higher standards of care and then to create awareness of and drive education about those standards with patients.
The strategy also involves training nurses to recognize and react to some of the most common causes of maternal mortality.
At the end of their initial three-year pilot with Jhpiego, they realized that nurses are a key factor in reducing maternal mortality.
Training nurses is "meant to implement not just better maternal health, but also safer and healthier pregnancies and births," says Scott.
“You talk to the doctors and they will tell that for every two minutes they get to spend with the patient, nurses are spending about two hours. There is a tremendous opportunity to integrate nurses more.”
Before the training, "not all the nursing staff or paramedic staff are fully qualified [to administer medical care]," Scott explains.
"The nurses, unlike the doctors, aren't always formally trained to deliver maternal care," he says. "They may be technically knowledgeable, but they don't necessarily know the best way how to do it. Once they’re trained in actually delivering care, and I saw it first-hand, there’s an incredible level of excitement because their level of impact and empowerment just skyrocketed."
A mother and her newborn smile in recovery thanks to a complication-free delivery due to maternal and newborn health (MNH) quality-of-care training. No mother should die giving life.
Merck for Mothers' work with global partners is creating real sustainable results.
As of 2015, 4,751 health care workers were trained and the quality of care was improved at 787 facilities in India, reaching more than 467,000 women. It's proof that these partnerships have created an atmosphere of sustainable improvement in India.
Working with local partners, like the Federation of Obstetric and Gynecological Societies of India (FOGSI), the initiative is helping set and maintain standards that can be passed down in training for years to come.
Time will tell whether his work will help reduce the country's rate of maternal mortality, but Wright seems pretty confident.
"That's what it's about," says Scott. "You can make a difference, but having a difference that lasts? That's what matters."
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There's a reason why some people can perfectly copy accents, and others can't
Turns out, there's a neurodivergent link.
A woman in black long sleeve shirt stands in front of mirror.
Have you ever had that friend who goes on vacation for four days to London and comes back with a full-on Queen's English posh accent? "Oooh I left my brolly in the loo," they say, and you respond, "But you're from Colorado!" Well, there are reasons they (and many of us) do that, and usually it's on a pretty subconscious level.
It's called "accent mirroring," and it's actually quite common with people who are neurodivergent, particularly those with ADHD (Attention Deficit Hyperactivity Disorder). According Neurolaunch, the self-described "Free Mental Health Library," "Accent mirroring, also known as accent adaptation or phonetic convergence, is the tendency to unconsciously adopt the accent or speech patterns of those around us. This linguistic chameleon effect is not unique to individuals with ADHD, but it appears to be more pronounced and frequent in this population."
Essentially, when people have conversations, we're constantly "scanning" for information—not just the words we're absorbing, but the inflection and tone. "When we hear an accent, our brains automatically analyze and categorize the phonetic features, prosody, and intonation patterns," writes Neurolaunch. For most, this does result in copying the accent of the person with whom we're speaking. But those with ADHD might be more sensitive to auditory cues. This, "coupled with a reduced ability to filter out or inhibit the impulse to mimic…could potentially explain the increased tendency for accent mirroring."
While the article explains further research is needed, they distinctly state that, "Accent mirroring in individuals with ADHD often manifests as an unconscious mimicry of accents in social situations. This can range from subtle shifts in pronunciation to more noticeable changes in intonation and speech rhythm. For example, a person with ADHD might find themselves unconsciously adopting a Southern drawl when conversing with someone from Texas, even if they’ve never lived in the South themselves."
People are having their say online. On the subreddit r/ADHDWomen, a thread began: "Taking on accents is an ADHD thing?" The OP shares, "My whole life, I've picked up accents. I, myself, never noticed, but everyone around me would be like, 'Why are you talking like that??' It could be after I watched a show or movie with an accent or after I've traveled somewhere with a different accent than my 'normal.'
They continue, "Apparently, I pick it up fast, but it fades out slowly. Today... I'm scrolling Instagram, I watch a reel from a comedian couple (Darcy and Jeremy. IYKYK) about how Darcy (ADHD) picks up accents everywhere they go. It's called ADHD Mirroring??? And it's another way of masking."
(The OP is referring to Darcy Michaels and his husband Jeremy Baer, who are both touring comedians based in Canada.)
Hundreds of people on the Reddit thread alone seem to relate. One comments, "Omfg I've done this my whole life; I'll even pick up on the pauses/spaces when I'm talking to someone who is ESL—but English is my first language lol."
Sometimes, it can be a real issue for those around the chameleon. "I accidentally mimicked a waitress's weird laugh one time. As soon as she was out of earshot, my family started to reprimand me, but I was already like 'oh my god I don’t know why I did that, I feel so bad.'"
Many commenters on TikTok were shocked to find out this can be a sign of ADHD. One jokes, "Omg, yes, at a store the cashier was talking to me and she was French. She's like 'Oh are you French too? No, I'm not lol. I'm very east coast Canada."
And some people just embrace it and make it work for them. "I mirror their words or phrase! I’m 30. I realized I start calling everyone sweetie cause my manager does & I work at coffee shop."