THE HEALTHY MOTHERS HEALTHY BIRTH SUMMIT: Addressing Maternal Mortality as a Community Part 2: Summary
Maddy Oden is not an imposing woman at first sight. She looks wise and slightly bohemian like many of the women present at the Healthy Mothers Healthy Birth Summit. She walks to the front of the crowded but silent conference room, quietly lights a candle, and explains that the light is for her daughter Tatiana, granddaughter Zorah, and all other women lost during childbirth.
She then looks across the audience, the expression on her face seeming to continue “…and we’re going to do something about this right now.” She sits down as a blessing is read for all present, quietly, but radiating lightning bolts of resolve that seem to echo through the whole audience.
And then, we got to work.
First to present was Nan Strauss from Amnesty International. Strauss shared research from the well-known Amnesty International report, Deadly Delivery: the Maternal Health Crisis in America. Among many other facets surrounding the maternal mortality issue, Ms. Strauss explained how Amnesty holds maternal mortality to be a human rights issue, as people of color and those with low income are disproportionately affected. She also shared Amnesty’s belief that all people have a right to [good] health (as delineated in 1948′s Universal Declaration of Human rights sent by Amnesty International to the United Nations) and also the conviction that most of these maternal deaths are preventable. Strauss’s presentation was research-rich, well-cited, and contained several jolting case studies that brought many in the audience to tears.
Following Strauss was Jennie Joseph, whose presentation “Bridging the Gap of Racial Disparity in Birth” was marked by Joseph’s ebullient humor as well as a passionate proposal for a more holistic model of maternal care (“The JJ Way”) similar to the Centering Pregnancy approach. “It’s amazing that a body of water can make such a difference,” Joseph (who is originally from Britain) wryly observed. “I got off a plane – that’s all I did – and I was in the land of teeny tiny pelvises that don’t work and huge babies that somehow can’t fit.” Joseph provided a thorough explanation of her “JJ Way,” which places the emphasis in maternal healthcare on forming families and involving partners in prenatal care with the goal of eliminating the currently vast racial disparities in perinatal care.
A collective discussion was held next, addressing the topic: “What is Broken?” and the panel was composed of Strauss, Joseph, Christine Isaacs MD, a representative from ACOG, and Lamaze’s own Barbara Hotelling and Debra Bingham among others. Dozens of proposals were made from the panel and audience alike with the following being a representative sample of the Summit’s answers:
* not enough midwives / other practitioners
* sexist culture
* not enough attention to mother-baby dyad
* poor access to quality healthcare
* not enough data transparency / accountability
* inadequate RN staffing, appreciation
* inadequate communication between healthcare team
* vast disparities in care
* closed community – the natural birth community tends to preach to itself
* not enough positivity
Following the group’s shared answers, the question was posed “How do we fix it?” The following are representative answers from those present:
* more midwives
* baby steps at a political level
* know your community’s statistics
* grassroots advocacy
* better community relationships
* more resources (federal funding, healthcare workers)
* more peer reviewed research on perinatal mortality
After the panel discussion and input, Ms. Basmah Karriem from the International Center for Traditional Childbearing – an organization dedicated to infant mortality prevention and indigenous midwife promotion – shared a statement of solidarity from Shafia Monroe, the organization’s president. All present then broke out into small work-groups to answer the question “How do we define Maternal Mortality?” Most groups began with clinical definitions similar to that of the World Health Organization (“the death of a woman while pregnant or within 42 days of termination of pregnancy…”)1 and then moved outward with their definition, including impact on communities, individuals, and implications for the American healthcare industry.
After lunch, Ina May Gaskin gave her eagerly-awaited presentation “Maternal Mortality and the Safe Motherhood Quilt.” Gaskin related many anecdotes of the women featured on the quilt . When sharing the mothers’ stories, Gaskin spoke extemporaneously and as though she knew every woman personally. “Lemme tell you about Angela here,” she would say to illustrate a point. Gaskin also raised questions about factors not commonly associated with maternal mortality such as primarily assisted reproductive technology and higher-order multiple pregnancies.
In the Panel Discussion following, Gaskin stressed the importance of getting insurance and malpractice concerns out of the picture. “Who invited these guys in?” she asked in her earthy mid-western cadence. “We need to elbow them back out of here!” she exclaimed to a room full of chuckles. Regarding reform of the mortality reporting system, Gaskin reminded the audience that “it’s complicated, but we can’t get disheartened.” She also reminded all present to focus on the power of loving, kind human relationships to enable healthy birth outcomes.
The Healthy Mothers Healthy Birth Summit of 2011 was a complex and emotional affair, attended by an audience both impassioned and clinical. The end of the summit was marked with hope as all present discussed ways to continue reforming birth culture in the United States so that every future mother and baby will be safer throughout the childbearing process.
Posted by: B. Kristine Burneko LCCE, BSIN who is the mother of Loudoun Lamaze as well as two boys, 2 years and 6 months. She holds a Bachelors of Science in Health Promotion from George Mason University, and received her Lamaze Certification from the University of Pittsburgh Medical Center program.
On April 10 at 2:00pm, several members and attendees of the Summit gathered at the US Capitol for a rally surrounding Gaskin’s Safe Motherhood Quilt project. To read about the rally, go here.]