25 Weeks: No Woman No Cry

May 21, 2012

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Continuing on the documentary tour!

The Business of Being Born

Pregnant In America

My friend Hillary brought over No Woman No Cry this week as a very ironic and extreme contrast to Pregnant In America. Unlike the latter, No Woman No Cry follows the stories of four high-risk pregnancies in four parts of the world and how women’s lack of access to healthcare puts them in danger – including death.

The film was directed by supermodel Christy Turlington Burns who herself experienced hemorrhaging shortly after giving birth to her daughter. Burns shares that she was lucky to be surrounded by a medical team at the time, but wondered what would have happened if she had been somewhere remote.

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Janet

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For me, the most moving story was the first one told of Janet, who lives in Tanzania where 1 in 22 women die in childbirth (many from preventable causes). Janet lives in a remote village where the closest midwife clinic is 5 miles away. At 40 weeks pregnant, she walks 5 miles to the clinic and is told that although she is experiencing contractions, she must return home because she is not dilating yet and the clinic needs beds for other patients. Janet then walks all.the.way.back. That’s 10 miles in 2 days. A few days later, she does the walk again – this time in more active labor. While at the clinic, it is determined that because her labor isn’t progressing, she needs to go to the hospital, which is an hour (bumpy bus ride) away. It also costs $30 – a monthly salary for Janet’s family. Her husband doesn’t get involved in the story until she leaves for the hospital, and it is mentioned several times that she doesn’t have any food or money.

Janet’s story just breaks my heart. I can’t even imagine the fear she must have experienced as she makes the trek through the wilderness, much less in pain, worrying about her baby and perhaps her own health and life. It frustrated me that I couldn’t just reach into the screen and share with her some of the things that I have – food, a bike, a car, a comfortable bed. I also can’t imagine how she managed without food or water on her journey. She may have had snacks that we didn’t see, but it didn’t seem likely. For Janet, survival was all that mattered. She was one brave woman. It surely makes me feel a bit different towards birthing in a cozy hospital room surrounded by healthcare professionals. And health insurance. And Pandora playing spa sounds. What luxury.

Even less major parts of pregnancy – like morning sickness – could be a huge complication for someone so isolated from medical care. I am so thankful there was a medicine that could help me take the edge off of my nausea, but what if there hadn’t been? I probably would not have eaten for a month and a half. When severe morning sickness hits these women and there isn’t much food around in the first place, they are really in danger of starvation.

Guatemala + The United States

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In Guatemala, abortion is illegal, even for rape and incest. The film follows the story of one woman who had been hemorrhaging for THREE DAYS before going to the hospital. Once there, the doctors discovered perforations to her fallopian tubes (that would be plural) that were likely caused by a home abortion. Even on the verge of death, the woman was reluctant to admit how this happened.

I can’t even imagine sticking something inside of me to do that kind of damage. But if you think about how horrible the pain must be, remember the women are choosing this option instead of having the child – which – in their eyes, in the context of their lives – must be worse. In these impoverished situations, women don’t necessarily have birth control pills that fail or perhaps even the power to say no to their husbands. Either choice has life-changing consequences.

One of the issues brought up in the movie is what would happen in any country if abortion was illegalized. Last year, 92 anti-choice measures were passed into law across the United States. [Source] If our country turns away from a pro-choice climate, would women will start making dangerous medical decisions to take matters into their own hands like the Guatemalan woman did? It’s easy to suggest they just have the baby and give it up for adoption, but that choice is much more complicated than it sounds. Every situation has unique circumstances. A sticky debate, for sure.

The film also interviewed a clinic that assists women who don’t have health insurance. The cost of a doctor (hospital not included) is $2-4,000, and hospital births can run upwards of $20,000. Sure some of these women could have midwife homebirths in their houses, but what about the ones with complications? Where do they turn? The film states that one in five women in this country has no health insurance. I remember a few years ago when I first got private insurance when I went back to school and I realized it did not include a lick of maternity care (which was sold a la carte). While we didn’t have plans to get pregnant, unplanned pregnancies do happen with all forms of birth control. Imagine if you did get pregnant without insurance and then had a very high risk birth – like triplets that required a c-section. The cost to those who already have little is more than overwhelming. Unfortunately, when faced with the high medical bills, women without insurance are often just not getting the prenatal care they need, which puts both their babies and themselves at risk for serious health situations.

