BlogHer - BlogHers Act - Comments

Kudos to BlogHer

amygeekgrl — Fri, 16 May 2008 12:57:57 -0500

I admit I did a doubletake, but loved seeing that number jump up yesterday. Thank you, BlogHer. :)

Amy
Crunchy Domestic Goddess
BlogHers Act contributing editor

Thanks for the links - Added them to my personal blog

amygeekgrl — Fri, 16 May 2008 12:55:40 -0500

Thank you all for posting the links to your Bloggers Unite posts. I added them to a post on my personal blog yesterday.

I finally got my own Bloggers Unite post up late last night: Women, children resort to eating dirt cookies in Haiti: Global Food Crisis

Amy
Crunchy Domestic Goddess
BlogHers Act contributing editor

mine's up

laurie — Thu, 15 May 2008 22:06:34 -0500

Nothing like the last minute.

It's kind of fuzzy on the details but it's more about a commitment to actually do something.

And examples.

With links, of course.

Here it is.

Laurie

www.notjustaboutcancer.blogspot.com

Since you are extending the project

Vered — Thu, 15 May 2008 19:55:50 -0500

I added the widget to my sidebar, but I have 2 questions, which I am going to ask here, since I'm not sure where else to ask them:

1. There was a smaller widget - I would prefer to use that in my blog - where can I find it?

2. Any chance of the widget becoming customizable color-wise, or is it one-size-fits-all type widget?

Thank you

Vered DeLeeuw
www.momgrind.com

Just made my monthly donation..

debra roby — Thu, 15 May 2008 17:20:25 -0500

I give myself an "allowance" for fun stuff: searching for used DVDs of movies I like, going out to lunch, getting my eyebrows waxed..

And once a month I figure out what I spent on fun and just give the rest to Global Giving through the buttons. This month, no time search those DVDs, so Global Giving got lucky!

Debra
A Stitch In Time
Deb's Daily Distractions

I reloaded and saw the jump and I was proud

Denise — Thu, 15 May 2008 15:50:57 -0500

Thank you Elisa - and BlogHer. Seeing that jump made my entire day.

I'm thinking my next donation will happen in the days before I move to Illinois. All of those jars of change that have been accumulating around the house in the six years I've lived here... they're going to the bank and from there to one of these projects.

~Denise
BlogHer Community Manager

Flamingo House Happenings

No problem...It's a great cause.

Catherine Morgan — Thu, 15 May 2008 13:44:22 -0500

I turn on the news first thing when I wake up every morning, and today this was the first thing I saw. And ever since I learned how to make my own video clips, I've been going video clip crazy. :-)

Contributing Editor Catherine Morgan at catherine-morgan.com, The Political Voices of Women, Care2 Election Blog

Thanks for posting the

amygeekgrl — Thu, 15 May 2008 12:57:03 -0500

Thanks for posting the video, Catherine.

Amy
Crunchy Domestic Goddess
BlogHers Act contributing editor

Nice coverage

Denise — Thu, 15 May 2008 12:07:28 -0500

Great link, Catherine.

~Denise
BlogHer Community Manager

Flamingo House Happenings

CNN coving this story -- (see video clip)

Catherine Morgan — Thu, 15 May 2008 10:25:35 -0500

Contributing Editor Catherine Morgan at catherine-morgan.com, The Political Voices of Women, Care2 Election Blog

Ours is here

alyssaroyse — Thu, 15 May 2008 08:57:36 -0500

The brilliant Anne-Marie McReynolds wrote hers on JUST CAUSE IT.

___________
Alyssa Royse
JUST CAUSE: A Web Site To Save The World

Start Her Up: A blog for Women Entrepreneu

I'm all over it

Mamikaze — Wed, 14 May 2008 22:49:53 -0500

my post is:

Campaign to End Fistula

Mamikaze

http://lifeontherunblog.com

Bloggers Unite

Britt Bravo — Wed, 14 May 2008 12:21:08 -0500

Thanks for the link to Bloggers Unite. I'd never heard of it before.

Beautifully stated. Happy

lalagirl727 — Sun, 11 May 2008 12:26:29 -0500

Beautifully stated. Happy mother's day to all the mamas and almost-mamas! We truly do make the world go 'round!

Mommy to a tween and two sets of toddler-age twins - eeek! Blogging at Twinfinite Chaos

Replying to Amy Tutuer on Mother's Day

Ina May — Sun, 11 May 2008 10:56:47 -0500

How interesting that I would find your blog on Mother's Day. Amy Tutuer is right about Group A strep infection and the very real possibility that Claudia Mejia's was not a hospital-acquired infection.

