Dr. Priya Agrawal on Maternal Mortality
Maternal mortality is a difficult subject to discuss. There is no polite way to address it. As we close out Mother’s Month it’s important we address that maternal mortality rates in some areas of the US are higher than in sub Saharan Africa. 50% of maternal mortality cases are preventable. This is a human rights crisis in USA. Mothers are the crux of community and we need to not only protect our babies during birth, but our mamas too. We spoke with Dr Priya Agrawal who is a part of the Merck For Mothers Initiative to eradicate maternal mortality worldwide.
Mama Glow: Why is maternal mortality on the rise in the US?
Dr. Priya Agrawal: When people think of maternal mortality, they don’t think of it being a problem in the US, and that has lead to complacency. So we don’t have the answers to the “why”. We need people to invest in the research. We do know the three major killers are: postpartum hemorrhage, pre-eclampsia, and pulmonary embolism.
- Postpartum hemmorage: excessive bleeding during birth and postpartum- it happened to Christy Turlington Burns and ignited her passion for maternal health.
- Pre-eclampsia: high blood pressure during pregnancy and childbirth.
- Pulmonary embolism: one of the most common, is when you develop a blood clot in the leg for instance and it travels to the lung and becomes fatal.
These are the three leading causes but why are these on the rise? Currently what the US maternal health community is saying is:
- We aren’t collecting the data state to state. Not every state records maternal deaths, that’s a basic tenant for figuring out what is going on. Maternal death is called a “never event” sort of like a plane crash. Whenever it happens, you have to figure out why- that isn’t happening in most states.
- There is no Code Blue– we don’t have a streamlined protocol for care across the board in the event of an emergency. There is too much variation in care and that leads to problems.
- Not all women are entering pregnancy healthily. Chronic disease is on the rise so if women can make sure to take charge of their care during pregnancy that would decrease the chances for issues during labor and later in life. What happens during pregnancy impacts your life.
There is a silence on this issue so the silence breeds a lack of awareness.
M.G: Is that silence cultural, we want to sweep it under the rug?
Dr. Agrawal: Women’s issues never get airtime. It’s always about infant mortality. We must remember that the woman is the pillar of society. To have a healthy child you need a healthy mother- period. There is so much focus on the child and very little advocating for the mother. Women are not strong advocators for themselves. We advocate for each other but not for ourselves. We need to use our voices and power to advocate for the women who are suffering and dying.
M.G: How does technology play into the education, advocacy, and the shift?
Dr. Agrawal: 60% of the deaths that are happening are happening postpartum. You go to your app store on your mobile phone and find only apps for taking care of the baby- nothing for looking after yourself. So we are developing an app for supporting postpartum moms. It will also allow women to get answers to certain questions. Everyone has a phone attached to them nowadays so tech plays a huge role. If you’re informed- knowledge is power. If you’re more responsive then the providers have to be more responsive. I think a Yelp for Health would be great for women to be able to vote for the best providers: did they get quality care, did they get respectful care, these sort of concerns are important. A lot of parts of America are isolated. You can bring care to women via technology and make it accessible. We have the ability to do this now.
M.G: Why Merck for Mothers? Why take on the huge task of holding the institutions responsible and get to the bottom of maternal mortality?
Dr. Agrawal: Merck for Mothers is a global initative in 30 countries and 3 years old. No one is focusing on this so we knew we needed to do something. Of the Millennium goals number 5 was the most pressing- maternal mortality. How can we use the resources Merck has to tackle a huge global health challenge. The number one problem is lack of awareness so we are grateful to you, Mama Glow, because you are part of the solution.
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