Introduction
While childbirth is one of the fascinating issues for many people, it can become the most horrifying accident. The baby can lose the closest person on the first day of life, while the family will simultaneously deal with the happiness of the baby’s emergence and the loss of the beloved person. A considerable number of ladies die every day because of pregnancy-associated issues. This assignment will analyze one of the most prevalent causes of mortality – blood loss in obstetric hemorrhage, figure out the alarming differences in the death rate among African American women during childbirth, and provide current proposals and directions on prevention issues. The thesis statement of the assignment includes the message for the needed attention towards such terrifying causes and suppose possible variants to overcome these awful current aspects.
Pregnancy Associated Mortality and According to Racial Rate
The death rate during pregnancy, during childbirth, or one year after birth is about the same. A total of about 200 women die each year in the United States due to pregnancy-related complications. Significantly, 54–93% of maternal deaths due to obstetric hemorrhage may be escapable (Quantitative Blood Loss in Obstetric Hemorrhage, 2019). This is a relatively high rate for developed countries. There are persistent differences in pregnancy-related death rates among women of different racial and ethnic groups in the United States. According to a recently published study by experts from the U.S. Centers for Disease Control and Prevention’s Division of Reproductive Health (Petersen et al., 2019), maternal mortality rates are much higher among black and Native American women than white or Asian women.
Dominant Causes of Mortality
Most countries worldwide have adopted the term “maternal mortality. The term “maternal mortality” refers to all deaths of women due to pregnancy, irrespective of the duration of pregnancy.
The term refers to all deaths of women due to pregnancy, irrespective of its duration and location, which occur during pregnancy or within 42 days after its termination. Pregnancy-associated conditions or complications arise from pregnancy or management, excluding accidents, miscarriages, or cardiovascular disease (Boyd et al., 2020). The following applies in the case of pregnancy, except for accidents or unexpected circumstances. Some experts believe that 10-15% of maternal deaths are due to medical causes, while 85-90% are due to poor environmental conditions, lack of nutrition, or education (Petersen et al., 2019). Poor nutrition, lack of education, and other factors have been identified as underlying causes of maternal mortality in CIS countries. The quality of life determines what share of medical deaths is attributable to such causes as hemorrhage, hemorrhage, hepatitis B and C, etc. The leading causes of maternal mortality are bleeding, gestosis and sepsis.
Frightening Racial Contrast in Maternal Mortality
The surprising fact of the statistics is connected with the racial differences in mortality rate differences between African American women and others, which commonly do not include the reasons for such awful circumstances. For a long time, the high mortality rate during childbirth was associated with undeveloped countries. Still, statistics in the USA from 1990-2016 show the highest rate among the developed countries, which sounds awful. Despite this, the ratio of African American women’s deaths is worse than in Mexico, where 39% of the population lives in absolute poverty (Levy, 2019). Compared to white women (Peterson et al., 2019), black women have a maternal mortality rate that is 3.2 times higher and 4.3 times higher at ages 30-34.
Black women have 5.2 times the maternal mortality rate from pregnancy complications among women with a college degree than white women (40.2 per 100,000 vs. 7.8 per 100,000). Thus, inequality in maternal mortality is a serious national problem. Experts suggest that this inequality is due to a combination of factors, led by differences in the availability and quality of health care and the prevalence of chronic diseases among women of different ethnic groups (McKinney et al., 2021). Most pregnancy-related deaths are preventable, and ways to reduce maternal mortality are known. Coordination is needed at the level of the patient, family, community, physicians, health care organizations, and the health care system as a whole.
Quantitative Blood Loss in Obstetric Hemorrhage
Currently, the main problem of obstetric hemorrhage has not been solved. Obstetric hemorrhage consistently maintains a leading position in the structure of maternal morbidity and mortality, is a critical, life-threatening condition, complicates 3-5% of births, predictable in the development of anemia, ischemia anterior pituitary lobe (Sheehan’s syndrome or postpartum pituitary necrosis), hemotransfusion, coagulopathy, myocardial ischemia, orthostatic hypotension, postpartum depression (Quantitative Blood Loss in Obstetric Hemorrhage,2019). In developed countries, the rate of MS is relatively low, so it takes 3 to 10 years to collect a sufficient sample based on which to assess the quality of care and the causes leading to MS.