I do have some comments about the rest of her post. She wrote: "There was a large increase in deaths from indirect maternal causes
(pre-existing disease aggravated by pregnancy) and deaths from maternal
causes more than 42 days after delivery or pregnancy termination. These
increases could be real, or they could merely reflect the fact that
death certificates now have additional questions on them that are
designed specifically to identify late maternal deaths."

Maybe Dr. Tutuer didn't mean it to read this way (I suspect she didn't), but late maternal deaths are just as important to track as deaths within the 42 days after the end of pregnancy. That's Point 1. Point 2 is that she failed to mention that only some states' death certificates have additional questions on them that are designed specifically to identify late maternal deaths. This is important: most states still do not have such questions.

Can we agree that it would be good for every state's death certificate to have the additional question asked in the way that the US Standard Certificate of Death now calls for? (The question was not even on the 1979 and 1989 Standard Certificate of Death because of the perception of some that there wasn't enough space! How about a larger piece of paper?) I found it shocking years ago when I first found out that our states don't even collect the same information. I'm not aware of any other country that allows this degree of chaos in its system. The CDC stated in 2007: "In 2003, only four states could capture information consistent with the standard." These states are Idaho, Maryland, Montana, and New York (including NYC). Surely, Dr. Tutuer and I should be able to agree to work together (not against each other) to apply the pressure to the rest of the states so that every one follows the US Standard. That would be a good starting place, but we need a lot more than this to fix what's wrong in our maternity care mess. And, contrary to what she claims, I do not blame this all on obstetrics. However, I do believe that ACOG could do more to help fix our problems, and I'm sure that she would have more influence with that organization than I.

Let's not miss the point that our own Dept. of Health and Human Services states that the maternal death rate should not exceed 3.3 deaths per 100,000 births. Even if we're doing a little better at ascertainment than we were a few years ago, our death rate is still way higher than it should be. It's extremely high for women of color.

"There were 473 direct maternal deaths in 2003, and 492 direct maternal
deaths in 2004, an increase of only 19 deaths. The rate for direct
maternal deaths rose from 9.3/100,000 to 9.6/100,000, a change that is
not statistical significant."

Dr. Tuteur dismisses this increase of "only 19 deaths" as "not statistical (sic) significant." i'm pretty sure that those 19 families are really missing their mothers today and every day. I can tell you that the ob.gyns with whom I speak in the UK are not so dismissive when they discuss maternal deaths. I think we have to care about every unnecessary death and seek to reduce these in the future. 3.3/100,000 is an attainable goal, even taking into account the inherent risks of pregnancy and chlidbirth.

"The rate of underreporting of maternal deaths is no different than in
many other first world countries, and we are taking steps to improve
surveillance and reporting methods. Far from trying to hide maternal
deaths, we are actively seeking out as much information as possible. "

Dr. Tutuer is correct in saying that some other wealthy countries have large rates of underreporting (France is one) and that some steps are being taken to improve reporting. I'm not sure from her comments that she read my article in Mothering, but it's available on the web. I'd like to discuss it with her. At any rate, she can't claim that the four countries of the UK are among the countries with substantial underreporting problems, and that is the standard that I think our country should follow. That is why I began the Safe Motherhood Quilt Project nearly a decade ago.

Additionally, she is factually incorrect when she claims that we are actively seeking out as much information as possible. If we were doing that, we would make sure that death certificates were uniform in the 50 states, Puerto Rico, Virgin Islands and Guam; we would make sure that physicians had proper training and incentives to fill out the cause-of-death section accurately (the CDC wrote in 2001: "Physicians receive minimal training in how to correctly complete death certificates." and "According to the NCHS (which uses ICD terms and definitions for maternal mortality), the completeness and quality of maternal death reporting could be improved if physicians completed the cause-of-death section of the death certificate more accurately."); grieving families wouldn't be talked out of having autopsies by a risk manager labeled as a grief counselor following a maternal death; autopsy rates would go up sharply, especially in larger hospitals and insurance companies would be required to pay for them (several countries make autopsies mandatory for possible maternal deaths); we would dispense with the honor system of maternal death reporting; audits would become possible; and there would be mandatory extra-hospital mortality and morbidity review committees functioning according to the best guidelines in every state. At present, fewer than half of the states have such systems of review. In my opinion, the ACOG should call for every one of these reforms. If it did, we would see these changes within a very few years, and then we might have a chance to see the maternal death rate go down for a change.

"The purported increase in maternal mortality is the result of improved reporting, not an increase in maternal deaths."

This is factually wrong. Neither Dr. Tutuer nor the CDC (by their own admission) has the facts to make this statement.

"These stories are receiving copious media attention (you wouldn't know about them if they were not)."

