Today we thank moms for the unconditional love and understanding, but two news items make us think this Mother's Day requires a better understanding of what mom needs when she first becomes a mom.
Kayla Goscinski will not be here to share the day with her three children, newborn Hudson, 2-year-old Joanna and 4-year-old Edward. She died May 3 from complications after Hudson's birth on May 1.
The 31-year-old Belleville woman was a new PTA board member and her friend called her "super mom." Her passing leaves a huge void.
"I was in love with her soul," husband George Goscinski said.
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This was her third cesarean birth. She developed an amniotic fluid embolism, which can lead to heart failure. The condition is seen in 1 out of 400,000 pregnancies in North America.
Kayla's death may not have been preventable, but it is a reminder that the United States is failing to keep a close enough watch on new moms.
American women die in childbirth at a higher rate than in any other developed country, according to an investigation by ProPublica and NPR. The startling part is that the rate is getting worse.
For every 100,000 live births, more than 26 U.S. women died in 2015. The rate was only 17 deaths in 1990. Compare that to China, where the 1990 rate was 114 women dying, but in 2015 dropped to just under 18 per 100,000 births. In Norway the rate is fewer than 4 moms.
With all our emphasis on health insurance coverage, on saving premature babies, on surgeries in the womb and intensive neonatal care, what are we missing?
Focus on moms, mainly.
The investigation found the U.S. rate was driven by older moms and a high rate of cesarean sections, but there were also more controllable health and public policy issues. Among the findings:
- Babies are seen as fragile, but the danger to moms is poorly understood. Only 6 percent of the state and federal block grants for maternal and child health go towards moms' health. Medicaid covers babies for a year, but moms for two months. Only one hospital in the U.S. has a unit for high-risk moms, but more than 20 in the past decade established units for high-risk babies.
- Medical professionals, especially nurses, don't properly understand the dangers to moms. Half of the nurses surveyed didn't know the maternal mortality rate was rising, only 24 percent properly identified heart issues as the leading cause of maternal death and only 12 percent knew most of the deaths happen in the days and weeks following delivery. If nurses don't understand, they cannot educate their patients.
- Hospitals are usually ready for a fetal emergency, but are often unprepared for a maternal emergency. Protocols vary across the country.
In real numbers, each year between 700 and 900 American women die — more than two a day — and 65,000 come close from complications of childbirth. About 60 percent of the deaths are preventable if only hospitals and doctors pay more attention to moms.
Heart problems, bleeding, infection and pre-eclampsia, a form of pregnancy-induced high blood pressure, are some of the biggest killers and can usually be stopped before they are fatal. The United Kingdom had only two pre-eclampsia deaths during three years because they focus on the condition and examine every maternal death.
So what to do?
One of the big needs is education. New moms typically get less than 10 minutes of instruction about complications.
We can expect the health care system to pay better attention, emphasize prevention and move faster to improve outcomes. One study showed it takes an average of 17 years for a new medical protocol to be widely adopted in the U.S.
Obesity, diabetes and kidney disease all can lead to trouble after delivery, so those moms need to be watched closely. African-American women are three times as likely to die after childbirth, so awareness is a start there. You can learn about the risks, especially of pre-eclampsia — mom's heartburn may be a symptom of something deadly. If mom says something is wrong, don't rest until a medical professional gets to the bottom of it.
Moms traditionally visited their baby doctor as long as six weeks after giving birth. Three weeks is the new standard, and patients should insist on it.
But the most essential thing may be to offer new moms help. If they are overwhelmed by their new or multiplied duties, they are less likely to pay attention to themselves and keep that three-week doctor's appointment.
Let's keep mom alive after she gives us life. That would lead to the happiest Mother's Day.