We need to talk about maternal mortality rates…

The rates of maternal and neonatal death have been dropping around the world since 2000. That's great news - but since 2016, rates of maternal deaths have remained stagnant. We have to do better. I've been invited by the @GatesFoundation to partner with them and attend the 2023 Goalkeepers conference, which focuses on neonatal and maternal health. Goalkeepers is an organization that keeps tabs on the 17 Sustainable Development Goals set by the United Nations in 2015 (links below), and this year's report & conference is all about maternal and neonatal health. We're not currently on track to meet the goals for maternal and neonatal mortality rates set out in 2015, but we can get there if we get the right tools to the right people.
00:00 Intro
1:34 UN Sustainable Development Goals
2:27 Maternal/Neonatal Deaths
4:49 Obstetric Hemorrhage
9:34 Anemia + IV Iron
11:44 Sepsis
13:24 Infant/Child Health
14:02 Conclusion
Follow me on Instagram (@mamadoctorjones) to see what I'm learning.
Watch Live! Goalkeeper's conference feed (Sept 19, 7pm EST): • Goalkeepers Global Goa...
#Goalkeepers2030 #GoalkeepersPartner #maternalmortality
References:
Goalkeepers 2023 Report: www.gatesfoundation.org/goalk...
United Nations' 17 Sustainable Development Goals: sdgs.un.org/goals
Postpartum hemorrhage bundle research: www.nejm.org/doi/full/10.1056...
Treating sepsis with azithromycin research: www.nejm.org/doi/10.1056/NEJM...
Maternal mortality in the United States: jamanetwork.com/journals/jama...
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** The information in this video is intended to serve as educational information and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/advanced practice provider. **
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[@Kb-gh2rk]

I almost died from placental abruption with my last baby five months ago. Lost 2000 ml. Please please please don’t ever stop the work you are doing. This is so incredibly important. My daughter and I were the lucky ones. Not everyone walks away fine with a healthy baby in their arms, but everyone who gives birth deserves to.

[@CharitysClarity]

Wow Same I had my little boy on the 16th of April, he was tiny an all my others were very big, he was 5 pounds 2!ounces.! He was my 4th and never with any of my others didn’t have this, there was no signs or warning, it was terrifying and the most agony ever, after natural birth I thought I was in the clue until hands were up inside trying to save my life, then I rushed to the er .. it was not fun an I’m still not right

[@whatnotification]

I had the same thing almost 15 years ago. I was actually sent home from the hospital 12 hrs before all hell broke loose because they didn't SEE anything wrong. Later they said that was when I the abruption might have JUST started or something. 4 transfusions for me.... and a long hospital stay for us both we are thankfully doing fine. I don't think my husband took a breathe for four days having to make so many decisions on his own

[@ShhIAmThinking]

Happened to me aswell in 2021 with my son, we were lucky the hospital was so close. But I've had a daughter this year and made it to 38 weeks to when my c section was booked with no problems

[@tianamarie989]

What work? Making you tube videos about it?

[@Kb-gh2rk]

@@tianamarie989 if you think all she does is make KZbin videos about it you must not have even tried to learn about who she is and what she does…..

[@jennydorrance1884]

My friend who just had a baby had a postpartum hemorrhage that wasn't identified until after she passed out. She had been saying that something was wrong and she thought she was losing to much blood but they didn't listen. She was alright in the end but not listening to mothers is a huge factor

[@jmadden7270]

My friend had that happen too. Her husband wanted to sue the midwife. She left and the on call doctor saved my friend. After asking my friend a few questions I told her that her husband was right and the midwife was negligent. I have a 2 year nursing degree, RN, and knew to do things the midwife, 6 yr nursing degree, failed to do.

[@PeteyThePenguin]

Doctors not taking their patients' concerns seriously is a huge issue here. It tends to be worse for women. It's amazing how many medical professionals will essentially just blow you off, and how much money we give them to do so.

[@elisharoberts1029]

Similar story for me. I hate that Drs refuse to listen to their patients sometimes!

[@annhans3535]

@@PeteyThePenguin My niece while giving birth told them that she was not feeling right, she couldn't catch her breath, something was not right. The doctor told her she was hyperventilating and to calm down. She had an embolism. Blood clot in her lungs, the one in her heart gave her a heart attack(she had 2 heart attacks) and stuff in her kidneys. She coded twice before saving her. A few days later she collapsed again because she developed another clot in her lungs. Numerous amounts of blood given because of blood loss. Thank God she is now doing well and in rehab. Baby is fine. She is also an RN.

[@wayfaring_stranger_]

​@@annhans3535that is terrifying!! Why won't medical staff listen, it's so troubling.

[@ChineseKiwi]

Here’s some more sobering facts: In 2020, the maternal mortality rate in the U.S. was 24 deaths per 100,000 live births - more than three times the rate in most other high-income countries. In the Netherlands, almost no women died from maternal complications at 1.2. per 100,000. In Australia this is 2 per 100,000. For black women in the US, the rate is **55** per 100,000.

[@Hippiechick11]

Those statistics are horrible. Especially for women of color. This makes me ill to think about this.

