Childbirth has been a constant in human history. Unfortunately, death among mothers was far from rare. We discuss how dangerous it was and how far we have left to go.

Welcome, everyone. With this episode, I have over 20 podcasts under my belt.  It has been a lot of fun and I appreciate allof you.  I have a completely self-servingrequest of you.  I'm trying to make mypodcast better and I really need some good feedback to do so.  I would like to know your favorite episodeand one topic that you would love for me to discuss.  Simply go to my website sci-vs-fear.com andclick on the red contact button or if it is easier, email me directly at [email protected].  Again, I’d like to know your favorite podcastso far and one topic you would like for me to discuss.  Thanks again for all of your support!

Today’s topic is:

Childbirth: There’s got to be a better way

As most of you could guess, the only direct experience I’vehad with childbirth is being born and those memories are a bit fuzzy.  I have four kids and so I’ve had plenty ofexperience on the Dad side, but doesn’t really count.  Not too long ago, we were in the hospitalwith our daughter, welcoming our first grandchild into the world.  As I watched her struggle to bring mygrandson into the world, I thought “this has to be one of the most dangerousthings ever.”  This episode goes out tomy daughter and my wife.

Today’s podcast is going to look at how dangerous childbirthis for the mother.  Making it to 5 yearsold is a big gamble for the baby and is a topic for another podcast. 

US Childbirth deaths

In the US, about 700 women a year die due to complicationswith pregnancy. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htmFor a country with the population of theUS, this is a pretty low rate.  Othercauses of death with similar rates are slipping and tripping falls, falls fromladders, drowning in swimming pools, and freezing to death. https://injuryfacts.nsc.org/all-injuries/preventable-death-overview/odds-of-dying/data-details/

As we will discuss in a minute, it has taken a lot of hardwork to get to this place.  The leadingcauses of maternal death are cardiovascular conditions, hemorrhage, infection,embolism, cardiomyopathy, mental health conditions, andpreeclampsia/eclampsia.  Interestingly,the death rates were very similar for black and white women, except that deathsdue to mental health conditions were noticeably absent among black women.

Of these fatalities, a quarter occurred during pregnancy,15% on the day of delivery, 18% 1-6 days postpartum, another 18% 7-42 dayspostpartum, and the remaining quarter 43-365 days postpartum.

The fatalities can be categorized as preventable, andnon-preventable.  Hispanics had thelowest rate of preventable deaths at 62%, blacks at 63%, and white at 68%.  I found it interesting that of the maternaldeaths in this CDC study, over 65% were still preventable. https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/mmr-data-brief.html

Childbirth in Africa and South Asia

So that is in the US, but how about the rest of theworld?  In 2015, over 300,000 women diedfrom pregnancy-related causes.  Of those,the US contributed about 700 with Europe, the Middle East, and Latin Americaall having similar contributions.  Thevast amount of pregnancy-related deaths come from South Asia and Sub-SaharanAfrica.  Since 1990, South Asian deathshave shrunk from 200,000 per year to about 100,000.  However, Sub-Saharan Africa has held steadyat about 200,000 deaths per year. Clearly, Africa has some problems.

Historic childbirth deaths

Surprisingly, it could be much worse.  If we use the 1800 Sweden/Finland mortalityrate of roughly 1% ( 900 deaths per 100,000 live births), the expectedmortality would be about 1.25 million per year. If we use the current European Union mortality rates of 0.01% ( 8 deathsper 100,000),