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maternal mortality

Women's Health

OB-GYN trains others to help after Mississippi closes maternity wards and patients lose care

Labor and delivery departments are shutting down all over the state leaving pregnant people scrambling.

Photo by Alexander Grey on Unsplash

OB-GYN trains emergency staff as Mississippi closes maternity wards

After the overturning of the Dobbs decision, people have been doing what they can to mitigate the repercussions but one of the first states to ban abortion is failing pregnant people in an unexpected way. Mississippi is one of the few states that had a trigger law in place before Dobbs was overturned. The law was set to go in place as soon as the Supreme Court turned the matter of abortion over to the states.

Some people celebrated that decision while doctors and other medical professionals prepared for the impact. While Mississippi doctors knew there would be an influx of dangerous situations, Mississippians weren't prepared for the wide closure of labor and delivery departments across the state. Some in areas that where people already have to drive more than an hour away to get to maternity care.

This measure is not only to save money but because there's now a shortage in obstetricians. The move is putting more pregnant people and newborns at risk as one OB-GYN attempts to prepare hospitals in the state for babies being born in the emergency room.

Dr. Rachel Morris is an OB-GYN based in Jackson, Mississippi who started a program called Stork at the University of Mississippi Medical Center. After noticing the sharp increase in maternal mortality and morbidity rates of pregnant people in the state, Morris knew something had to be done. Stork provides training to emergency workers on how to deliver babies, help the mom recover and care for newborns after delivery.

"We started noticing increasing trends of maternal mortality and morbidity," Morris tells CBS. "In the state of Mississippi almost ninety percent of the deaths that we encountered from 2017 to 2019, we're talking pre-covid, were preventable."

woman holding pregnant belly

OB-GYN trains emergency staff as Mississippi closes maternity wards

Photo by freestocks on Unsplash

Mississippi has been leading the country in infant mortality for a while the maternal mortality rate is worsening according to the Mississippi State Department of Health. The department reports that "43% of maternal deaths were directly related to pregnancy," and 87.5% were preventable. It also highlights that Black women were four times more likely to die pregnancy related deaths than white non-Hispanic women.

Yet, it the past year the only neonatal intensive care unit in the most rural and poorest part of Mississippi closed while some maternity wards in the state have shut down. The closures are affecting people across the state and isn't isolated to the rural Delta community. Upworthy spoke with a woman who lives on the Gulf Coast of Mississippi and expecting her third child who has had several major complications and requires extra care.

Hadley Hill is a young mom and teacher that enjoyed her experience with working with a midwife and delivering her second child at Singing River Hospital in Gulfport. She expected to have the same wonderful experience with her third, a baby boy, but early on Hill and her husband found out the baby had complications that would require further monitoring. The mom made a plan with her medical team to stick with her midwife and do follow ups with the OB-GYN as needed.

Things were going smoothly and the baby's complications were being addressed but when she went in for her last appointment a couple of weeks ago, she was informed it would be her last visit. The labor and delivery department was closing and the midwife was no longer with the practice.

"We had been seeing her regularly, along with a few other doctors because of the complications," Hill told Upworthy. "I hadn't seen my midwife for a few visits, but I thought nothing of it because I had been seen by other people. It wasn't until my most recent doctors appointment, the first visit of my third trimester, that the nurse asked me who was going to be delivering."

baby lying in incubator

OB-GYN trains emergency staff as Mississippi closes maternity wards

Photo by Alexander Grey on Unsplash


This wasn't a smooth transition for Hill and she still hasn't located a new doctor or hospital she feels comfortable delivering her son.

"I'll either have to deliver at Memorial Hospital with a new doctor this late into pregnancy or risk traveling an hour while in labor to New Orleans to keep my current midwife," Hill explains.

After a previous bad experience delivering her first child with Memorial Hospital, Hill is reluctant to deliver another child there. But she feels like she has little choice since she works full time and has two other children, there's little time in the day to find another OB-GYN that delivers at a hospital she can get to.

"Mississippi is setting us up for failure. Pregnant people living in Mississippi deserve safe and reliable access to healthcare, and it doesn't seem to be a priority," Hill tells Upworthy. "I can't tell you how many times I look at what other states are doing for their pregnant population and wonder how nice that must be. Here we can't even dream of paid maternity leave, we're too busy searching for doctors and hospitals to safely deliver our babies."

There are more pregnant people like Hill just learning of the closures and attempting to navigate a severely broken system in the state. Analyzing their risks for having to deliver out of state or driving hours to get to the nearest labor and delivery department. Until things start to turn around in Mississippi, programs like Stork will be pregnant people's lifeline and the waiting list for trainings is currently six months long.

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Family

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.

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Merck

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."

For more information about the work being done by Merck for Mothers, visit their website.

Heroes

A bright yellow suitcase is saving moms and babies around the world.

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The CW

It's common to do certain things in the dark: get your snooze on, watch a movie, maybe even deliver a baby.

Deliver a ... baby? In the dark? It happens.

It's a scenario that's almost hard to fathom, considering many of us can barely find a light switch in the dark without stubbing a toe on every piece of furniture. But as U.S.-based OB/GYN Dr. Laura Stachel discovered on a research trip in 2008, babies around the world too often are being delivered in near darkness — until she found a unique way to fix it.

Check out her story in this video and then scroll down to read the whole story!