[@tedtimberson4262]

I think you're saying this in a way that it's indicating bad care in the United States. But as said in the video even when controlled for wealth and region POC have much higher likelihood of maternal mortality. So what you're statistics really are showing, is those countries lack diversity.

[@cheekyb71]

​@@tedtimberson4262 ummmm in part, but the research actually shows that the main issue in the USA is the systemic racism within the medical community and the healthcare system in general. Women of colour receive less pain medication in labour because of centuries old belief that people of colour don't experience pain the same way white people do - that's a fact and absolutely nothing to do with the absolutely OUTSTANDING wraparound care women in Europe receive in comparison to the US. Paid maternity leave who dis?? Funded pre and post partum healthcare workers? What? Women of colour aren't believed when they report feelings of unease after birth, they're often told not to worry, where white women are kept a closer eye on and morbidity factors are acted on promptly. You can't just say "those stats don't mean anything because they're white nations"

[@ChineseKiwi]

@@tedtimberson4262 try again. White maternity death rate in the US is 17 per 100,000. Australia has the highest immigrant population in the Western world at around 30% of the population. The US is 15%. Why do Americans like you always try to find dumb excuses?

[@ChineseKiwi]

@@tedtimberson4262 you are anti abortion, which highly contributes to this exact problem. Just shut up. A woman’s body is not a man’s or any one else’s choice. Less BS fantasyland bro.

[@GhostRider-ce3eb]

Maternal death rates in states that restricted abortion were 62% higher than in states where abortion was more easily accessible, new research showed.

[@_Julia.K_]

It is an expected and unevitable outcome...

[@waitaminute2015]

Drs are leaving red states now. Imagine the horror they see and can't help.

[@WildflowersCreations]

​@@waitaminute2015Which will only make the whole situation worse but I can't fault them for leaving. I just feel for everyone still there who can't afford to leave.

[@WildflowersCreations]

My grandparents only escaped Arkansa because my grandfather joined the military. They wanted their kids to have more opportunities and in my grandmother's words "a good education" and that was in the 1960s. Note they are both white, so just imagine how bad it was for anyone who wasn't. Throughout my grandparents life they saw other states get much better but Arkansa and other Southern states stay at the bottom.

[@meahdahlgren5875]

​@WildflowersCreations right

[@BroccoliAndCheese01]

They could not have possibly chosen anyone better than MDJ for this project ❤

[@zenuchiha5263]

Agreed!

[@kellibrenneke2253]

I agree

[@pattyolson3842]

Totally agree!

[@WhitFyffe]

💯

[@noreendeasy2012]

💯

[@d_izzy]

It's humbling for me around this issue, as it was the quick actions of the hospital I was in and of the midwife I had at the time. I had a traumatic childbirth where I lost over half my blood volume as I had a perinatal haemorrhage. Luckily I was in a Western hospital with free access to healthcare. They saved my life.

[@resQfurppl]

thank God!! so glad you’re okay

[@Nevertoleave]

Yeah, we’re really lucky living here. Sometimes it’s easy to forget what boon it is to live in a medically advanced society with universal healthcare

[@Visshaldar]

i was in a hospital in large US city and my mother had to point out the puddle of blood that was 3 ft in diameter and growing to the docs. none of the professionals in the room noticed even though excess uterine bleeding is a known side effect of one of medications they gave me during labor. this happens in western 1st world countries too.

[@liznichols4916]

We nearly lost my sis twice! The actions needed to save her both times were so quick. A moments delay would have had a very different outcome.

[@MiracleFound]

Sadly, the US is at dead last in the developed world.

[@CorwinFound]

You should really do a collab with Hand and/or John Green. They are actively working on this exact issue in Sierra Leone and have raised literal millions to help build and support a maternal health center that is having a direct impact on women and AFAB people in that area. Great work Dr. Jones!

[@kimw3284]

I immediately thought about the @vlogbrothers too. That would be amazing if they did a collaboration video about what Hank and John have been doing with Partners in Health.

[@LizBurman]

Please do a collab! @vlogbrothers @scishow

[@lyndsaybrown8471]

Thought about them immediately at first. They are knee deep in the war against TB, but I'm sure TB doesn't help maternal mortality rates so maybe they can tie it together.

[@blue8ify]

The @vlogbrothers - @hankgreen @johngreen are master multitaskers for the betterment of those overlooked, left behind, unseen and/ or forgotten. I cannot think of one area of humanity that have not set out to lift up in a real life action way that is sustainable and effective. I find them to be the most altruistic people I have seen or heard of. MDJ is a PERFECT partner in their endeavors in Sierra Leone 🇸🇱 . I love this so much!!!

[@WouldntULikeToKnow.]

My first thought too! I hope she sees this!

[@autumnmoonfire3944]

One concern in the US, in rural areas women are having to travel unacceptably long distances to receive prenatal care and to have their babies. Why? Because hospital systems are closing slow maternity units to save money. This is awful and more attention needs to be focused on this!

[@jenniparish2135]

They are closing because insurance does not pay for the baby, just a small amount for the mother. Hospitals need to make money to keep programs open.

