99% of Maternal Deaths occur in Public Hospitals

SKing

Silver
Nov 22, 2007
3,747
163
63
RD con 173 muertes maternas? 2011; van 30 en 2012


Some significant quotes from the article:

"En la mayor?a se comprob? que hubo negligencia m?dica."

"La mortalidad materna ha sido impactada, sostienen las autoridades, pero todav?a las madres siguen falleciendo en los hospitales por causas evitables."

"En casi todos los casos est? involucrada la deficiencia en la calidad de los servicios por parte del personal de salud y de los centros."

"No es casualidad que compartamos el premio con Ruanda, Afganist?n y Camboya, tres pa?ses extremadamente pobres y con sistemas deficientes."

SHALENA
 

dv8

Gold
Sep 27, 2006
31,271
358
0
not a good time for me to read this. my sis in law had c-section in the morning. private hospital but still the same crappy service.
 

Eddy

Silver
Jan 1, 2002
3,668
218
0
RD con 173 muertes maternas* 2011; van 30 en 2012


Some significant quotes from the article:

"En la mayor?a se comprob? que hubo negligencia m?dica."

"La mortalidad materna ha sido impactada, sostienen las autoridades, pero todav?a las madres siguen falleciendo en los hospitales por causas evitables."

"En casi todos los casos est? involucrada la deficiencia en la calidad de los servicios por parte del personal de salud y de los centros."

"No es casualidad que compartamos el premio con Ruanda, Afganist?n y Camboya, tres pa?ses extremadamente pobres y con sistemas deficientes."

SHALENA
Has anyone ever visited a public hospital. The animals in a slaughter house get better treatement. Blood all over the place,bathroom, floors walls filthy, bring your own sheets for the bed. C-Section, you’re probably out the same day. They cut you open like gutting a pig. Pathologists sew up a cadaver better than the surgeons do a living person. Oh yea, we have a metro and big shopping centers. Almost forgot.
 

dv8

Gold
Sep 27, 2006
31,271
358
0
C-Section, you’re probably out the same day. They cut you open like gutting a pig. Pathologists sew up a cadaver better than the surgeons do a living person.
this i have seen, on a haitian girl who came to the pharmacy to get something for her c-section scar. all the way from between titties to inside her panties. with smaller, horizontal stitches. barbarity.
 

Lobo Tropical

Silver
Aug 21, 2010
3,031
96
48
It really is a crime!
I immagine most of this at the low end hospitals of public health.
I hope at least at the high end hospitals in Santiago and Santo Domingo there is better service.
One family member had an examination two weeks ago at CMB- Bournigal in PPL which seemed clean.
An other family member survived a C section last week at a low end public hospital in PPL and stayed a few days.
As we discussed before the DR has a percentage of C sections which is way too high, and consequently uneccesary.
Who knows better than Shalena?
 

Castle

Silver
Sep 1, 2012
2,982
0
0
Just for the sake of the argument, it would be good to know what is the % of births in public hospitals and in private clinics.
 

dv8

Gold
Sep 27, 2006
31,271
358
0
it does not surprise me. public hospitals charge money and patients are clients. serving them is business. so the level of service is considerably higher. public hospitals are reality of all those who have no money and no insurance. or no money and insurance that does not cover maternity services.

there was an article few months back contributing high maternal mortality to the number of teenage pregnancies. apparently there are far more dangers if the mother is young and undernourished.
 

SKing

Silver
Nov 22, 2007
3,747
163
63
So......

To play devil's advocate and to look at both sides of the story there are also other reasons that the majority of maternal deaths occur in the public hospital....
- Usually women who have the ability to birth in a private hospital have insurance and/or money. They usually have adquate or excellent preventative care. The women arriving at the public hospital mostly do not see a doctor unless they are pregnant. Lots have undiagnosed conditions such as diabetes, hypertension, cardiac disease, etc.
- The public hospitals receive the haitians who just show up not having had any prenatal care. Pre-Eclamptic, HIV positive, with a multitude of other co-morbitities.
- The public hospitals do not have enough staff and there staff are not well-educated.
- The public hospitals receive the majority of pregnant adolescents who in themselves come with an array of issues.

