It used to be really dangerous to be a woman. It used to be even more dangerous to be a low-income woman. The decrease in maternal mortality rates is a fairly modern thing, as the following graph of maternal mortality rates illustrates:
The data on maternal mortality is complicated by the way statistics are collected and recorded, is the mortality the result of a complicated pregnancy (one in which the woman dies within 42 days of delivery)? Or, is it the result of a direct obstetric problem (omissions, or incorrect treatment)? Or, should the death be classified as an indirect obstetric death, one in which existing conditions or diseases were aggravated by the pregnancy? However the mortalities were classified, the results were the same.
Significant improvements in women’s health care since the 1930s have reduced the maternal mortality rates such that the topic doesn’t often appear in common discourse in developed nations.
One study published in the American Journal of Clinical Nutrition posited reasons for the decline in mortality rates:
“The sudden and dramatic decline in maternal mortality rates, which occurred after 1937, took place in all developed countries and eliminated the previously wide country-level differences in national mortality rates. The main factors that led to this decline seem to have been successive improvements in maternal care rather than higher standards of living. As a result of this decline in maternal mortality in developed countries, there is now no mortality for which there is a greater disparity between the developed and the developing world than the disparity in maternal mortality rates.” [Am.Jrnl Clinical Nutrition] (emphasis added)
Thus, it’s not just that we are “eating better,” the reduction in maternal mortality rates is connected to “successive improvements in maternal care.” Cavalierly dismissing the inability to access general and maternal health care for women by saying, “There are other clinics…,” (yes, IF they are located in places where women need them, and IF they are affordable) or “Title X will cover the expenses…” (yes, if Title X funds are still available after all the Republican presidential candidates have promised to cut them), is an invitation to reverse the trends in those successive improvements which reduced maternal mortality rates in the first place.
Black Bordered Invitations
The Republicans at the state and federal level are doing their best to insure that the maternal mortality trend reduction is reversed. Some samples:
“The Arizona Senate has approved a bill that would shield doctors and others from so-called “wrongful birth” lawsuits. Those are lawsuits that can arise if physicians don’t inform pregnant women of prenatal problems that could lead to the decision to have an abortion. The Senate’s 20-9 vote Tuesday sends the bill to the state House.” [AZCapTimes]
What’s wrong with this picture? Are Arizona Republicans saying that if there is a condition or disease present during a pregnancy which could result in an “indirect obstetric death” it is allowable for a physician to withhold the information in order to avoid a possible decision to terminate the pregnancy? And, the grieving husband will have no recourse to the courts if an obstetrician fails to tell the family a pregnancy could be fatal?
Is a physician supposed to ignore the potential complications related to hypertension and heart disease, or pituitary or adrenal gland problems which could be fatal, all in the interest of encouraging the family to carry the pregnancy to term? What happened to “first, do no harm?”
Then there was New Hampshire 2011:
“In June, the state of New Hampshire exercised its right to decline renewal of a $1.8 million contract with Planned Parenthood of New England, which operates clinics – including those where abortions are performed – in the state,” the leader of the pro-life political group said. “It is well within the purview of the New Hampshire state government to decide not to continue to subsidize America’s abortion giant with taxpayer dollars.” [LifeNews]
The fact that only 3% of Planned Parenthood’s total services involve abortion procedures seems to have escaped them. [PP] This would be the state in which approximately 64,500 women of child bearing age and who have maximum incomes of 250% poverty line level need help obtaining contraceptive medication. This would also be the state in which the abortion rate was well below the national average. And, this would also be the state in which unintended pregnancies cost the state and federal government about $27 million. [Guttmacher]
Deep in the heartlessness of Texas. Governor Rick “I can’t remember the third thing” Perry suddenly remembered that if he refused federal funding for women’s health services there was going to be a major hole in money for those “successive improvements in maternal care.”
“The health program provides care to about 130,000 low-income women statewide. It had been expected to close next week, when Texas begins enforcing a law passed last summer that bars state funding from clinics affiliated with abortion providers. The Obama administration has said it will stop funding the program because federal law requires women to be able to choose any qualified clinic. Perry spokeswoman Catherine Frazier countered that Texas has the right under federal law to determine qualified providers in the program.” [WaPo]
That’s a Texas Tall Order to fill a $40 million program without the usual 90% coming from the federal government. It’s going to be a taller order since low income women tend to use Planned Parenthood Clinics as a source of health services (cancer screenings, contraception, etc.) The “They Can Just Go Somewhere Else” argument falls apart quickly when we look at where women in Texas go to find affordable contraceptive prescriptions.
So, according to the Guttmacher Institute 78,490 women in Texas needed help from Planned Parenthood for contraceptive services, and now the Governor believes the state can “fund the gap?” Did the Governor miss the part wherein if the services graphed above were NOT available Texas’s teen pregnancy rate would be 13% higher than it is now? [Guttmacher] It may well take more than a ten gallon hat to fill this void in women’s health care services in the Lone Star State, or “Ladies don’t let your daughters grow up and marry Cowboys…” It will be hazardous to their health.
Just Peachy! Female members of the Georgia Legislature walked out in protest.
“The Senate voted, 33 to 18, to prohibit state employees from using their state health benefits to pay for abortions.
And the Senate decided, by a vote of 38 to 15, that employees of private religious institutions have no right to demand that their insurance policies pay for contraceptives, as the Obama Administration wants to require.” [WXIA, C&L]
A statute enacted in 1999 requiring coverage for contraception hadn’t been controversial in the Peach State until now. So, imagine a female employee of the state of Georgia faced with a pregnancy that could cost her very life, and note that according to this legislation she cannot use state health benefits to terminate the pregnancy? Additionally, even if the federal government requires that the insurance corporation which underwrites the health benefits cover contraception, a female state employee in Georgia can’t even ask for it? This carries “Let ‘em die” to an entirely new depth.
At some point the Kipling Men who are promoting these, and other, egregious plans to reverse the improvements in women’s health made since the Depression Era, are going to electorally discover the truth in Kipling’s poem:
Man’s timid heart is bursting with the things he must not say,
For the Woman that God gave him isn’t his to give away;
But when hunter meets with husband, each confirms the others tale -
The female of the species is more deadly than the male.