Bangladesh

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The final story was that of Monica, a woman living in a slum in Bangladesh. She shared sentiments that she was embarrassed to go to a hospital and that most women hid in their homes to hopefully have a quick and quiet labor. She also had experienced three years of infertility that was an embarrassment to both her and her husband in their culture. Shame is put on the woman if conception doesn’t happen, and she said her husband might have left her to pursue a more fertile woman (even though it could have been a problem on his end!) When Monica does go into labor, she chooses not to call the midwife support team that is there to assist women who don’t have any medical help. After some scary bleeding, she ends up going to the hospital, at 2am, after hailing down some kind of taxi in the middle of the night. Like Janet’s story, it’s easy to forget that if you live in a slum you probably don’t have a phone to call 911, a car to drive you there or money for a cab. All major barriers to simply get from one place to another. Monica does have a healthy baby and the next day she is back at home carrying on. I couldn’t help but wonder about post-partum practices – was she wearing a “pad” of sorts? Did she tear and have stitches or was the tear expected to heal on its own? Did she have the means to properly treat herself to heal? My guess… probably not.

Missing Pieces

While I understand that the purpose of this film was to show high-risk pregnancies, I wish there had been some attention given to normal births and how they are handled within each culture. I was surprised that Janet’s village didn’t have a woman experienced in childbirth to help her. Maybe it did and Janet just knew her complications went beyond that of the woman’s capabilities. Maybe the village was just too small. My impression of how womankind has handled childbirth throughout the ages is that sisters, mothers and midwives all came to help a woman in labor, but it seemed that Janet was all alone. I had lots of questions about her circumstances that went unanswered – and about births that weren’t in medical trouble.

At the end of the film, they touched on a clinic (I think in Peru) that had a very high maternal mortality rate that had been cut in half thanks to some new practices and education. I would have liked to hear more in the end of the film about education and change and what has worked to help reduce complications and mortality. The film does shadow a doctor, Linda Valencia, MD, who works for Planned Parenthood Guatemala and is working hard to make changes in her country.

I really enjoyed this film as a contrasting perspective to the home birth movement in the US. While I don’t think there’s anything wrong with homebirths, nor do I think our hospital system is anywhere near ideal, it’s still an ironic situation. Childbirth is very normal and natural – except when it’s not.

Read more at Everymothercounts.org.

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{ 52 comments… read them below or add one }

1 Krissy @ Shiawase Life May 21, 2012 at 8:12 am

What a thought provoking post, Kath. Thanks for sharing these stories.

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2 Erin Motz May 21, 2012 at 8:34 am

Loved this. I totally agree with you. It’s all about balance. While there’s nothing wrong with a natural at-home birth, there’s definitely a place for western medicine. People that shun either is a little unreasonable, I think. I come from a family of doctors and they all prefer a natural route up to the point where there’s extreme discomfort or danger. I wish fanatics on either side of the fence would take a step towards the middle. Personally, I can’t see any reason why I’d push for an at-home birth if I was at risk and I was blessed enough to have other safer options. I feel for the women in the documentaries. What a burden to carry…

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3 Jillian @ Reshape Your Life May 21, 2012 at 8:45 am

The health insurance thing is definitely hitting home to my husband and I… We are both self employed and do not have health insurance… We started looking into it because we would like to have children eventually, and come to find out… private insurance in our state doesn’t cover maternity anymore. We’re kind of at a loss for what to do, we don’t have the cash available to just pay for it, and the only insurance we found that minimally covered maternity was over $1,000 a month and you would still have to pay a deductible and 20% of all costs! It’s sad that our modern culture even has this problem!

Thanks for the review on the video, it definitely opens your eyes!

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4 KERF May 21, 2012 at 8:47 am

Oh wow, not even an option? I was thankful ours was pretty affordable, given the 6 month waiting person. I’m sorry you have so limited options.

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5 Amanda May 21, 2012 at 2:00 pm

It is horrible that you have to pay to have a baby. I live in Canada and it’s covered under our universal insurance coverage. I had a little boy and never even saw a bill for anything. It still amazes me that your country will not insure its people. Ridiculous in my opinion.

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6 Carolyn May 21, 2012 at 2:34 pm

I would consider using a midwife then if your insurance won’t cover you. You will save an incredibly amount of money as long as there are no complications.

