The Alabama Mothers We Lost in 2018
This article originally appeared Jan. 3, 2019 on al.com
If anyone wants to know what it feels like to bleed to death, they can ask me.
It was nearing midnight. On the operating room table, I felt it happening. I knew something was terribly, terribly wrong. I literally felt the life draining out of me. It is - over 16 years later - the feeling of my nightmares.
The morning after my daughter was born, it's the looks they gave me that I remember.
Even while receiving blood transfusions and barely conscious, I saw the faces of each doctor and nurse as they filed into my hospital room. Their wide-eyed stares told me clearly that I was not supposed to be in this world. To them, I was a ghost.
"You're lucky to be here," one said. Another I had known for years said, with the slightest hint of a smile to let me know he was glad I was alive, "Wow. Rough night?"
I've written about my post-partum depression, but have never talked about the PTSD I also have as a result of briefly slipping away during childbirth. During my C-section an artery was torn. My uterus and cervix were ripped. My organs started to shut down.
"I was," my doctor told me at the time, "sewing blindly because there was so much blood."
I am one of the lucky ones. I am here to tell a story that needs to be told for the women who died.
For years I've not written about what happened because it's overwhelming. It's sad. It's gross. It's upsetting. Guess what? Childbirth can be like that, and not just for me.
America has the worst rate of maternal deaths in the developed world. (We have 26.4 deaths per 100,000 live births. The second-closest is the U.K. with only 9.2.)
But 2019 brings new hope: Just before the new year, the Preventing Maternal Deaths Act of 2017 was passed to give states money to look at maternal mortality so we can figure out why it's happening and what can be done about it. $12 million a year for five years will go to make sure states have review committees to explore maternal deaths. Because without accurate data, we cannot prevent more deaths from happening.
The bad news is that historically, when federal money trickles down to our state, we're not great at knowing how to spend it, or doing it well. Let's keep an eye on this money, Alabama.
Depending on the data used, for every American woman who dies from childbirth, 70-100 more nearly die. Many times, women are blamed, instead of hospitals or doctors who should be held accountable.
Women are blamed for almost dying in childbirth. That needs repeating.
An NPR/ProPublica report, Lost Mothers: Maternal Mortality in the U.S., brought my own journey roaring back to me. It showed that of federal and state funding only 6 percent of block grants for "maternal and child health" actually go to the health of mothers.
"Any time you deliver a baby and two people are alive at the end, it's a good day," a doctor told me after my daughter's birth.
I had never thought about it like that.
That's because American women are conditioned by watching an endless stream of diaper and formula commercials that have smiling mothers who somehow sprung forth with boundless energy after giving birth. They are running and playing and dancing through grocery store aisles, or at home with immaculate kitchens. Movies show maternal bliss just seconds after the baby arrives.
That's not always real. Not even close.
Few people knew what happened to me in childbirth because there was a shame I could not explain when it happened. I felt like I, as a new mother, had let down everyone by not having the perfect birth. It was messy, complicated, expensive, and almost fatal.
I have a memory: In the middle of the night I somehow got tangled in IV/transfusion cords. I tried to be quiet and figure it out myself so that I would not disturb anyone, even though that would have been impossible in my drugged state. I was so confused I grabbed scissors and tried to cut my gown away to release the tangle. I fell. There was blood everywhere. I was hurting. Yet I was concerned with making too much noise.
How ridiculous. I was half-dead and worried about waking someone, but that's the kind of mental gymnastics we make new moms feel pressured to do.
The truth is, women die in childbirth regardless of class or race. It's hard not to scare women by telling the truth but we need to tell the truth: Get your house in order. Make a checklist. Draw up a will, especially if you have other children. Think about funeral arrangements for you and the baby. It's extremely painful to have these conversations, but sometimes life is painful.
I wish I had thought about these things because the whisper-thin cosmic grace that separated me from death that day was so delicate, I still shudder.
In America we still don't measure maternal deaths in a uniform fashion, or sometimes at all. We track premature births (The March of Dimes gave Alabama an F on its report card that was just released), but we don't track maternal deaths or even agree on what constitutes one. Why is a mother's life less important than that of a baby? Does a "maternal death" have to happen during childbirth? What about afterward, days or weeks or months later from complications after childbirth?
The problems are many. Hospitals can't agree on how to treat complications, so women die. Hospitals are often prepared for potential fatal problems with a newborn, but seldom have the same processes in place for the mother.
It is in 2019 in America and this is happening. Women die bringing life into the world. Today I will pause to remember those mothers we lost in 2018. I would love to list their names here, but I can't, because death certificates don't always note maternal mortality as cause of death.
Alabama, let's make sure the money that comes our way is well spent. Let's give these moms the respect they deserve. At the very least, let's count the dead so we can honor the memory of the moms we didn't bring with us into 2019.
If it had been me, I would want to be counted.