The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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I had a nice long chat on Monday with Christy Turlington Burns and dang - that girl’s having a big week.
• She’s just back from Paris, where she’ll broadcast of her documentary, No Woman, No Cry for France’s Mother’s Day.
• She blogged and interviewed for the TODAY Show about why she cares about maternal health.
• She’s officiating at a friend’s wedding. Uh-huh, for real, Christy does everything.
She makes my to-do list look pitiful. Why does Christy care so much about maternal health? Her Aha moment arrived on her daughter’s birthday. She wanted a home birth, but settled on a birth center located in a hospital. Christy says, “It was exactly as I envisioned it - a completely natural birth. I was exhausted and blissed-out, holding my baby.” Then the delivery room atmosphere changed dramatically. “The placenta wouldn’t come. I began bleeding heavily and suddenly, there was all this medical equipment in the room.” Christy became part of a frightening statistic: 15 percent of deliveries involve a potentially life-threatening complication.
Christy had a retained placenta. Usually, the placenta slips out within half an hour after baby. When it doesn’t, the uterus can’t clamp down enough to minimize bleeding. That can cause postpartum hemorrhage – the leading cause of birth-related deaths.
What causes retained placenta? Sometimes it’s uterine atony - the uterus is too exhausted after delivering baby to deliver the placenta. Sometimes, it’s placental entrapment – the placenta separates from the uterus, but the cervix won’t let it out. Then there’s placenta acreta - the placenta grows into the uterine wall.
Christy’s obstetrician-midwife team manually extracted (peeled it out by hand) her placenta and controlled the bleeding. Christy says, “It was the MOST painful experience.” She needed an episiotomy repair (they used surgical glue), then a catheter (poor girl couldn’t pee). Still, Christy considers herself lucky. She had skilled medical help and emergency equipment. “This happens to mothers all over the world and many die because there’s no way to save them.”
Christy hooked up with CARE and became their maternal health ambassador. She went back to college for her master’s degree in public health, formed Every Mother Counts and filmed No Woman, No Cry. “My hope from day one was to mainstream this issue in a big way. We brought it to the Tribeca Film Festival, CARE’s conference and universities, but we wanted a bigger audience. Oprah’s people understood immediately that a Mother’s Day presentation would be ideal to bring it to the general public. It feels like it’s been a long pregnancy with lots of pushing. Finally, she’s being born.”
Global maternal health changed during Christy’s labor of love. The film originally included the long-held global statistics: 500,000 deaths annually from pregnancy related causes, with the US ranking 41st for maternal mortality. Christy says, “The global number everybody is rallying around now is 343,000 annual deaths. That’s great, but unfortunately, US rank dropped to 50th.”
We talked about what this juxtaposition says about American access to healthcare and education, diabetes, obesity, medical-legal and health insurance issues. Christy says, “ When I show this film around the world, people are most shocked by US statistics. They really don’t get it. One woman in France said, ‘I never paid one penny to have my children and I had excellent care.’ For American women, we all know, regardless of insurance, having a child is expensive.” That means many don’t get the care the need to avoid becoming a statistic.
What about the connection between increasing c-sections and increasing mortality rates? Christy sees this trend all over the world. “There will never be enough doctors and midwives to care for women in rural settings. C-section skills can be taught to all kinds of health care providers. That’s important to improve outcomes. Unfortunately, it’s becoming a leading model of care that’s getting out of hand. I was in Guatemala recently at this brand new birth center. It didn’t have a generator, but, hey, the hospital next door did so that was good. They had mostly women doctors and I’m thinking, ‘Great!’ They had their statistics on the wall and I’m thinking, “Excellent! Transparency.” But every single patient had a c-section. This was a teaching hospital and people wanted to practice, but patients won’t want to return to their birth center after this experience. And now these women need expert medical care because that c-section made them vulnerable to risks in their next birth. Maybe the US numbers will be a red flag to other countries that we’re using the wrong model of care.”
I’ll share more of my conversation with Christy and viewing party details next week, but I’ll leave you with Christy’s insight: My goal is to increase education and health care options for all mothers. Women have unlimited capacity to give, love and provide. When mothers stand together, nothing’s more powerful.”
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.