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7 vegtastic May 21, 2012 at 5:57 pm

That’s not necessarily a given! We have good insurance, but it would cost us way more out of pocket ($8500, assuming no complications) to go the home birth/midwife route.

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8 Kate L. May 22, 2012 at 4:47 pm

See, and being American, I think it sounds crazy that you *don’t* have to pay. I can’t imagine just getting stuff for free. It seems perfectly reasonable to me that to have certain things and to have certain experiences (like having a baby, something no one is forcing you to do) you have to help pay for them. I don’t know how to describe it, but I’m actually proud of every opportunity I have to pay for things and spend my money the way I want to (instead of being taxed more and losing say over what my hard earned money does). Different worlds of course!

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9 Jillian @ Reshape Your Life May 22, 2012 at 6:20 pm

You do realize that “universal healthcare” isn’t actually free right? You pay for it through taxes…

Either way, it’s not that I think having a baby should be free, but paying over $10,000 for INSURANCE for 10 months just to have a baby is ridiculous, which is the point I was getting at… If you are paying 10k plus your deductible and whatever percentage of the total afterwards, you might as well be paying out of pocket.

And thanks for pointing out the midwife option, it was something we have already looked into and is definitely an option, but the nearest one is a little over an hour away, so it’s a little nerve racking to even consider.

Also, for others who may be in my situation, insurance companies say to contact the hospital and/or doctor of your choice and try to work out a deal and payment plan… Apparently you might be able to save some money by doing this and negotiating a price beforehand rather than just going when you are in labor and hoping for the best. :)

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10 Allison May 23, 2012 at 8:42 am

It may not be free, but it saves everyone money in the long term by pooling risk and making sure that people don’t use the emergency room more often than they need to. The US spends more on healthcare than any other similarly-developed country, so while universal healthcare may not be “free,” it’s certainly a better deal than US citizens are able to get right now. Not to mention, it’s in society’s (and the taxpayer’s) interest to have healthy babies who will then need less medical care throughout their life, so it makes sense for the government to devise a system that lets us take care of that out front without parents either paying an arm and a leg to be covered or foregoing coverage entirely because they can’t afford it.

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11 Jillian @ Reshape Your Life May 22, 2012 at 6:25 pm

That’s why we looked into it so early, we figured it would be some kind of addition with a mandatory wait… but with the healthcare reform only a few states mandate that private insurance offer it until the reform actually states what the actual laws are… While it’s in limbo they aren’t required… It’s silly.

I keep joking to my husband to send me away to one of those states to have a baby, it will be like those controversial pregnancies of the 50′s when the daughters would go to “boarding school” for 9 months. lol

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12 smallstatic May 22, 2012 at 8:15 am

Just wanted to throw in my own $.02 and let you know you’re not alone. We moved to VA lazt year and are both contractors (ie, self employed). So we make living wages but don’t qualify for group health insurance. I was shocked to find out that there is no maternity coverage for individual policies here. And lord help you if you ever had to see a doctor for anything non routine. In that case you’ll most likely get denied even for nonmaternity care. Things here are better for women than in the places in the documentary, and thank you to Kath for so aptly and nonconfrontationally illustrating how important it is that we continue to have the choice whether to continue a pregnancy, but health insurance reform, esp. in fiscally conservative states like VA needs to happen asap.

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13 KERF May 22, 2012 at 8:52 am

Hey smallstatic,
I’m in VA and have private insurance and bought maternity care a la carte. Are you sure it’s not available for you?

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14 smallstatic May 22, 2012 at 11:02 am

Yep, pretty sure. In fact when I spoke with Aetna I was told that you can’t get maternity coverage on an individual policy here. We may be confusing private, ie not publically funded/paid for, with individual, ie nongroup, meaning the risk of insuring me isn’t diversed amongst a group. In most circumstances group plans are via an employer so if you’re self employed (or your employer just doesn’t offer it which is becoming more common than you’d think) you apply for what insurers call an individual/nongroup policy but you personally/privately pay the entire premium. I don’t want to hijack the comments with a health insuance debate but I did want to acknowledge what Jillian said because I have been really shocked and disappointed with the health insurance options for individual policies here in VA and I am not sure regulation will be enhanced for our benefit unless we talk about it.

