On Monday, June 17,
ACNM Vice President for Global Outreach Suzanne Stalls, CNM, spoke at a
congressional briefing sponsored by ACNM, AMREF USAI, AWHONN, Frontline Health
Workers Coalition, IntraHealth International, Jhpiego, and White Ribbon
Alliance for Safe Motherhood. Below is an excerpt of her comments. Her full
text comments are available here.
I am pleased that we are here today to discuss the
challenges that face women’s health access around the world and here in the
United States. The annual rate of maternal deaths today is equivalent to 939
Boeing 777s crashing every year, or 2 to 3 of these jets crashing per day. The
lifetime risk of dying in pregnancy and birth is 1 in 8 in Afghanistan and
Sierra Leone; in Ireland it is 1 in 48,000. Can you imagine any other public
health scenario where so many deaths occur and such huge disparities exist
without an enormous public outcry?
One might think that these bleak numbers and circumstances apply
only to the developing world. While 99% of the maternal deaths occur in the
developing world, the situation in the United States is alarming. We spend more
than $111 billion annually on care related to childbirth, spending twice as
much as France, and yet we rank 31st in Save the Children’s 2011 Mother’s
Index. The top 5 countries in this index are Norway, Australia, Iceland,
Sweden, and Denmark. All of these countries have midwifery as the front line
model of care for women.
Women in the US now have a higher risk of dying from
pregnancy and birth related complications than in 45 other countries. Our
maternal mortality ratio has doubled since 1987. With the 47% decline in
maternal mortality around the world, we are one of only 26 countries where the problem
Given this disturbing snapshot of both the world and here at
home, where do we go from here and what can we do?
There is a shortage of midwives and obstetrical providers
throughout the world. It is estimated that by 2015, with enough skilled and
competent midwives supported by a functional health care system, more than two
thirds of the maternal and newborn deaths could be averted. To ensure access
and adequate supply of providers, it is essential that the federal government
continue to invest in the growth of midwifery education programs and midwifery
students. ACNM appreciates the investments Congress makes each year and urges
continued support for midwifery education through Title VIII of the Public
Health Services Act.
Currently there are 2 major bills that members of Congress
can support or co-sponsor to improve the health of moms and babies:
The MOMS 21 (HR 2286) Act, sponsored by Rep.
Lucille Roybal-Allard will ensure greater national focus on improving maternity
care. Part of this bill would enable designation of a maternity care shortage
so that critical workforce issues can be identified and addressed and measures
instituted to foster growth in the professions of obstetrics/gynecology and
The Quality Care for Moms and Babies Act (S.
#425/HR #896 introduced by Senators Stabenow and Grassley and Rep. Eliot Engel)
will provide funding for inter-professional collaboratives to improve care and
updating quality measures used by Medicaid. In addition, this bill would direct
the Agency for Healthcare Research and Quality (AHRQ) to develop surveys to
measure the care experience of childbearing women and newborns.
My children often ask me when I am going to retire. I tell
them that I can only rest easy when I know that there is no longer a woman in a
remote village in South Sudan who is bleeding to death by the side of a road
for lack of a medication that costs several dollars, or a woman who dies from
eclampsia in Pakistan because of the gender inequity which prohibits her from leaving
her house to seek the care she needs.
My grandfather, a small town physician, watched his wife die
from a pregnancy-related complication that could easily have been treated today.
His hair turned white in 6 months; my grandmother left behind 3 small motherless
children who have felt her loss their whole lives. I would ask you to join with
us in working to end such a senseless tragedy.