Hoped-for drop in childbirth deaths not happening

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Eleven days after her son Benjamin's birth by C-section, Linda Coale awoke in the middle of the night in pain, one leg badly swollen. Just as her doctor returned her phone call asking what to do, she dropped dead from a blood clot.

Pregnancy-related deaths like Coale's appear to have risen nationwide over the past decade, nearly tripling in the state with the most careful count — California. And while they're very rare ... they're nowhere near as rare as they should be. The maternal mortality rate is four times higher than a goal the federal government set for this year.

... "Maybe as many as half of these are preventable."

Two years after Coale's death near Annapolis, Md., her sister says topping that list should be warning women about signs of an emergency, like the clot called deep vein thrombosis, or DVT, that can kill if it breaks out of the leg and moves to the lung.

No mention here of warning women of the risks of caesareans! The majority of which are not necessary and are therefore entirely preventable.

... A jump in cesarean deliveries that now account for almost a third of births. One in five pregnant women is obese, spurring high blood pressure and diabetes. More women are having babies in their late 30s and beyond.

... black women are at least three times more likely to die from pregnancy complications than white women, and research is too limited to tell why.

Then there are the near-misses. For every death, 50 additional women suffer serious complications of pregnancy or delivery ...

At issue are deaths directly related to pregnancy or childbirth, up to 42 days after delivery. In 2006 ... there were 13.3 maternal deaths for every 100,000 births. A decade ago, the rate hovered around 7 — and by this year, the U.S. government had hoped to lower it to 3.3 deaths. California in 2006 charted 16.9 maternal deaths for every 100,000 births, up from a rate of 5.6 in 1996.

How pregnancy-related deaths are coded and counted changed during that time period, but ... only about 30 percent of the increase may be due to that.

At the request of California health officials, Main is finishing an in-depth study of maternal deaths that already has prompted a project to reduce hemorrhage in 30 of the state's hospitals.

"Jumping on it early is very important," says Main, who worries that hospitals can lose track of bleeding that happens a bit at a time until "before you know it, you've bled a lot."

Among other safety steps:

* Seek early prenatal care ...

* Hospitals should consider using compression boots on C-section patients ...

* C-sections can be lifesaving but women should understand how to reduce their chances of needing one — because next pregnancies tend to end in C-section, too, and repeat C-sections increase hemorrhage risk. Coming to the hospital before you're properly dilated or seeking induction before the cervix is ready unnecessarily increases the C-section risk ...

What about saying no to caesareans? Health professionals are not obliged to perform unnecessary surgery!

Melissa Maimann, Essential Birth Consulting 0400 418 448