Maternal Mortality, Childbirth & The Importance of Education
In recent years, many of the younger members of the royal families from around the world have been getting married and starting families. Most of these new parents can expect the best care modern medicine can offer during the pregnancy, the delivery and the first weeks of having their new baby home. However, this was not always the case, even for the richest and most famous royals of the world childbirth could be deadly.
One such case was Prince Friedrich Victor Wilhelm Albert Hohenzollern, (Kaiser Wilhelm II 1888-1918). When his mother, Victoria (daughter of Queen Victoria of the United Kingdom) went into labor with her son he presented in a protracted breech position. A combination of doctors, without the level of training we can expect today, caused irreversible damage to nerves in his neck and arm, leaving him with Erb’s palsy. This resulted in his left arm being 15 centimetres shorter than his right.
Training doctors and midwives to deal with a breech delivery is now possible with medical simulators such as RealMom 2.0. Understanding the complexities and remedial action necessary for Breech Shoulder Dystocia (MacRoberts Maneuver) can easily be explained between teacher and student without endangering patient safety.
However, while currently many mothers-to-be can expect a safe delivery, the sad reality is that approximately 830 women still die every day due to pregnancy and childbirth complications. Most of the causes could be dealt with by better-trained medical practitioners.
99% of all maternal deaths occur in developing countries and the risk is even higher for women living in rural areas and among poorer communities.
Why Do Women Die?
According to the World Health Organization, the following are the main causes of maternal death:
- Severe bleeding (mostly bleeding after childbirth)
- Infections (usually after childbirth)
- High blood pressure during pregnancy (pre-eclampsia and eclampsia)
- Complications from delivery
- Unsafe abortion
The Development of Childbirth Care
During the middle ages only women were allowed to assist with deliveries & it was thought obscene for men to be present. Death during childbirth was accepted as a fact of life and many pregnant women prepared their will when they found out they were pregnant.
During the 16th century doctors, who had rarely seen childbirth, started writing books and instructional pamphlets to set rules for the assisting midwives. Many of the regulations, unsurprisingly, went against much of the medical knowledge we have today.
Before the invention of forceps, in the 18th century, when a baby became stuck in the birth canal during delivery, only two options were available: breaking the mother’s pubic bone or the baby’s skull. The first option could kill the mother, the second the baby, and many times both would happen. About 100 years after the creation of forceps, the suction cup was developed.
Today, medical students can learn to assist with difficult and even emergency deliveries by using the medical simulator C-Celia for Cesarean deliveries and experience fetal extraction methods including manual delivery utilising fundal pressure as well as vacuum assisted and forceps extraction.
However, it was with another royal delivery that progress was made once again. Chloroform was administered to Queen Victoria for pain relief when she went into labor with her eighth baby. While we know nowadays that chloroform is not safe to be used in this way, at the time its use was groundbreaking. Only in 1591, Eufame Maclayne was burned at the stake for asking to use pain relief whilst giving birth to twins. Suffering pain stoically, particularly in childbirth, was thought to be an admirable quality and anything less was the work of the devil!
Later, delivering mothers started being fully anaesthetised and deliveries made only with the use of forceps and large episiotomies. This practice brought the rate of childbirth-related deaths up once again. While many women from lower-income families delivered at home with midwives who used traditional methods, this form of delivery, using anaesthetics, was the norm within the upper classes up until the 1960’s.
During the 1960’s and 70’s and the increasing medical knowledge of these decades, most deliveries started taking place in hospital delivery rooms with more concern for the well-being of the mothers. Full-body anaesthetic was replaced with natural births and milder pain killers. Water births, breathing techniques, essential oils and epidurals became the norm. And for the first time in centuries fathers started taking an active part in births.
The State of Childbirth Now
Even though childbirth options from home deliveries to water births to C-sections are available to women in developed countries, in many parts of the world women are not able to freely choose what type of childbirth they would prefer. This can be seen in the growing rates of elective C-sections of the past decade.
Right now, the main causes surrounding childbirth deaths and injuries are fully preventable. Many could be avoided with better training by the medical practitioners who support women during their deliveries.
The World Health Organization states that maternal and newborn health are closely linked. As approximately 2.7 million newborn babies died in 2015 and an additional 2.6 million were stillborn, it is particularly important that all births are attended by skilled health professionals.
At 3B Scientific, our vision is to advance medical and healthcare delivery through the quality, breadth, and global reach of relevant educational and simulation products. To improve obstetric training, we now have highly realistic medical simulators that can offer a variety of presentations and possible complications. When doctors and midwives train with them, they are better prepared to deal with these issues when they arise in real delivery situations. It is a fact that skilled care before, during and after childbirth can save the lives of women and newborn babies.
World Health Organisation