Why is childbirth still sometimes fatal for women, and what measures is modern medicine taking to reduce these risks?
In: Biology
A baby’s head is too big for the hole it needs to come out of. This makes it harder for the baby to come out safely because it needs to be in exactly the right position – a bit like a (meaty) shape sorter. Otherwise, the baby can get stuck, and that can lead to extreme tiredness and stress (the mother’s body working too hard), which can kill both the mother and the baby, or bleeding, which can also kill the mother or the baby.
Even if the baby does manage to come out exactly right, there’s a second bit called the placenta which also has to be born. It’s like a big, slippery, veiny frisbee that attaches to the baby’s belly button and feeds the baby while it’s in its mother’s tummy. Sometimes, the placenta doesn’t come out properly – a bit of it can get left behind. This can lead to bleeding – which can kill the mother – or to infection, which can also kill the mother. Infection is when germs get into your body and make you ill. If an infection gets REALLY bad, you can die.
Talking of infection: the womb (the space in a woman’s body where a baby grows) is like a big, open wound just after a baby’s born – so there’s a lot of space for germs to grow in and make the mother very ill. Again, if she gets ill enough, she can die.
That’s how I would explain the basics to a five year old. Not even going into things like pre-eclampsia or amniotic fluid emboli or any of the other less common but still eminently deadly conditions that can appear peri-natally.
A big part of it is that up until birth, the mother is delivering all the oxygen, food, and waste exchange the infant needs via blood contact with the placenta. It requires pushing an enormous amount of blood past the placenta every minute. When the child is born, the blood flow needs to stop and allow the placenta to leave the body without bleeding out. Sometimes it goes wrong, and the mother risks bleeding to death.
The changes in the blood circulation to support an infant can also cause high blood pressure, clots, diabetes, anemia, and other issues that risk the mother’s life. The exposure of the blood supply to outside bacteria via C-section, wounds, or incomplete removal of the placenta can lead to fatal infection.
The main successes of modern medicine have been better pre-natal monitoring to see if blood conditions are developing, better surgical/obstetric techniques to shut off bleeding as soon as possible, and better access to antibiotics. But none of those are perfect, tragically.
People come in all shapes and sizes. The mother’s underlying health plays a rather major role because pregnancy is very taxing on the human body. Things like age, high blood pressure, overweight, underweight, smoking are shown to correlate to difficult pregnancies. On top of that are things that can happen BECAUSE of pregnancy – very high blood pressure, anemia, diabetes etc.
Modern medicine has been ENORMOUSLY successful in reducing pregnancy risks. Just modern economies like US. In 1900, on average 850 women out of 100,000 died due to pregnancy. Today, this is in the range of 10 per 100,000 births. This is 85 times less. Even taken at a global level – the maternal mortality rate today is way below that of 1900 USA. Most countries have made significant (ie double digit percentage) decreases even in the last 25 years.
Longer article:
[https://www.who.int/news-room/fact-sheets/detail/maternal-mortality/](https://www.who.int/news-room/fact-sheets/detail/maternal-mortality/)
Here’s an article from [The Atlantic](https://www.theatlantic.com/books/archive/2024/06/invisible-labor-book-review/678723/?utm_source=msn) from just two days ago that explains a tiny slice of the problem.
In developed nations death due to complications from childbirth is EXTREMELY low….but no matter how advanced we become the risk is never zero
In 1920s is was close to 900 per 100000 births; in 202; it was 19 per 1000000
Most childbirth deaths occour in less developed nations where medical care is infrequent or low quality and often both.
Latest Answers