I posted a link when NPR did their investigative reporting on the poor care for giving birth in this country.
I posted a link when NPR did their investigative reporting on the poor care for giving birth in this country. USA Today, of all things, seems to have done some in-depth follow-up to that.
This is long and Trigger Warnings on how very bad the maternity care in this country is. The reporting on this is almost entirely under the headline: U.S. the Most Dangerous Developed Country to Give Birth In. This is an accurate headline. (NB: article points out that California is the one state that seems to have done better overall because they implemented and followed proper guidelines.)
This article doesn't say it, much, but there is obviously a component of racism and misogyny to this. Also a cultural tendency to somehow blame women for their condition, frequently based on appearance. One thing they specifically call out is discrimination based on weight. For real, this is a thing that happens.
I have another set of questions. There is a significant number of women, now, in Ob/Gyn and the other groups that would be dealing with pregnant women and deliveries. It's no longer the boys club it once was. That this is going on while that change happened, and that it continues bothers me very much. Why would care get worse coincidentally with more women being in the field? It might be only a coincidence, but I would like that looked at, as well. There are so many places along the way in that continuum that leave concerning questions.
Lastly, I would like to slap every pro-life, anti-planned parenthood ideologue upside the head with this report. You want everyone with a uterus getting pregnant (no contraception!), you blame them/castigate them for that if it's not in a marriage between a man and a woman, but you don't give a damn if they are permanently damaged or die. Please don't point out that one person who's an exception to this, either. If you don't care about the women, you are not pro-life.
Most of all, I want to slap every idiot in Congress with this. Guess what else is somewhere in this reporting? The lack of a centralized system, i.e., some form of national healthcare/insurance. They can't even get the information on which specific hospitals, etc. are the most dangerous because we don't have some sort of central system. That's why this is primarily based on those states that have some sort of legislated way of compelling the information.
P.S. They mention that Medicare has compelled certain information and changes but only in older people. Duh. Medicare is for the over 65. They deal with what they take care of. Medicaid is apparently not worth enough money to be able to compel care and changes for the people under 65 who get that form of assistance. Why? For one thing, they don't insure everyone under 65. For another, people on Medicaid are "poor". Add economics to the discrimination happening, here.
Medicare is a major player in the market. In fact, it pretty much dictates the market. Even though we officially don't have national healthcare we really do, if you're over 65. As a pretty consistent rule, women over 65 do not give birth. So there is no reason for Medicare to have any interest in this. The federal government has no compelling interest in what happens to people under 65 without some kind of national health care/insurance. The states are trying to get rid of people on Medicaid, while blaming them for their poor health. I'm not being particularly articulate, here, but it should be clear why there's no government pressure on this.
The fact that this is the crappy response to voluntary enforcement of proper guidelines tells you what this society thinks of the value of women. It's so bad even other women think this way. Unconscious bias is strong, folks. And it's killing women, or worse, leaving them permanently damaged and disabled.
https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/07/26/maternal-mortality-rates-preeclampsia-postpartum-hemorrhage-safety/546889002
https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/07/26/maternal-mortality-rates-preeclampsia-postpartum-hemorrhage-safety/546889002
This is long and Trigger Warnings on how very bad the maternity care in this country is. The reporting on this is almost entirely under the headline: U.S. the Most Dangerous Developed Country to Give Birth In. This is an accurate headline. (NB: article points out that California is the one state that seems to have done better overall because they implemented and followed proper guidelines.)
This article doesn't say it, much, but there is obviously a component of racism and misogyny to this. Also a cultural tendency to somehow blame women for their condition, frequently based on appearance. One thing they specifically call out is discrimination based on weight. For real, this is a thing that happens.
I have another set of questions. There is a significant number of women, now, in Ob/Gyn and the other groups that would be dealing with pregnant women and deliveries. It's no longer the boys club it once was. That this is going on while that change happened, and that it continues bothers me very much. Why would care get worse coincidentally with more women being in the field? It might be only a coincidence, but I would like that looked at, as well. There are so many places along the way in that continuum that leave concerning questions.
Lastly, I would like to slap every pro-life, anti-planned parenthood ideologue upside the head with this report. You want everyone with a uterus getting pregnant (no contraception!), you blame them/castigate them for that if it's not in a marriage between a man and a woman, but you don't give a damn if they are permanently damaged or die. Please don't point out that one person who's an exception to this, either. If you don't care about the women, you are not pro-life.
Most of all, I want to slap every idiot in Congress with this. Guess what else is somewhere in this reporting? The lack of a centralized system, i.e., some form of national healthcare/insurance. They can't even get the information on which specific hospitals, etc. are the most dangerous because we don't have some sort of central system. That's why this is primarily based on those states that have some sort of legislated way of compelling the information.