I guess that "copious media attention" means one article in Mothering magazine. There'll be another published in the Journal of Perinatal Education next month. If the project makes the NY Times or Washington Post or the wire services, I'll agree that the attention is copious.

"The baseline maternal mortality rate would predict approximately 40,000
maternal deaths per year in the US. Instead we have only 400-500. "

If Dr. Tutuer paid closer attention to the facts as stated by the CDC (which does not claim to have a 97% rate of ascertainment that is based upon additional surveillance techniques, as does the UK's Confidential Enquiries), she would not confidently claim that we have only 400-500 deaths per year in the US. Why the obfuscation?

"Ms. Gaskin represents herself as shocked at the current rate of
maternal mortality. Perhaps that because she is unaware of the inherent
dangers of childbirth. The Safe Motherhood Quilt is a publicity stunt.
As far as I can tell, Ms. Gaskin herself, and direct entry midwives in
general have done NOTHING (no research, no education, no fund raising
and no outreach to victims' families) to reduce the incidence of
maternal mortality. Apparently, maternal mortality is not the real
issue; criticizing obstetrics (inappropriately and unfairly) is the
real issue."

i will admit to having been so naive as to have thought for many years that our maternal death rate was among the lowest in the world. The World Health Organization stated in 2007 that 40 countries have lower maternal death rates than we do, and many of these countries have far better rates of ascertainment. Contrary to what Dr. Tutuer claims, I did not start my "publicity stunt" to inappropriately criticize obstetrics. I believe that mothers, their families, obstetricians, family physicians and midwives are all ill-served because we in the US haven't yet created an infrastructure adequate to the task of accurately ascertaining every maternal death possible that occurs each year in this country. I have been in many other countries, many of which aren't as wealthy as our own, that do a far better job of gathering this necessary data. Slovenia is just one of these. So, yes, I have been learning shocking things about maternal deaths in the US. I did not expect to find women dying for lack of sufficient postpartum attention after hospital discharge (or even in hospital following birth or amniocentesis, amnioinfusion, or vaginal birth). Google these names, you, too, might come to understand that we could be doing better for our mothers: Galit Schiller, Tameka McFarquhar, Virginia Njoroge, Elizabeth Davis (+ Danville, Virginia), Heather Egan-Haynes, Melissa Farah, Valerie Scythes, Tina Long (+ Tripler Army Base), Caroline Wiren, Carrie Krone, Julie LeMoult, Jasmine Gant, Elisha Crews Bryant, Mara McGlade, Jennifer Adams, Inamarie Stith-Rouse, Sabine Elias, Lynne Saiter, Genesis Metcalfe, Gwyneth Vives, Tatia Oden French, Julie Crowley + Mountain Home, Arkansas.

As for the NOTHING that Dr. Tutuer claims that I have done regarding maternal mortality, I have actually carried a lot of research (has she ever sat down and read the full report of Why Mothers Die/Saving Mothers' Lives for any given triennium?) and outreach to families of mothers who have died. I have trouble understanding how she can claim that what we have in place reaches the standard set by this excellent system. See www.cemach.org.uk and you can download the huge pdf copy for free and see what I mean.

I'm even trying fundraising because the expenses for the project are increasing beyond my ability to keep up with them, and there is a DONATE button on my website (backed by a 501 c 3 organization called Rocinante). When my website is more developed (my son is currently working on it, so there should be 160 women's names and quilt blocks represented there very soon), I will be able to display some of the comments that have come to me from families of women who died from pregnancy-related causes. By the way, some of my informants and contributors of quilt blocks are ob.gyns, nurse-midwives and family members.

I know that many women need to take better care of themselves as well
and that this, too, is a factor in our comparatively high death rate. But if ACOG's British counterpart can
participate in the reflective practice of publishing Saving Women's Lives and making it easily available to the public, why shouldn't we follow their example? What would be wrong with that? Sorry, I couldn't figure out how to get rid of the underline.

I have shown the quilt at several medical centers in this country and have been urged by obstetricians and epidemiologists to continue this work. It's Mother's Day, Dr. Tutuer. Please realize that it's easier for me to collect the names of women who wanted natural births in birth centers or at home who died than it is for me to obtain names of women who died in hospital. Once we get a good system in place, I'll be happy to give up my "stunt" and make a happier quilt—perhaps the one you have suggested. But every time I show the quilt, I hear of another 4-5 names, most of which took place during the last year or two, and the number of deaths that follow induction at 40 weeks or so and c-section for singletons, twins or triplets is higher than most women (or physicians, I suspect) imagine. And the refusal of the insurance companies, so far, to pay for the postpartum home visits that our women should be getting after hospital discharge is something that we should all be able to agree should end.

Ina May Gaskin, MA, CPM

Curator, The Safe Motherhood Quilt Project