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15 KERF May 22, 2012 at 11:06 am

Hmmm.. It’s so confusing. I have Anthem and was able to add it for $71/mo on individual/self employeed/non-group policy

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16 kt May 21, 2012 at 8:47 am

I hate that crap about “just have the baby and put it up for adoption.” it’s still completely denying the woman agency over her own body.

People in the US already die from botched abortions, because of regulations that have made it harder for lower income and young women/teens to access abortion care. Dr Gosnell in Philly? That happened because that was the cheapest option for so many women affected by terrible state regulations.

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17 Kate L. May 22, 2012 at 4:59 pm

I really do feel for women here and all over the world that find themselves pregnant against their will and/or they just don’t want to be. However, what about the agency of the unborn child? They didn’t ask to be holed up in some woman’s womb that doesn’t want them. It’s a terrible thing that for one person to have agency over her own body (a good thing) someone else’s agency has to be exterminated.

I’m not a pro-lifer that’s against it in all cases – there should be exceptions for those extreme cases of rape, incest, etc. But we have to come to a point as a society where we at least put a time restriction on it. If in by the end of the first trimester (or thereabouts) you cannot stand the idea of carrying to term for whatever reason, fine. But after that, the fetus should have rights and we should live in a society that can recognize that at some point life can’t be ended because a woman decides later that she then wants agency over her body.

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18 Jeanette May 21, 2012 at 8:54 am

Wow! I think it’s so important that we remember how fortunate we really are.

I was lucky enough to spend 10 luxurious days in the local hospital (I’m totally serious, they took such good care of me), while bigger hospitals bid on who would get to birth my son. Once born he was cared for by some of the best NICU nurses in town for 45 days. Without this my son would not have lived.

It’s easy for us to take for granted that if something goes wrong we’ll just head to the clinic or hospital and we’ll be just fine never giving a second thought to all the women and children in this world who are not as lucky. Thank you for this eye opener!

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19 Kate L. May 22, 2012 at 5:04 pm

So true. And we take for granted that anything can go wrong in the first place! We in more more developed areas think if our birth plan isn’t followed perfectly and we can’t listen to Enya (or whatever…:) during labor, that it’s a terrible thing. Just the joy of having an uncomplicated, safe labor and birth that results in a healthy mom and baby is something we should all be more grateful for (and I feel you as a mom that had her baby in the NICU for 60 days).

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20 Kristi May 21, 2012 at 9:15 am

I heard lots of these stories while living in Honduras. Women in my town had to travel 45 minutes by bus to birth at the nearest hospital. While admitted their families were responsible for providing bed linens and all food! Afterwards the ladies traveled back on the bus with their days old babies. Cannot imagine! It definitely opens your eyes to how lucky we are in the US!

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21 Ann May 21, 2012 at 9:18 am

I lived in Togo, West Africa for two years while serving with the Peace Corps. The family I lived with had five children and the mother, Rachael, gave birth while I was there. She also walked 3 miles to the clinic in our village while having contractions. Her husband did not go and went out to the fields to work. I realized later that morning that the other kids had gone to school with no breakfast so I rode my bike to school to give them food. Later that day Rachael got home with a healthy baby boy! She had women at the clinic who helped her but because I wasn’t yet a mom there were questions I could not ask about her experience. It wouldn’t have been appropriate and now that I have a child, I know I wouldn’t have understood the right questions to ask anyway! I don’t know what she did for pain management. Also I cannot imagine how she walked home. I gave birth vaginally and could not walk comfortably for days! I also had tons of bleeding (which is normal)…How was Rachael handling that?!! Rachael’s sister came over to help, but life really went on. Rachael was up and walking and taking care of the kids and house. She even insisted on making me dinner that same night. Her husband and kids expected food, so why not me? CRAZY! I am in AWE of her and all women who give birth and raise families in such circumstances. Thanks for sharing this with everyone!

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22 KERF May 21, 2012 at 9:42 am

THanks for sharing your story too

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23 Elisabeth May 21, 2012 at 9:19 am

That documentary sounds really good! I’m not really planning on having any kids, but I definitely need to check that out.

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24 Carla Runs the World May 21, 2012 at 9:47 am

Look for the BBC show “Toughest Place to Be…” — in this episode, “Toughest Place to Be a Midwife” I think it shows Liberia, and they had a midwife from the UK spend a while there to see the difference. Over there, because of the lack of hospital beds, when women are in labor, the midwives literally push the baby out by forcing it from outside of the stomach. Needless to say, it causes all sorts of complications and hemorrhaging and death. It was horrifying.

