Amnesty International minces no words in its new report on U.S. maternity care. Deadly Delivery: The Maternal Health Care Crisis in the U.S.A., reports that more than 2 women die per day in the United States from pregnancy- or childbirth-related complications, a rate that’s worse than in 40 other industrialized countries. “Preventable maternal mortality
is not just a public health issue, it is a human rights issue,” states Amnesty.

“Women in the USA face a range of obstacles in obtaining the services they need. The health care system suffers from multiple failures: discrimination; financial, bureaucratic and language barriers to care; lack of information about maternal care and family planning options; lack of active participation in care decisions; inadequate staffing and quality protocols; and a lack of accountability and oversight.”

The report profiles several women who died or nearly died because of inadequate, inappropriate, or discriminatory care: one woman dies of a blood clot following a cesarean section, which could have been prevented with simple circulation stockings (a standard prophylactic for other major surgeries); another woman bleeds to death following a C-section, even after she and her husband plead with medical staff to address her troubling symptoms; a high-risk woman experiencing complications late in pregnancy is turned away from a prenatal clinic because she can’t afford a $100 deposit; both she and her baby die after care is delayed.

Each death represents dozens of “near misses” that often leave women in worse health; of the 4 million American women who give birth each year, 1.7 million women experience complications that lead to adverse effects. “The US health care system is failing women,” says Amnesty. Read the full report here.

With the historic news that a majority of the U.S. workforce is now female, it’s clear that American women have more power than ever before, says OB/GYN and bestselling author Christiane Northrup, MD. But is that power reflected in the healthcare available to women? No, she writes in an essay for Huffington Post, especially when it comes to childbirth:

“Our so-called healthcare system, which is a direct reflection of the beliefs of our culture, sees the female body and its processes (like labor) as an accident waiting to happen…The truth is that labor and birth need not be the emergencies we think they are. And the medicalization of birth actually does more harm than good.”

Northrup criticizes the rising rates of cesarean section and labor induction, and cites the rising maternal death rate. “Studies have repeatedly shown that in healthy mothers with no risk factors, home birth is as safe as hospital birth. Increasingly, savvy women who trust their ability to birth normally [and, we should add, who have the resources] are opting to avoid the hospital altogether.”

Northrup concludes the essay with a call to action: “When it comes to pregnancy and birth, we as a culture and as individuals need to wake up and claim our right to literally birth right!”

Here’s more reason to be wary of scheduling birth: a study published in this month’s Journal of Pediatrics found that babies born even slightly premature, at 34-36 weeks, are six times more likely to not survive the first week of life than those born at “term” (after 37 weeks). They are also more likely to have respiratory and feeding problems, body temperature irregularities, jaundice, and brain development issues. According to national data (see below), one in eight babies are born premature in the United States.

Here’s a “due date” calculator worth endorsing. It gives you what it calls a “safe range” for the baby to be born, and explains why thinking in terms of a due date isn’t very helpful — or healthy:

A due date does not mean there is only one safe day for your baby to be born. It is meant to establish a range of time that your baby is mature and safe to be born. Because modern obstetrics narrows this to a specific day, unnecessary interventions, like inducing labor, come into practice.

Indeed, a baby is considered “term” (or fully cooked) between 38 and 42 weeks gestation. The due date is simply the estimate of 40 weeks (the midpoint in that 4 week stretch). So if we think of being “due” as a period of time rather than a specific date, then a woman is not “overdue” once the due date has passed — she has just simply reached the halfway mark in her due month!

The calculator is courtesy of the new web site Mothers Naturally (mothersnaturally.org), which was launched by the Midwives Alliance of North America. If you’re looking to give birth with minimal intervention and maximum support, you’ll find great information and resources at this site.

It has been reported that a very large study published in this month’s Obstetrics & Gynecology found that women who try to give birth vaginally after a previous cesarean are 50 times more likely to suffer a rupture of the uterus than women without a cesarean scar. Is this news? Not really.

Uterine rupture — when a scar on the uterus separates during labor — has been a known risk of vaginal birth after cesarean (VBAC) for decades. The literature has consistently showed a risk of about .5%, or 1 in 200, with what’s called a low transverse scar, the kind most all women get today. The new study found a similar rate, .7%.

The study is already being misreported, though. This local ABC affiliate in Chicago warns that, “women who have had previous caesarean sections and are now thinking about vaginal births might want to think again.” Reuters got it right, with the headline, “Uterus rupture rare after prior cesarean delivery.” But what most are missing or burying is the relationship between induced labor and uterine rupture: induction drugs doubled the risk of a rupture. (Which leads one to question the use of any synthetic oxytocin during a VBAC, even if it is only to “augment” contractions.)

If you were thinking about inducing a VBAC, you might want to think again…

The L.A. Times reports that hospitals are rethinking the induction craze and cites a large Utah hospital chain that “reigned in” the practice with strict guidelines for doctors to follow.

The before: nearly 30% of women were induced into labor prior to 39 weeks gestation (when babies lungs may be immature.)

The after: “Hospital administrators no longer see sudden spikes in deliveries before major holidays, three-day weekends and Jazz basketball playoff games. The program has resulted in plunging C-section rates, fewer newborns in intensive care and fewer medical interventions in delivery. Length of labor has decreased by an average of two hours per patient.”

Other large hospital companies are taking similar action to both lower costs and increase patient safety. “Some doctors do many elective labor inductions at 38 weeks,” one doctor said. “But if you do them long enough, eventually you’re going to have a baby with respiratory distress and complications. And that can be very serious.” Read the full article.