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Our Health Care System Needs a Massive Overhaul — Especially in Maternal Healthcare

Updated: Apr 25, 2023

Choosing to bring a life into the world should be one of the most supported, joyous, and positive events someone could experience.

Yet the unfortunate reality of being pregnant in the US means expecting an increased chance of medical complications and maternal mortality.

America is known to have the worst maternal mortality rate among other developed countries, which has only gotten worse since the pandemic — and it doesn’t appear to be trending in the right direction anytime soon. In 2019, the CDC reported a maternal mortality rate of 20.1 up from 17.4 in 2018.

Break these stats down by race and it gets even worse. For non-Hispanic Black women, the maternal mortality rate is 2.5 times the rate for non-Hispanic white women and 3.5 times the rate for Hispanic women.

Our healthcare system is failing when it comes to maternal care, and we should be outraged.

I won’t necessarily go into the history of patriarchal oppression — although so much of what we’re dealing with today stems from there — but I do want to reflect on this:

People who give birth are too often dismissed, disrespected, and discarded by doctors. This is a result of a profit-first healthcare system that has failed to prioritize people, despite people being at the center of its purpose — including those very caretakers, as doctors and providers are spread too thin and expected to perform beyond human capacity, leading to oversights and mistakes.

What is really upsetting is that research continues to show that oftentimes, these deaths could have been stopped. The Maternal Mortality Review Committees (MMRCs), multidisciplinary committees that convene at the state or local level to comprehensively review deaths during or within a year of pregnancy, found in this study that 80% of the 1,018 pregnancy-related deaths were “determined to be preventable.”

Chest and/or leg pain, consistent headaches, swelling, dizziness, and extreme fatigue are a few noticeable maternal warning signs that should be considered as an indicator of potentially fatal consequences at any point of a pregnancy timeline, including up to a year after giving birth.

Because women’s pain is commonly dismissed or underestimated, women have become accustomed to tolerating pain beyond an average threshold, so it may come as no surprise why symptoms would be brushed off — regardless if they’re minor or more obvious and unbearable.

This is exactly why the issue of poor maternal healthcare isn’t just about the number of people who die, but the equally alarming amount of people who come close. In this essay, it’s illuminated that according to CDC statistics, “more than 50,000 women in the U.S. annually face a range of serious and sometimes long-lasting pregnancy and childbirth complications.”

Whether it’s internalized (or outright) sexism or racism by the individual care provider, or the broader inequities surrounding the entire United States healthcare system, it is clear that people who give birth are often put into positions that neglect their personhood.

Humanity (and Consistency) is Lacking in Maternal Care

Pregnancy is emotional. A complete and total shock to your world — and your body — as you know it. Yet, we’ve become so accustomed to allowing a system to operate in a way that can be completely unemotional. When we get shuffled from doctor to doctor, room to room, insurance company to insurance company, it starts to feel a lot more like you’re in a manufacturing plant.

Take billing, for example. A friend of mine was sharing how her hospital bill was split between her and her baby between the labor and delivery of her birth stay — very similar to my own experience. Once the baby entered the world in that hospital room, the newborn was charged close to nothing on the final bill, even with a stay in the NICU. The mother’s bill? 4x more. If the majority of the care and services rendered are for the sake of the child, why aren’t those charges on the baby’s bill?

Throughout your pregnancy, you are treated as the keeper of this most precious gift, with the focus being all on the baby and not on you. This example is one of the far too many inconsistencies in maternal care, as well as how we separate AND join baby and mother in this process, which creates a less-than-ideal experience for pregnant patients and their loved ones.

People are three-dimensional, and our lives are intersectional. We need a healthcare system that can support that — consistently and reliably.

How To Use Our Individual Agency To Improve Maternal Care

I know there are so many wonderful care providers out there (I did marry a physician after all!), and I know that they, too, are adamant to see changes made on both their own and their patients’ behalf. But how can we use our individual agency to make a tangible impact?

By learning how to better advocate for ourselves as patients.

Some of the actionable ways we can do this include:

  • Developing more beneficial and productive relationships with our primary care physicians, continuing to ask for care even when you feel silly or needy, or are dismissed. Keep asking, find a better fit, ask a support person to step in and advocate alongside you.

  • Talking with our employers to offer better, more modern benefits like adding mental health services, inclusive fertility benefits, abortion coverage, extend paid parental leave, or extended bereavement leave to cover pregnancy loss.

  • Understanding current US public policy and getting involved to create better laws and protections

  • Connecting with our mom friends or friends in the family-building stage of life to offer support and resources so no one has to go it alone — especially vital given that the number one killer in the first year is postpartum depression that leads to suicide.

These are small but powerful steps we can take to help make a dent in the larger journey toward maternal care equity. The burden isn’t, and shouldn’t be, ours alone to carry and fix, but we do have a role in improving such a daunting mission, because if we continue to allow the system to operate as is, it will continue to fail us.

Funding & Building The Future of Maternal Care

I’ve met with countless founders trying to make various digital health improvements across the spectrum of care to connect and educate patients outside of clinical visits. This includes wearables to monitor and prevent complications seen in pregnancy, as well as devices that bring care into the home when more emotional attention is needed than a clinical setting can provide, such as fertility, sexual health, and cancer diagnostic tools.

Ultimately, what I’ve learned through hundreds of hours and countless conversations is this:

There isn’t one part of the pregnancy and the childbirthing process that doesn’t need improvement and modernization.

Pregnancy naturally takes up so much of a person’s time, energy, and attention, which is only multiplied when unexpected obstacles arise, including pregnancy losses, fertility issues, and the like. This should be a centrally supported time by care providers and employers to ensure the most beneficial experience for the pregnant individual.

We must keep advocating for the right care, resources, and support during the foundational pregnancy period, because the current state of maternal care cannot continue.

Our healthcare system needs a massive overhaul. There is simply no alternative.

Stay tuned for upcoming blogs on how to take specific action and make meaningful changes that will create a larger butterfly effect and help make this a reality.

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