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25 Carla Runs the World May 21, 2012 at 9:49 am

Oh yeah, and in Brazil, where I’m from, abortion is also illegal (except in cases of rape), so you hear of people dying, or more commonly becoming infertile, by doing home abortions, or going to clinics (and since those are illegal, there are no regulations). That’s why I’m 100% pro-choice. I don’t think abortion would ever be a decision I’d make for myself (but then again, I never had to make that decision, so who am I to judge?), but I do know that women who don’t want their baby, WON’T have their baby, so might as well provide a safe environment for that to be done.

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26 Michelle @ Turning Over a New Leaf May 21, 2012 at 9:50 am

Great perspectives. I think we can easily get caught up in the home birth, all natural mentality and forget just how necessary hospital interventions can be. Someone commented on your last documentary review about how she was told that “Not everyone is supposed to live.” It got me thinking about just how common dying in childbirth used to be here in the US and still is elsewhere. While I don’t think a C-section is as necessary of an intervention as US medical protocol makes it, it does give light to the idea that perhaps individual births are less “normal” and more “risky” than we like to think they are.

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27 Earthy Nicole May 21, 2012 at 9:53 am

Of course, my heart goes out to all women who deal with difficult and life-threatening pregnancies and child-birth. I feel like it’s often forgotten or overlooked that there are women even in America that have difficulties receiving the care they or their babies need. Even with the help of Medicaid and food stamps, there are women who can’t afford gas to get to doctor’s appointments. And food stamps and WIC only go so far, meaning women have to choose between healthy foods or enough food to feed their family. Some people, sadly, are not educated enough to know when something is the matter with them or their child and don’t receive care until it’s too late.

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28 Jamie May 21, 2012 at 11:31 am

You’re awesome. You’re so likeable and easy to relate too. No wonder your blogs are such a hit! Whether your showing me your wonderful back porch dinner or discussing international abortion law- you really are a joy to read! Thanks for the interesting post- I’ll have to check this doc out!

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29 jen May 22, 2012 at 1:14 am

COMPLETELY AGREE with this is comment!!

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30 Janelle May 21, 2012 at 11:41 am

Thanks for sharing Kath! My husband and I don’t plan to have kids for a few more years, but I appreciate all of the thought-provoking information and stories.

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31 Angel7 May 21, 2012 at 11:51 am

Thanks so much for sharing that, Kath! That film seems like it was very informative! When watching a film of the such, your heart goes out to those women who might be suffering, and wish they could only have a few of the luxuries that we have. More women need to be humbled by watching a film like this. We have a lot to be thankful for!

http://faithfulsolutions.blogspot.com/

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32 Claudia S. May 21, 2012 at 12:44 pm

Hey Kath, thanks a lot for sharing. It’s seems like a very interesting film. But yeah, that’s true about Peru, I’m a peruvian gal. Very high maternal mortality rate is a fact here, specially in the Andes and Rainforest. However and through the years, and also for experience, women there have come to the conclusion that giving birth standing up give them a better chance to survive. It’s because giving birth standing up reduces pressure on the uterus and large blood vessels that can affect the amount of oxygen going to the baby. I was so happy to hear stories like this in my country, but it still makes me think that for the most part we still have a lot to improve in our practices at giving birth.

This an interesting link to read about it: http://www.reuters.com/article/2008/07/11/us-peru-birth-idUSN7B38571520080711

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33 Christina May 21, 2012 at 1:33 pm

There is a great short video on “normal” births in other countries. I’m not exactly sure where you can get a copy, but the title is 5 countires, 6 births, 7 babies. Maybe it can fill in some of the missing pieces from the other video for you?

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34 Jill B. May 21, 2012 at 1:56 pm

Great post! I highly recommend the book “Half the Sky”. http://www.halftheskymovement.org
It’s all about maternal mortality across the world. It touches on more than just childbirth, but it’s one of those book I wish everyone could read. I’m pretty excited that PBS is promoting this movement. There will be a documentary this fall….

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35 Jill B. May 21, 2012 at 1:57 pm

oh! and another documentary that I loved: “Babies”

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36 KERF May 21, 2012 at 2:04 pm

On our list!

