In her poem, ‘Calling All the Grandmothers’ writer Alice Walker declares: “We have to live differently or we will die the same way.” The poem goes on to engage the grandmothers to step forward ‘to rise and lead.’ In fact, declares Walker, ‘the life of our species depends on it.’
I thought deeply of Alice Walker’s poem when USA Today and CBS National News printed ‘Deadly Delivery’ on Thursday, July 26, 2018. The article profiles the heartbreaking story of maternal morbidity and mortality in the USA, with an emphasis on the role of hospital safety quality indicators that are inconsistently used and the trauma for families left grieving in such unanticipated loss. In the United States, maternal death and near misses have been on the rise the last 18 years and we are now at a watershed moment where media outlets are making visible a broken system of maternity care where 60 percent of these deaths could have been prevented. But how media outlets cover maternity care and maternal loss has an impact on how resources are allocated and how likely and unlikely stakeholders understand the topic of giving birth and being born in the United States.
Alas, the USA Today article which was featured in partnership with the national CBS Television News and reprinted in thousands of local newspapers owned by Gannett publications missed the mark in telling the full story.
USA Today’s article got it right with compassionate profiling of family voices: literally over 5,000 videos where birthing parents themselves explained their trauma and were amplified through this national platform. But after that seminal place of family inclusion, I’m left wondering why two other critical pieces were blatantly left out: the role of cesarean births in escalating our poor outcomes and the role of racial disparities impacting maternal health.
My challenge to the journalists at USA Today is to dig deeper. Prior to USA Today’s article last week, two major media outlets recognized the role of overusing cesarean birth as a mitigating factor with their reporting:
In the article Nearly Dying in Childbirth: Why Preventable Complications Are Growing in the US? the author states: “The reasons for higher maternal mortality in the U.S. are manifold. Half of pregnancies in the U.S. are unplanned, so many women don't address chronic health issues beforehand. Greater prevalence of C-sections leads to more life-threatening complications. The fragmented health system makes it harder for new mothers, especially those without good insurance, to get the care they need. Confusion about how to recognize worrisome symptoms and treat obstetric emergencies makes caregivers more prone to error.”
And Time Magazine reported in 2016, “Cesarean has its complications and these can increase the risk of maternal death.” Racial disparities in maternal health should have been part of the report. This past spring’s New York Times’ magazine and NPR radio broadcasts both covered maternal death with racial disparities:
“Documented pregnancy-related deaths have doubled in the United States since 1990, health experts say. And the rates among African American women are triple that of white women. Another reason for the increasing rate of mortality is that complicated pregnancies are more likely to result in a cesarean section,” Fischer said. “If you have a C-section, it is more likely you are at risk for maternal complications and death,” (source)
The poem stanza, “we have to live differently or we will die the same way” could very well be a critical call to action for improving maternity care. In my state of New Jersey, the most recent LeapFrog data revealed that NJ is doing worse, not better when it comes to reducing low-risk NTSV cesarean births. Thus, if we don’t speak differently to expectant parents and policymakers about birth, we will lose a critical opportunity for engagement. Twice this week in NJ, two terrific organizations who deeply impact social justice and equity statewide did programs specific to the needs of infants and children in NJ but did not bring up the maternity care. As The Bergen Record reported, “37 women die, on average, for every 100,000 live births in NJ compared with 20 nationally…. And African American women in NJ are five times more likely than their white counterparts to die from pregnancy-related complications.” When national media outlets exclude racial disparities and over using cesarean births, they leave off the opportunity for resources to be accelerated and toolkits like ones from SisterSong and The National Partnership for Women and Children to be unused.
Alice Walker challenged grandmothers to ‘step forward’ and I challenge USA Today to step up this important team of editors and writers to acknowledge what was left out and the implications of not naming cesarean sections and racism in this important dialogue on maternal health. As Alice Walker reminds us, “The life of our species depends upon it.”
About Jill Wodnick
Jill Wodnick, M.A., LCCE, is a national speaker on improving maternity care and a Lamaze educator at Montclair State University. Prior to that, Jill led a Community Doula Program in Hudson County, NJ for Medicaid participants. She has been part of the United Nations Commission on the Status of Women's Global Prenatal Initiative as well as on local and statewide programs for improving maternity care, eliminating racial disparities and the intersection of early childhood well being through birth. Jill can be found at @JillGW #SpeakingofBirth or www.JillWodnick.com .