OPINION: The Indiana maternal mortality rate is high. Blame our healthcare system.

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As a woman in my early 20s, childbirth isn’t exactly on my immediate radar. It’s somewhat of an abstract concept, considered only when my mother tells me to be careful because women in my family are notoriously “fertile myrtle” or when my Flo app prompts an alarming and frankly unwarranted “Early Signs of Pregnancy?” informational tab. 

In sum, it’s not a topic I’ve strongly considered beyond the general premise of potentially having a child many years from now. Of late, however, I’ve felt compelled by our healthcare system — or lack thereof — to more seriously examine my potential maternity, and its potential effects on myself, my family or my future children. 

Therefore, this tasks women with doing our own research and coming up with our own plans when faced with childbirth. We must do this not only to protect our babies but to protect ourselves. Infant mortality rates have fallen to a historic low, but this has come at the expense of maternal care, which is largely neglected in lieu of prioritizing fetuses, according to ProPublica and NPR.

Not only does childbirth have the propensity to be risky in general, but this is especially the case in the United States. In the developed world, the U.S. has the worst record of pregnancy or childbirth-related deaths at between 700 to 900 deaths and around 65,000 near deaths each year, according to NPR. These rates are especially high in Indiana.

Last month, the IndyStar published a series of research and reporting on maternal mortality in the state. It found significant inaccuracies in the ways maternal deaths are being classified, what stage in the postpartum process these mothers actually die and whether their deaths were pregnancy-related or pregnancy-associated. Pregnancy-related deaths are caused by a complication from the pregnancy or childbirth itself whereas pregnancy-associated deaths include all deaths within a year after birth, regardless of the cause.

In general, the IndyStar found a lack of reliable reporting from the state, cases where cause of death couldn’t be determined and discrepancies between different states regarding maternal mortalities. 

Though Indiana’s Maternal Mortality Review Committee is aware of and working toward rectifying past mistakes, this leaves a substantial question mark for women looking for reliable pre- or post-natal care. Having a child can be an intense process anywhere, but particularly for Hoosiers. 

In general, the Star’s reporting also showed rural Hoosiers are at particular risk due to “obstetric deserts,” or places without birthing wards. Black women are also at higher risk due to frequent neglect for legitimate concerns expressed not only during childbirth, but in the delivery of healthcare for Black people generally. It also found substance abuse and mental health concerns as contributing factors to postpartum deaths. 

So what as women are we supposed to do? The Centers for Disease Control and Prevention recommends maintaining a healthy lifestyle and addressing all health concerns before conception. But what about the near 50% of all pregnancies that are unplanned? What about the women who don’t have access to healthcare at all?

For women who do have healthcare, elected C-sections put them at an increased risk for life-threatening complications. Going into labor on Saturdays or Sundays also heightens risk for complications, otherwise known as the “weekend effect,” which causes a 50% higher mortality rate, more blood transfusions and more perineal tearing. 

I’ll try to remember all that when my water breaks. If you see that happening on a Saturday or Sunday, no you didn’t.

All joking aside, we need to take women’s healthcare more seriously and provide greater and more substantial options to pregnant women. Though hospital births deserve ample support for those who choose them, we should also dismantle the stigma surrounding midwives and at-home births, as many women choose these options for their reduced cost, freedom from hospital and healthcare biases and ability for more autonomy in the pregnancy process. 

Though these internal conversations might seem premature to 20-somethings, they’re not necessarily unjustifiable. It’s important to take healthcare into your own hands, especially considering recent blows to a woman’s right to choose. Though it’s unfair and deserving of greater societal attention, I can’t sit idly by and wait for something to happen to me. I will do everything I can to avoid becoming another contributor to this state’s abhorrent maternal mortality statistic.

Natalie Gabor (she/her) is a senior studying journalism with minors in business marketing and philosophy. She hopes to one day find a career that tops her brief stint as a Vans employee.



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