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37 Amanda M May 21, 2012 at 3:24 pm

Another book you might like is “Half the Sky”. It won’t help you with your pregnancy, but it might help answer some of the questions you have regarding the video.

As someone very active in the women’s rights community, I appreciate the many issues you addressed. The rate of maternal morality in many parts of the world is shocking. The fact people here can’t get maternity care either due to lack of insurance is deplorable. As another person commented, it’s not even an option without paying thousands of dollars. Holy crap, we can’t even get insurance companies to cover The Pill without a big deal, never mind that the vast majority of companies cover Viagra. “Sex is a choice, if you are female. Men have needs.” The attacks on abortion – I just don’t think these people live in the same world I do. I wish I lived in a world of cotton candy and rainbows where everything worked out and nothing bad happened. But it doesn’t for so many reasons. Do they not know what the other side of the coin is? It’s not like the choice is an easy one (or a form of birth control like so many seem to think).

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38 Erin May 21, 2012 at 3:56 pm

Hey Kath – Thanks for sharing this. I read this post this morning and am still thinking of it now. I don’t know what it could be or look like, but it seems like with your voice and online presence you could help other mothers and inspire thousands of others to help mothers too. I know you have a lot on your plate preparing for your own little one, so this is just a seed of an idea. Best!

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39 Melissa May 21, 2012 at 4:43 pm

Kath- Thanks for this and your thoughtful words. This may be some of the best writing I’ve seen from you ever!

Just to touch on the abortion topic as some others have- the truth of the matter is that if abortions were banned, most of the women who would have gotten them now would still try regardless. What it will come down to is that the rich will find a safe way, and the poor will end up like so many of these sad stories, or worse.

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40 Lauren May 21, 2012 at 7:56 pm

Hi Kath,
I’m an undergrad student studying nutrition in SC and came upon your blog at the beginning of the year. I’ve followed your postings regularly and really appreciate all the hard work you put into creating and maintaining it!

I’m not one to comment often but the abortion topic specifically peaked my interest b/c I volunteer at a local pregnancy center. The women that most frequently visit the center are young and of low income and come in with a variety of burdens and concerns plaguing them. Most of the pregnancies are unplanned and often unwanted and many of the women are seeking the free pregnancy tests we offer so they can either proceed with medicaid paperwork or proceed with abortion at another clinic. My sister who is 20 (I just turned 22) is a counselor at the center to some of the women who come in. She herself had twin boys at age 18 (so she can relate on many levels). She and many of the other counselors most often have clients that feel stuck without a steady income, health insurance, and the myriad of other needs that factor in. Though every need can’t be met, many women that have come into the center have received free ultrasounds and extensive education classes on preparing to become mothers by equipping them with great resources. Pregnancy in America (especially unwanted ones) can be tough but there are great clinics waiting and seeking to help :)

Seeing your pregnancy progress is so exciting! There is evident joy and anticipation about the life that will forever change yours as you know it. Though there are many obstacles facing women with unwanted pregnancies, the lives inside of them are each as precious as seeing your little one grow too. I don’t presume to understand or try to relate to each situation because I can’t, but I do believe each life is important, even the difficult, unwanted ones.

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41 Lisa May 21, 2012 at 9:06 pm

Lovely comment! Every life and beating heart is precious, and I am so glad there are people like your sister able to help and listen to those going through such difficult situations.

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42 Averie @ Averie Cooks May 21, 2012 at 6:35 pm

What a powerful post and thank you for sharing this documentary. I wasn’t aware of it until now and just reading these passages and stories..so much to think about and ponder.

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43 Allison May 21, 2012 at 8:26 pm

This is my favorite post I’ve read of yours, Kath. Access to healthcare for women, including access to safe abortions, is already shamefully lacking in this country and, minus some recent efforts to make sure that a woman’s employer does not also become her doctor, only seems to be getting worse. Anyway, a lot to think about, in this country and others. Thanks for the post.

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44 Kristen May 22, 2012 at 8:01 am

Just being devil’s advocate here… but in the case of Guatemalan women, where health care in general is lacking, do you think just legalizing abortion would be enough? If a woman can’t get adequate care and a safe environment for delivering a child, I’d venture to think that they probably wouldn’t get adequate care and a safe environment for having an abortion.

This site says rural women in Guatemala don’t have much knowledge about contraceptives… that would be a good place to start, and would certainly decrease the # of attempted abortions.
http://www.guttmacher.org/media/nr/2006/10/31/index.html

It is very interesting to read these comments, and I’d love to hear different points of view!

