In 2020 the US maternal mortality rate was 23.8 deaths per 100,000 live births. This is three times more than the rate in 10 other high-income countries studied. What’s more, this number has been on a steady rise for the last several years. Texas ranks 7th in the top 10 worst states in the country for maternal mortality.
While these statistics are absolutely disgusting, I am not remotely surprised.
My Own Birth & Postpartum Story
I gave birth to my daughter in March 2013. We took the classes. We read the books. We did the hospital tour. We were giving birth at one of the top five maternity hospitals in the greater Houston area, at one of top rated hospital systems in Texas. I had a birth plan, understanding if there were changes in my status or our daughter’s we’d have to adjust. I knew my doctor was out of town with her own kids and the on-call doctor would be the one delivering our baby.
It was the beginning of Spring Break. The labor and delivery unit was oddly quiet. Only one other baby was born that day, which was especially interesting considering they average around 10 births per day at that hospital. Many doctors, nurses and staff members were on vacation.
After about 8 hours of labor and at about 8 cm dilated the doctor came in for the very first time. She stood at the end of the bed and strongly suggested they administer Pitocin. She explained how I would never progress further than 8 cm without it. The head delivery nurse (God bless that woman) stood behind the doctor, met my eyes and slowly shook her head no. I told the doctor I didn’t want Pitocin and would rather continue to progress naturally. She seemed frustrated by my decision and left.
Three hours and a low dose epidural later, it was time to push. This was the second time I saw the doctor, seconds before my daughter was born and the nurse had told me to stop pushing because the doctor HAD to be there to deliver her.
Our daughter was perfectly healthy. I however had a level 3 internal tear. After all the hustle and bustle, the doctor started stitching me. I could feel…everything. I told the doctor, she said the epidural should be numbing everything and went on stitching. The anesthesiologist stopped in his tracks with a blank stare, “Ummm, I already removed the epidural.” The doctor’s eyes got wide as she called for local anesthesia.
In additional to the tear, I had a slightly elevated temperature and the doctor immediately put me on a high level rotation of intravenous antibiotics.
I didn’t see her again for three days.
When she finally did return, she didn’t even come into the room. She just stuck her head in the door wearing jeans and a pink college hoodie. I asked her if I could please get off the antibiotics because I hadn’t been able to take a shower.
Her response was, “Get off what?”
I pointed to my IV.
“Oh yeah, they should have stopped those days ago.”
The nurses knew this but they didn’t have the authority to stop them. They’d reached out to her several times for change orders. She’d forgotten about me for three days.
It was not lost on me that it was Spring Break. It was not lost on me that I was an absolute inconvenience to this doctor. What was lost on me was how little care I would receive after I left the hospital.
When I was discharged I expected my first postpartum appointment to be within a few days. They said no, they’d see me in 4 weeks.
Remember, I had a level 3 internal tear.
When I did finally see my doctor, exactly 4 weeks later, I let her know I still had stitches and they hurt.
She didn’t believe me until she saw them herself, confused why they hadn’t dissolved.
During that same appointment the nurse asked me how I was doing. I told her that I was feeling really sad. She told me it was baby blues and I would get over it in a few weeks.
I did not, in fact, get over it. When our daughter was four years old and our house burned down we started regular therapy. It was then that it was finally confirmed by our therapist, based on the experiences I shared with her, that I indeed had undiagnosed postpartum depression.
I Know I Am Not Alone
I share all this because I am not surprised by these statistics. I’m not surprised by the long article about poor maternal care in Texas in our local Community Impact newspaper. I’m not surprised by the countless articles in the Texas Tribune over the years.
I’m not even surprised that Texas has had a Maternal Mortality and Morbidity Task Force since 2013, the year my daughter was born, and our numbers have not changed; 18.5 deaths per 100,000 in 2017 compared to 18.3 deaths per 100,000 in 2019 {though I did read articles that put that statistic closer to 34.5 per 100,000 births}.
I’m not surprised because my story is not unique. My story is like hundreds, if not thousands of other stories. No I did not die. Though, my postpartum depression often suggested that I should. Even though it went undiagnosed, I had a network of friends and family who helped keep me grounded. I wonder what it would have been like if I didn’t have those networks, if I didn’t have that support.
We Shouldn’t Set The Bar At Not Dying
The problem here isn’t just maternal mortality. The larger discussion is abysmal postpartum care for mothers. There are so many things we could address here: maternity leave, paternity leave, extended Medicaid coverage for postpartum care, and better recognition and treatment of postpartum depression, just to name a few. We need to set the bar higher. Success isn’t just lower death numbers, it is better postpartum care overall.
14 of the 17 members of the Maternal Mortality and Morbidity Task Force are doctors. The other three are one registered nurse, one licensed clinical social worker, and one community advocate. They’re studying statistics and practices within their industry, but they are not hearing our stories.
We need to tell our stories because 20.1 women per 100,000 no longer can.
If we don’t talk about it outside our mom groups, our book clubs, and outside of drinks with our girlfriends, it will not change.
It will not change for other new moms.
It will not change for our daughters.
Let’s Change the Maternal Mortality Statistics. Share Your Story
I originally shared parts of my story and some of these statistics on my Instagram stories. I requested people send me their stories. If you would like to share your story, I am compiling them all, anonymously, to send to the Maternal Mortality and Morbidity Task Force, the Governor, and the state Legislature. You are welcome to send in a direct message on Instagram to @StrongerThanFire.
Let’s tell our stories, let’s start the change.
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