P.S. They mention that Medicare has compelled certain information and changes but only in older people. Duh. Medicare is for the over 65. They deal with what they take care of. Medicaid is apparently not worth enough money to be able to compel care and changes for the people under 65 who get that form of assistance. Why? For one thing, they don't insure everyone under 65. For another, people on Medicaid are "poor". Add economics to the discrimination happening, here.
Medicare is a major player in the market. In fact, it pretty much dictates the market. Even though we officially don't have national healthcare we really do, if you're over 65. As a pretty consistent rule, women over 65 do not give birth. So there is no reason for Medicare to have any interest in this. The federal government has no compelling interest in what happens to people under 65 without some kind of national health care/insurance. The states are trying to get rid of people on Medicaid, while blaming them for their poor health. I'm not being particularly articulate, here, but it should be clear why there's no government pressure on this.
The fact that this is the crappy response to voluntary enforcement of proper guidelines tells you what this society thinks of the value of women. It's so bad even other women think this way. Unconscious bias is strong, folks. And it's killing women, or worse, leaving them permanently damaged and disabled.
https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/07/26/maternal-mortality-rates-preeclampsia-postpartum-hemorrhage-safety/546889002
https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/07/26/maternal-mortality-rates-preeclampsia-postpartum-hemorrhage-safety/546889002
The only quibble I have is the implicit assumption that we are a developed country, as opposed to a less completely developed nation with many wealthy people but a incomplete or broken system for the non wealthy, like Mexico or China.
ReplyDeleteI would argue piles of data like this argue for the latter.
Jeffrey Huo the thing about the whole “developing/developed country” terminology is that it doesn’t actually make provision for countries to fall back. And I think it’s unarguable that 70 years ago, the US led the world in many ways. It’s really only the last fifty years that that has been slowly changing.
ReplyDeleteUntil and unless we are officially removed from the list of developed nations, we are regarded as a if not the representative of said group. We promote ourselves as such and rely on our reputation as such in many areas.
ReplyDeleteI think the whole point of investigations like this is just how far we've fallen from that standard, and how we keep working on falling further. That we refuse to see ourselves and our behavior as a society clearly. So, your point about where we really are and where we will end up. Unless we wake up.
Jasper Janssen (nods) That's why I prefer the 1st / 2nd / 3rd world categorizations, which don't have the implied inability to fall backwards. "Third" world for nations so underdeveloped that services like quality higher education or health care are only available to the wealthy by going overseas (Zaire, Laos, Haiti). "Second" world for nations which do have quality services for the wealthy, but the majority either have to go heavily in debt or can't afford them at all (Russia, Mexico, China). And "First" world for nations where quality services are available to all citizens at affordable prices as a right of citizenship (Canada, Germany, Japan).
ReplyDeleteI think in that rubric, it's patently obvious which category the United States now belongs. And it sure as hell ain't the category in which Canada, Germany or Japan belong to.
Pamela Korda First / second / third world was definitely used in a geopolitical sense when I was a child, with the unaligned states like India making up the third world. But that is now two generations ago, and for at least the latest of these, I have hardly ever seen or heard any other usage than referring to economy and/or infrastructure. Also the "second world" as a concept has fallen out of use outside of history.
ReplyDeleteI kind of like the way Jeffrey Huo tries to reintroduce the concept of a second world, somewhat legitimized by Russia still being a prime example of the category even today.
I have elsewhen promoted the concept of a rising "zeroth world" that relates to the first world as the first world relates to the third world. But maybe this will become the new standard for first world countries, and we will need another designation for those who cannot or will not keep up.
Or maybe we can just start considering women human beings with intrinsic value. Like actually make that cultural change, regardless of politics and economics. In all 3 worlds, granted the first two like to claim they've already accomplished this and in our specific case that is 100% fake news (the having accomplished it bit).
ReplyDeleteNot that I'm not up for a good historical philosophical debate. Please, do, carry on. Also, very keen on understanding terms and their context when employing them, not that I haven't ever messed that up in my life, but I'm very pro know what your words/terms mean.
Aside from that, though, I am seriously pissed off that our medical system and society at large politicize both health in general and specifically women's health. Making sure to make women of less use or value than popping out a new organism that is totally useless and unable to care for itself. Compounding the error by documentably placing higher value on white women considered conventionally physically attractive. Flames, on the side of my face!!! I, uh, may have feelings on the subject.
F-L Silver I don't think this is unrelated? In the classic first world, you had economic freedom. In the second world, you had social safety. In the third world, you had neither. In the "zeroth world" like northern Europe, you have both... but you cannot have 100% of both. America is right now rushing toward 1 again: Absolute freedom, taxation is theft, dismantle the federal government, each (wo)man for themself. 40 years ago you had tax rates that you now would think of as communism (70% marginal tax rate when Reagan took the wheel). That is far more than Norway has today. Your people really love taking things to the extreme, eh?
ReplyDeleteWell, some of us don't, but as a society we seem to be having issues, yes.
ReplyDelete