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Boise fan

USA the Most Dangerous Place To Give Birth In Developed World

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https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/07/26/maternal-mortality-rates-preeclampsia-postpartum-hemorrhage-safety/546889002/

"Every year, thousands of women suffer life-altering injuries or die during childbirth because hospitals and medical workers skip safety practices known to head off disaster, a USA TODAY investigation has found."

"Doctors and nurses should be weighing bloody pads to track blood loss so they recognize the danger sooner. They should be giving medication within an hour of spotting dangerously high blood pressure to fend off strokes."

"These are not complicated procedures requiring expensive technology. They are among basic tasks that experts have recommended for years because they can save mothers’ lives."

"As a result, women are left to bleed until their organs shut down. Their high blood pressure goes untreated until they suffer strokes. They die of preventable blood clots and untreated infections. Survivors can be left paralyzed or unable to have more children."

"...the U.S. continues to watch other countries improve as it falls behind. Today, this is the most dangerous place in the developed world to give birth."

"Countries around the world have reduced maternal deaths and injuries by aggressively monitoring care and learning from mistakes. The result has been two decades of steady or reduced maternal harms in the rest of the developed world – as U.S. rates climbed."

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I only skimmed the article, but I wonder whether this is related to the rise in natural childbirth, things like "baby friendly" certifications and unquestioned devotion to breast-only feeding that is really becoming a thing in American maternity wards today. They already put newborns and mothers who have c-sections at risk.

Planning is an exercise of power, and in a modern state much real power is suffused with boredom. The agents of planning are usually boring; the planning process is boring; the implementation of plans is always boring. In a democracy boredom works for bureaucracies and corporations as smell works for skunk. It keeps danger away. Power does not have to be exercised behind the scenes. It can be open. The audience is asleep. The modern world is forged amidst our inattention.

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3 hours ago, Boise fan said:

https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/07/26/maternal-mortality-rates-preeclampsia-postpartum-hemorrhage-safety/546889002/

"Every year, thousands of women suffer life-altering injuries or die during childbirth because hospitals and medical workers skip safety practices known to head off disaster, a USA TODAY investigation has found."

"Doctors and nurses should be weighing bloody pads to track blood loss so they recognize the danger sooner. They should be giving medication within an hour of spotting dangerously high blood pressure to fend off strokes."

"These are not complicated procedures requiring expensive technology. They are among basic tasks that experts have recommended for years because they can save mothers’ lives."

"As a result, women are left to bleed until their organs shut down. Their high blood pressure goes untreated until they suffer strokes. They die of preventable blood clots and untreated infections. Survivors can be left paralyzed or unable to have more children."

"...the U.S. continues to watch other countries improve as it falls behind. Today, this is the most dangerous place in the developed world to give birth."

"Countries around the world have reduced maternal deaths and injuries by aggressively monitoring care and learning from mistakes. The result has been two decades of steady or reduced maternal harms in the rest of the developed world – as U.S. rates climbed."

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This is such a ridiculously stupid article.

Another example of journalists being too stupid to understand what they are writing about.

The measures that are used depend on each countries reporting systems.  The U.S. is militant and honest about complying with these systems and our standards of reporting far exceed what the World Health Organization requires.  The U.S. statistics are reporting all deaths and complications from conception to the end of the first year of life.  The WHO statistics are from conception until the the mother leaves the hospital.   So if a premature baby dies a week after its birth and the mother had already left the hospital it doesn't count in the WHO statistics yet it would count in the U.S. statistics.  Not only that but U.S. hospitals try to save every birth after the 5th month.  The WHO reporting requirements do not count premature births before the third trimester.

Just like all the bullshit education statistics that ignorant people use.  This article without the data to look at is not an honest comparison.

That doesn't even count comparing the population dynamics in the different countries being compared.

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22 minutes ago, smltwnrckr said:

I only skimmed the article, but I wonder whether this is related to the rise in natural childbirth, things like "baby friendly" certifications and unquestioned devotion to breast-only feeding that is really becoming a thing in American maternity wards today. They already put newborns and mothers who have c-sections at risk.

I don't think so. But even if it were involved with natural childbirth, the issue of high blood pressure is still there.  Attending to the causes and conditions and applying the proper treatment are commonplace in other developed countries and apparently are being ignored here. 

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1 minute ago, bluerules009 said:

This is such a ridiculously stupid article.

Another example of journalists being too stupid to understand what they are writing about.

The measures that are used depend on each countries reporting systems.  The U.S. is militant and honest about complying with these systems and our standards of reporting far exceed what the World Health Organization requires.  The U.S. statistics are reporting all deaths and complications from conception to the end of the first year of life.  The WHO statistics are from conception until the the mother leaves the hospital.   So if a premature baby dies a week after its birth and the mother had already left the hospital it doesn't count in the WHO statistics yet it would count in the U.S. statistics.  Not only that but U.S. hospitals try to save every birth after the 5th month.  The WHO reporting requirements do not count premature births before the third trimester.

Just like all the bullshit education statistics that ignorant people use.  This article without the data to look at is not an honest comparison.

That doesn't even count comparing the population dynamics in the different countries being compared.

You haven't read the article, have you cupcake?

 

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15 minutes ago, Boise fan said:

You haven't read the article, have you cupcake?

 

Sure I read it.  You don't understand the words do you.

The anecdotal parts of the article that make up almost all of it, I am sure really got an emotional cripple like you excited.

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Just now, Boise fan said:

You haven't read the article, have you cupcake?

