Reply to US ranks 40th in places to give birth. Really?

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[quote=Anonymous]way, way too many c/s and other interventions brought on by a fear of litigation.   Countries with lower maternal and infant mortality have MUCH lower rates of medical litigation across the board.  The interventions may lead to complications but they also protect practitioners from being sued.  A woman may die from hemorrhage from a c/s (because by it's very nature there are risks) but unless there was a gross error the physician will be fine (as he should be--even a c/s performed perfectly has risks! it's MAJOR abdominal surgery).  However, had he not done the c/s in the first place and something went wrong with the pregnancy he would be held liable for not doing c/s.   And so if there is any question, he does the c/s.   And so the cycle continues and continues and leads to the 50% c/s rate in many hospitals.

Also, it is REALLY difficult to get young, poor women to seek prenatal care.  Mostly because they have no support at home--no one to drive them to the doctor, no one to take care of other children, etc.  Way too many other life issues that take precedent over getting weighed and measured every 1-4 weeks in pregnancy.  Most (if not all) states make it INCREDIBLY easy for women to get state insurance for prenatal care.  In fact, they have very liberal income limits (much higher than for traditional Medicaid) and will back pay providers who start care before the woman is insured.  Plus they pay providers better than traditional Medicaid pays for other medical issues.  In Maryland (where I worked as a midwife), they actually pay BETTER than most private insurance plans.  However, it's just REALLY, REALLY hard to get the inner-city teenage population to go to the doctor/midwife.  Health departments dream up all sorts of intervention programs using nurses in school, etc, etc. but none of it really works.  It's to the point where it's ingrained in the culture.

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