Now that we've estableshed that there are some reasons WHY you are more likely to die giving birth in a public hospital that has nothing to do with the above causes. Some of these things are proven while others are my personal observations.
- There is a non-chalant attitude among the staff. Some really could care less. This is my personal observation. Women are treated as if they are nothing. So if they are nothing, who cares if they die, right?
- The quality of care in public hospitals is lacking. They have no money for continuing education, alot of the doctors do not keep up with new studies and standards of practice which we know that especially in OB, is paramount to good care. In OB the standards change all of the time with new evidence, studies, etc. If you do not keep up with it, as most doctors in pubic hospitals don't, you may actually be giving care that was ok before but at present is actually harmful. This is proven (not my opinion). I saw in one hospital where there big rate of death was postpartum hemorrhage that after vaginal delivery the women are put into a 6 bed "recovery room" where they recover for 1-2 hours before going to a postpartum room. They lay in the bed for 2 hours then go to their room. The first hour after delivery is critical for Postpartum hemorrhage, the fundus and vital signs should be checked every 15 minutes. In this first hour, a woman can be left alone and if not checked, she could fal asleep and bleed to death. This happens alot in DR. I teach my ladies to check their own fundi and bleeding. I tell them to try not to sleep the first hour, they can go to sleep once they get into their postpartum room. I educate them on what are the signs that they are bleeding to much and how to advocate for themselves if no one is taking them seriously. One girl told me that after delivery, NO ONE checked her fundus until the next day when the doctor came to see her. She said luckily she was doing it herself!
- The hygiene in the public hospitals is lacking. This is fact, not my opinion. And it is self explanatory. Especially for C-section patients, catching an infection in the hospital and not being diagnosed before you are discharged (because the nursing care is so poor) can be a death sentence.
- Patient education in the public hospitals is lacking. Fact, not my opinion. If patients are not educated on how to take care of themselves once at home, with vaginal or C-section and not educated on the signs and symptoms that there could be an issue and not told when to return to the hospital then your job as a provider was not complete. Many women leave the hospital not knowing simple education facts that could save their life postpartum.
- C-sections make money but are not the safest option for the patient. The C-section rate in DR is an embarrassment. The WHO states that the rate should not exceed 15%, and ours (DR) is between 40%-45%, even MORE in private clinics. Women are women are women, and our bodies have NOT changed so significantly in the last 100 years that almost half of women now need a C-section.

Hopefully the DR will come around, there ARE strides being made. Doulas are now all the rage, more patients are being educated so that they can stand up for themselves. We just need to make enough stink so that instead of just talking about it, they DO something about it.

SHALENA

P.S. I have been named by DONA International as their Regional Representative for the Dominican Republic so I will be overseeing DONA's activities in the country. If you don't know about DONA here is an excerpt from the website.

"DONA International: We are the world's premiere doula organization

Pardon us for bragging, but we are the oldest, largest and most respected doula association in the world. Our founders are among the foremost experts on doula care, and DONA International certification is a widely respected measure of quality and professionalism. We are an international, non-profit organization of doulas that strives to have every doula trained and educated to provide the highest quality and standards for birth and/or postpartum support to birthing women and their families. To that end, we promote continuing education for doulas and provide a strong communication link among doulas and between doulas, families and the medical birthing community.

We are an amazing community with a shared passion for families that reaches around the world. DONA International doulas and the families they serve are in more than 20 countries."
 

charlise

Bronze
Nov 1, 2012
751
0
0
Why is there so many C-section in DR ?? Women can't deliver naturally like it's been done since the beginning of times ???
 

Castle

Silver
Sep 1, 2012
2,982
0
0
Why is there so many C-section in DR ?? Women can't deliver naturally like it's been done since the beginning of times ???
I've found more and more women prefer C-section. They say it's better for their sex life afterwards. Whatever. Many doctors prefer C-sections because it's faster, less work, more profitable, and no late night/bad timing calls.


Maternal deaths are high anyway in DR. I guess it's a combination of factors. Teen pregnancies, malnutrition, multiple pregnancies, uncontrolled pregnancies, etc. It's a shame, given DR has near 100% rate of medical assisted births. As always, of course, we must try to read between the lines to watch out for any agendas, as these rates are not new.
 

Eddy

Silver
Jan 1, 2002
3,668
218
0
I've found more and more women prefer C-section. They say it's better for their sex life afterwards. Whatever. Many doctors prefer C-sections because it's faster, less work, more profitable, and no late night/bad timing calls.
Babies too big
Malpositioned and doctors don't have time to spend repositioning them.
Sex "Of course" actually #1
Don't want pain. #2
 

charlise

Bronze
Nov 1, 2012
751
0
0
I had 2 kids naturally and I'm only 85 pounds and I would choose natural birth anytime over a C-section.... After a C-section you have at least a week of recovery.....

Natural birth, I was walking the next day and shopping the next week...
 

AlterEgo

Administrator
Staff member
Jan 9, 2009
19,740
873
113
Playa Najayo & South Jersey
Why is there so many C-section in DR ?? Women can't deliver naturally like it's been done since the beginning of times ???
Well, I agree there are too many Caesarians in DR.

Don't forget that a lot of women used to die in childbirth. With my first child, after 25 hours of labor my BP was off the charts and his heartbeat was spotty - C-Section. 100 years ago it's possible we both might have died, so they do have a place. I was shocked the first time I heard about an 'appointment' for a c-section was being made by a first-time mother. Let me tell you from experience - the recuperation from one isn't a picnic.
 

SKing

Silver
Nov 22, 2007
3,747
163
63
C-Sections are warranted medically in approximately 15%-20% of pregnancies. Rates any higher than this require investigation. In DR, done reasons for Hugh C-Section rates are
- Doctor convenience
- Pay is higher
- Request from mom concerned about her vagina
- Request from mom to avoid pain of vaginal delivery
- Having first C-section for medical reason and bring told age can only have C-Sections after

THE WHO STATES THAT NOWHERE IN THE WORLD ARE WOMEN ARE SO MEDICALLY UNSTABLE THAT IT NECESITATES A C-SECTION RATE OF OVER 15%-20%

SHALENA