 

I've read the article. Sensationalized for the masses. There are plenty of protocols in place for those conditions and are automatic when you come in to the hospital. The article conflates several conditions including preeclampsia, postpartum hemorrhage, intraoperative hemorrhage and venous thrombosis. These conditions are grilled into an obstetrician from day 1 of residency. Blues is right in that it's the reporting of complications from state to state, country to country that can be suspect. The article infers that quantifying blood loss is a good first step and again this conflates blood loss with preeclampsia. That's not to say there isn't a problem. Smltwnrckr actually is quite insightful in that the trend in obstetrics is toward a more natural, hands off approach to management of labor including use of midwives and home births which can end up with train wrecks dropped off in the hospital. Of course there are bad outcomes that are preventable and it's actually a good step that attempts at improvement in care are a priority. Just leave the sensationalization out of it.

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18 minutes ago, NMpackalum said:

I've read the article. Sensationalized for the masses. There are plenty of protocols in place for those conditions and are automatic when you come in to the hospital. The article conflates several conditions including preeclampsia, postpartum hemorrhage, intraoperative hemorrhage and venous thrombosis. These conditions are grilled into an obstetrician from day 1 of residency. Blues is right in that it's the reporting of complications from state to state, country to country that can be suspect. The article infers that quantifying blood loss is a good first step and again this conflates blood loss with preeclampsia. That's not to say there isn't a problem. Smltwnrckr actually is quite insightful in that the trend in obstetrics is toward a more natural, hands off approach to management of labor including use of midwives and home births which can end up with train wrecks dropped off in the hospital. Of course there are bad outcomes that are preventable and it's actually a good step that attempts at improvement in care are a priority. Just leave the sensationalization out of it.

Are you an OBGYN by chance ? You sound pretty educated about this 

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1 hour ago, NMpackalum said:

I've read the article. Sensationalized for the masses. There are plenty of protocols in place for those conditions and are automatic when you come in to the hospital. The article conflates several conditions including preeclampsia, postpartum hemorrhage, intraoperative hemorrhage and venous thrombosis. These conditions are grilled into an obstetrician from day 1 of residency. Blues is right in that it's the reporting of complications from state to state, country to country that can be suspect. The article infers that quantifying blood loss is a good first step and again this conflates blood loss with preeclampsia. That's not to say there isn't a problem. Smltwnrckr actually is quite insightful in that the trend in obstetrics is toward a more natural, hands off approach to management of labor including use of midwives and home births which can end up with train wrecks dropped off in the hospital. Of course there are bad outcomes that are preventable and it's actually a good step that attempts at improvement in care are a priority. Just leave the sensationalization out of it.

Certainly not an expert on the subject as I have only been involved with 2 births of my own child plus a couple as a first responder in training.  But I have seen this being pushed a lot these days.  Nothing wrong with a dula or midwife being in the hospital but I think it's nuts that everyone has this opinion that it's a natural process and we should be able to do it at home with no complications just like the middle ages....  My wife would have died on the way to the ER from postpartum hemorrhaging had we not be in the hospital.  Never going to convince me that home births are a good idea.....

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I'm with HR on this matter...my boys mother nearly died due to extreme blood loss during birth. Had our doctor not been as sharp as he was, it would have been really bad...dude had a surgical team ready in an OR and a transport/prep team parked outside the birthing room. When he said "go", it was like a choreographed activity...after a few hours, she was done in the OR.

You will never convince me of the hemp crowd middle ages home birth thing being "okay".

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Mike Bronson, on 27 Sept 2013 - 8:45 PM, said:

 

    Don't be mad because the refs are going to need Tommy John surgeries after this poorly played game.

 

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mugtang, on 27 Sept 2013 - 8:49 PM, said:

 

    Your mom is going to need Tommy John surgery after jerking me off all night.

 

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6 hours ago, NMpackalum said:

I've read the article. Sensationalized for the masses. There are plenty of protocols in place for those conditions and are automatic when you come in to the hospital. The article conflates several conditions including preeclampsia, postpartum hemorrhage, intraoperative hemorrhage and venous thrombosis. These conditions are grilled into an obstetrician from day 1 of residency. Blues is right in that it's the reporting of complications from state to state, country to country that can be suspect. The article infers that quantifying blood loss is a good first step and again this conflates blood loss with preeclampsia. That's not to say there isn't a problem. Smltwnrckr actually is quite insightful in that the trend in obstetrics is toward a more natural, hands off approach to management of labor including use of midwives and home births which can end up with train wrecks dropped off in the hospital. Of course there are bad outcomes that are preventable and it's actually a good step that attempts at improvement in care are a priority. Just leave the sensationalization out of it.

I haven’t read the article but benchmarking against other countries is never a bad idea.   In my experience, organizations rarely change unless benchmarks show them to be sub-standard.   To Blues point the benchmarks should be apples to apples but organizations will often avoid apples to apples comparisons to not look bad.   In this case it would seem further investigation is warranted as to the root causes.  

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16 hours ago, sactowndog said:

I haven’t read the article but benchmarking against other countries is never a bad idea.   In my experience, organizations rarely change unless benchmarks show them to be sub-standard.   To Blues point the benchmarks should be apples to apples but organizations will often avoid apples to apples comparisons to not look bad.   In this case it would seem further investigation is warranted as to the root causes.  

Generally agree. It's always difficult to get apples to apples comparison because self reporting by insurance companies, practitioners, hospitals etc are inconsistent at best. It's difficult to compare States much less countries because definitions of common conditions are often different. In this aspect at least, single payer , employed provider staff and government hospital ownership would make comparison of root cause analysis easier. Until then, it's a struggle. That said, despite the headline of the article, there isn't a place in the industrialized world where I would want to deliver a complicated pregnancy other than the US.

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