Obstetric Hemorrhage Classification
This part will focus on the simple period-based classification of obstetric hemorrhage and some aspects of this period. Bleeding during pregnancy is distinguished as not related to the pathology of the fetus, which means such occasions as cervical ectopy, polyps of the cervical canal, cervical cancer, varicose veins of the vagina, and vaginal trauma (Konar, 2017). Also, there are bleedings associated with fetal egg pathology, caused by such factors as ectopic pregnancy, spontaneous miscarriage, cervical pregnancy, bubble skid, placenta previa, and premature detachment of the customarily located placenta. Speaking about bleeding during labor is divided into periods. The classification also distinguishes postpartum bleeding, which is associated with such concepts as hypo-atonic uterine bleeding, retention in the uterine cavity of the placenta, soft tissue rupture of the birth canal, and congenital and acquired disorders of the hemostatic system.
Terms of Prevention
An essential factor in the development of obstetric hemorrhage can be called an organizational issue. The main barriers to adequate bleeding prevention are:
- Lack of flowcharts on bleeding control measures or clinical protocols in the delivery room within walking distance.
- Overestimation by professionals of their knowledge regarding the definition of high-risk categories of patients for PPH and their treatment.
- Lack of communication in the team, lack of clarity in the management due to ignorance of each team member, their skills, and experience, frequent changes in team composition.
- Disagreement between team members and allied professionals (blood bank staff, anesthesiologists) about the seriousness of the situation.
- Costs of hierarchy.
All these issues should be addressed at the level of the highest authorities and the organizations; it is necessary to create coordinating bodies and communities that will draw up all the required protocols and schemes (Muñoz,2019). It is needed for such organizations to conduct the required training and staff studies and perhaps provide the required materials even to ordinary people. So that at every level of protection and attention, there is a concrete understanding and capacity to analyze the woman’s condition during, before, and after childbirth.
Conclusion
Obstetric hemorrhage remains relevant to the present day and requires continued research. The wide possibility of open access to the data of the world databases of clinical and scientific research allows one to get acquainted remotely with the latest trends in the prognosis and prevention of obstetric bleeding, study their effectiveness, and implement the obtained knowledge into real practice. While modern realities allow consolidating international scientific and clinical experience in the study of features, differences in the prevention and treatment of obstetric bleeding will update current clinical protocols to adapt them to modern conditions.
References
Boyd, L., Chazotte, C., Illescas, A., Johansson, E., Koch, A., Langston, A., Nathan, L., Searing, H., & Ma. (n.d.). (2020). Pregnancy-Associated Mortality in New York City, 2011-2015. New York City Department of Health and Mental Hygiene.
Konar, H. (Ed.). (2017). DC Dutta’s Textbook of Obstetrics (9thed.). Jaypee Brothers, Medical Publishers Prt. Limited.
Levy, B.S. (2019). Social Injustice and Public Health. Oxford University Press.
McKinney, E.S., James, S.R., Murray, S.S., Nelson, K. & Ashwill, J. (2021). Mental -Child Nursing [eBook]. Elsevier Health Sciences.
Muñoz, M., Stensballe, J., Ducloy-Bouthors, A. S., Bonnet, M. P., De Robertis, E., Fornet, I., Goffinet, F., Hofer, S., Holzgreve, W., Manrique, S., Nizard, J., Christory, F., Samama, C. M., & Hardy, J. F. (2019). Patient Blood Management in Obstetrics: Prevention and Treatment of Postpartum Hemorrhage. A NATA consensus statement. Blood transfusion = Trasfusione del sangue, 17(2), 112–136.
Petersen E.E., Davis N.L. & Goodman D. (2019). Racial/Ethnic Disparities in Pregnancy-Related Deaths —United States, 2007–2016. MMWR Mortal Weekly (68), 762–765.
Quantitative Blood Loss in Obstetric Hemorrhage. ACOG Committee Opinion. (2019). American College of Obstetricians and Gynecologists, 794.