In many countries, delivering a baby in darkness isn't what the doctor ordered — but it's what the doctor got.

Take rural Nigeria, for example, where the electricity can be extremely unreliable.

When Laura went there on her research trip, she was shocked at what she saw: nurses delivering babies at night, using lanterns and flashlights to see. Surgeons working in near darkness, and patients needing life-saving procedures but getting turned away because of the dark conditions.

As you can imagine, the results were often tragic.

A midwife in Tanzania holds a cellphone in her mouth to enable her to see and care for a woman. All photos from We Care Solar/Facebook, used with permission.

On a list of reasons why maternal mortality is still so high in 2016, "light" isn't usually one that would come to mind. But 300,000 women are dying during or right after pregnancy or childbirth every year, and access to light is a contributing factor.

Because as you know, babies don't wait until conditions are ideal to make their world appearances. Countries with unreliable electricity can only adapt as best as they can.

When Laura realized that access to light was such an issue, it gave her an idea that's paying off for a whole generation.

She and her husband, Hal Aronson, a solar energy educator in Berkley, California, developed an off-grid solar electric system and gave it to the Nigerian hospital. It provided reliable lighting, easier communication, and allowed for a blood bank refrigerator through its power source.

And guess what? Maternal mortality there decreased significantly. That's not a coincidence.

Back then, Hal Aronson and Laura Stachel were just getting started.

Knowing that portability and ease of use was going to be key for their success, they created a compact version of their solar electric system and dubbed it the "solar suitcase."

It's a suitcase, people! That provides light. And a power source. And saves the lives of moms and babies.

Solar suitcases in Tanzania are now replacing candlelight and oil wick lanterns.

What more could you want? Besides more of them ... everywhere. (Don't worry, they're working on that!)

More than 1,500 solar suitcases have served moms, babies, and health care workers in more than 27 countries since 2009. In the next five years, they hope to light up 20,000 health clinics.

What a difference some light makes. Photo taken after the Nepal earthquake, using a solar suitcase.

It's a seemingly simple solution with a huge impact. The suitcases currently cost around $1,645 each and have been funded by individuals, UN agencies, and foundations; although donations are obviously welcomed. The suitcases are provided at no cost to the clinics in need.

Some of our world's biggest problems can feel too complex and difficult to fix. Laura and the We Care Solar team are showing why that's not always the case.

Her simple fix is impacting maternal mortality rates around the world in the best way possible, and there is much more good to come.

She's a hero, shining bright.

More

Sierra Leone just legalized abortion – and it's going to save women's lives.

As politicians in the U.S. try to take away abortion rights from its citizens, Sierra Leone just did the opposite.

In 2015 alone, state legislators in the U.S. introduced nearly 400 bills to restrict abortion access. Meanwhile, Sierra Leone just made the procedure legal.

On Dec. 8, 2015, Sierra Leone's parliament overwhelmingly passed the Safe Abortion Act, lifting a 154-year-old ban on abortion.

Abortion had been illegal in Sierra Leone since 1861 (before the lightbulb was invented!). Repealing the law has the potential to save many women's lives, as Sierra Leoneans know all too well what happens when women don't have access to the resources and care they need.

Women taking to the streets to support the Safe Abortion Act. Image via Ipas, used with permission.

Sierra Leone leads the world in maternal mortality, which isn't a statistic any country should be proud of.

1 in 70 women in Sierra Leone die during or shortly after childbirth. One-third of those deaths are due to complications from unsafe abortions, according to the World Health Organization.

"Practically everyone in Sierra Leone knows someone who has been affected in some way by unsafe abortion — people have lost wives, daughters, and love[d] ones," said Val Tucker, from the reproductive rights group Ipas.

No woman with an unwanted pregnancy should have to resort to visiting an unskilled person in unhygienic conditions to get the abortion she needs. But with the procedure banned, that was what many chose to do. And the dire outcome of illegal, unsafe abortions isn't specific to Sierra Leone.

Other countries where abortion has been legalized show how many more women's lives are saved when they have access to the procedure in a clean, safe space.

Photo by U.K. Department for International Development/Flickr.

It turns out abortion-related deaths go way down in countries with less restrictive laws (1 or fewer per 100,000 childbirths) than in countries with more restrictive abortion laws (34 deaths per 100,000 childbirths).

That was the case when abortion became legal in the United States in 1973. Pregnancy-related deaths and hospitalizations due to complications of unsafe abortion effectively ended. The same thing happened recently when abortion law was reformed in Ethiopia.

"We don’t see the tragedy of severe abortion complication and death any more in this hospital, it has become something of the past," one Ethiopian doctor noted to Ipas.

Image via Ipas, used with permission.

It goes to show that restricting access to abortion doesn't stop abortion from happening — it only makes it unsafe.

Having safe and legal access will undoubtedly save women's lives in Sierra Leone. And there's something that could save even more: putting sexual and reproductive health information more out in the open. As 44% of 18-year-old girls in Sierra Leone are married, taboos on sex only keep people in the dark. Access to contraception and other sexual health services can play a significant role in the success of the country's future, and luckily organizations like Ipas are leading the way.

Legalizing abortion 154 years later is better than never. This move will help women and families in Sierra Leone decide what's best for their own futures, and it shows the progress the world around us is making.

Politicians in the U.S. should take note.

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