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45 CC May 22, 2012 at 9:26 pm

I recently spent 9 days in Guatemala and in the most rural and poverty stricken areas. My brother was a Peace Corp. volunteer there. The one thing to take into account is(as you aptly mentioned) education. What a wonder that information can do! HOWEVER, one thing few have taken into account on this board is CULTURE and RELIGION in these parts of the world. In Guate, using contraception is a “sin” and culturally the more babies you can have, the better your husband looks. Also, the choice there about the baby IS NOT THEIRS. (We as Americans ofter also neglect this issue, our bodies, our choices, another luxury few women elsewhere have) Women have little rights. Perhaps in this country we should fight for (and abroad) quality healthcare for all, regardless of “beliefs” having to do with culture and religion. (steps off soap box…lol)

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46 Karen May 22, 2012 at 1:24 pm

What a refreshingly deep and meaningful post. You did a terrific job of capturing the highlights and offering your perspective. And, I love this thought provoking discussion offering different views. I had heard of this independent film but you’ve intrigued me enough to hunt it down.

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47 Darien May 22, 2012 at 4:01 pm

If you’re interested in getting a more “complete” picture (i.e., not only the standout stories), you should read Monique and the Mango Rains, http://www.moniquemangorains.com/ . It’s written by a peace core worker, chronicling the two years she spent assisting a midwife (among other tasks) in Mali. The book gives a fairly accurate picture of maternal health care in Africa (although HIV/AIDS is not really touched upon because the events took place in the late 1980′s). A portion of the proceeds from the book go towards funding the Clinic Monique in Mali.

Decreasing maternal mortality was also one of the UN’s Millennium Development Goals, and many countries are training health care workers for this purpose. One other eye-opening PBS video follows a midwife surgeon in-training, http://www.pbs.org/wnet/wideangle/video/birth-of-a-surgeon-video-full-episode/1795/ , in Mozambique.

It’s good to see that you are so thankful for the health care that we have access to in the US, because many people forget the big picture, especially with respect given to women (and women’s health) in various cultures. Best wishes for a safe and straightforward birth! :)

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48 KERF May 22, 2012 at 4:05 pm

Thanks for the resources!

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49 Halee May 22, 2012 at 6:07 pm

Wow, I can’t imagine having to pay for having a baby! I live in New Zealand where any sort of hospital care is free. It costs to go to the doctor (well it’s free for kids, and anywhere up to $75 for an adult to see an after hours doctor), prescriptions are $3 a pop, and hospital admissions/operations etc are free. I can’t imagine having to pay thousands, or pay for a midwife, or having to worry about insurance not covering maternity. NZ is much more expensive for many things, so I guess maybe it evens out over a lifetime?!

In Australia, not only will it not cost you anything to have a baby, but they govt will give you a $5,000 payout!

Such differences.

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50 Jeanette May 23, 2012 at 12:37 am

Wow! No hospital bills? I can’t imagine! That would be so nice.

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51 Michael Tavallaei May 22, 2012 at 7:21 pm

this was a great review and interpretation.

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52 Alicia May 24, 2012 at 4:46 am

I’ve seen this documentary and am writing my Masters thesis on maternal mortality in Somalia. This topic is a passion of mine which may be surprising since I’m not married and don’t have kids yet. However, there is TONS of info out there and could recommend some sites if you want (I just need some time to gather them all).
Even in countries where skilled birth attendants (like midwives) are plentiful, it doesn’t guarantee that women will use them. Indonesia has a really high maternal mortality ration. In attempts to combat this, the government started the Village Midwife Training Program in 1989. There are 300,000~ trained midwives in the rural villages throughout Indonesia. However, majority of the women still go to the local, traditional, untrained woman who was always in charge of delivering babies. The midwives are available to women for FREE because it’s paid for by the government, however, due to cultural issues of not feeling comfortable not paying for services (among others) and not being educated enough, women don’t use the midwives.

It’s an incredibly complicated issue that I don’t think can be resolved with simply having more doctors or midwives. We have to raise the status of women globally in order to get these things to change. If childbirth was something men had to do, I don’t think we’d have the issues that we do have now.

I recommend reading the book “Half the Sky”. It will shed a lot of light on this subject. A documentary for that book will be out in October as well.

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