[@autumnmoonfire3944]

@@jenniparish2135 while yes, you are right it the sense that the money situation is hopelessly borked, However human lives should be more important! It shouldn’t be about money, it should be about healthy and safe moms and babies.

[@jahbern]

@@jenniparish2135hospitals don’t NEED to make money to stay open. They NEED to operate differently. They NEED to all be not-for-profit and our government NEEDS to pick up the slack in areas where insurance companies aren’t pulling their weight. Publicly funded hospitals exist. Unfortunately our capitalist society has brainwashed everyone to think that EVERYTHING MUST turn a profit or run as close to the red line as possible. Even our kids’ schools. It’s bonkers. One simple change in the way we think about services like healthcare and education would solve these problems.

[@lisaskarbeck7634]

In France too :/

[@marolatv618]

​@@jenniparish2135The United States government needs to foot the bill for women giving birth. If they want more babies to be born by restricting access to abortions, then the government needs to pay for it and also 4 months mandatory maternity leave.

[@JBHRN]

What is dreadful and infuriating is that the US is rolling back the clock. Reducing access to care & placing women of child bearing age at risk. Speak to your legislators. Be active against the efforts that are underway rolling back access to care. John B Hall, APRN.

[@ladyeowyn42]

Yeah notice how maternal mortality flatlines starting in 2016 when global misogyny was on the rise.

[@SonjaHamburg]

and TRAVEL! I fel like Americans are fed so many lies about universal healthcare

[@JBHRN]

@@SonjaHamburg You can tell a lot about the character of a nation by looking at the quality of its health care system. The US is #1 in expenditure and #49 in clinical outcomes among developed nations.

[@lucyhardman8386]

I had a cardiac arrest during my c section in the first lockdown of the pandemic, 6 minutes of cpr and 4 blood transfusions later I’m here thanks to some amazing medical staff and our wonderful NHS here in the UK. Waking up to hear “we didn’t think you were going to make it” will haunt me forever, all the PTSD that comes with it is worth it for my baby boy though x

[@SonjaHamburg]

Oh. Glad you made it! That must also be so traumatic for the nhs staff when they think they are loosing a newborn baby's mom

[@QJJ245]

My state is supposed to be better. And regular care is great however obgyn care is garbage. Especially for black women. I almost died in both of my pregnancies and I kept getting ignored when I tried to advocate for myself. I was told everything was too risky or "uncomfortable". They kept saying "uncomfortable" as a reason not to give me better care. And yet my fair skinned acquaintances got everything I begged and cried for without any pushback. It's ridiculous. I switched OBs 3 times! They only reason I made it is bc we kept having to call for an ambulance and ER doctors helped me everytime. I decided to stop getting pregnant bc its too risky without better care.

[@toxicginger9936]

I hear you. I was 12 weeks when I started hemorrhaging. Called 911, ambulance trip to the ER, I was clear with them that I am a high risk pregnancy and on blood thinners and yet I still laid bleeding on a gurney for 2 hours before a doctor came to see me, and another 2 full hours before I was wheeled to ultrasound to find the source of my bleeding. It felt like they just don't care about pregnant people to begin with. (I say people, because I'm fair-skinned)

[@yippee8570]

That's horrific! I'm so sorry you went through that.

[@solsystem1342]

As a trans women I fortunately don't have to worry about how the health care system would treat me while pregnant but it's absurd. I literally had to bring a friend to advocate for my treatment because the doctor brushed off my concerns after I struggled to cough to clear my throat and didn't sleep for the rest of the night afraid I might choke on my saliva again😢 It's like, hello! I'm in pain breathing, can hardly sleep or feed myself! I need help! But they'll only listen if someone else tells them. After that they figured out they should give me steroids to reduce the swelling so I would at least be able to breathe while in pain sleeping😅 Then again I got told off when I went in after that on the triage nurse's recommendation because my symptoms lined up with a potential serious lung issues that can be caused by bedrest 😢 I hate interacting with the medical system in general but transitioning has honestly just made it way harder to get needed medical care. Stay strong y'all❤

[@NickyMariecox]

I almost died 3 years ago giving birth to my daughter, we had a complete detachment of the placenta, an old meconium. They think it was a few weeks old and a newer one that happened during labor. My daughter had acute fetal distress but once she came out she was fine and the one that was in trouble was me. I had a emergency C-section while I was already almost completely dilated because my daughter didn't have a heartbeat. I was 37 weeks pregnant and was trying to get to the hospital but I dialeted to almost 9 in about 2 hours. It was extremely painful and once they opened me up I started bleeding profusely and almost bleed out had huge clots. Had a hemoglobin of 5 at the end of it. With other complications and after a week post partum had to have emergency surgery because I had a bunch of clots in my womb. It took months and months for me to recover but thankfully we both survived.

[@sophiophile]

Glad to hear you both made it through

[@KJ-bj2oi]

I've never been pregnant, but I've been chronically iron deficient basically my entire adult life. I can say from experience that even when you have good access to healthcare and can afford to buy supplements, iron supplements are incredibly hard to take long term. I have had strong and painful gut reactions to every single iron pill I've tried. Increasing iv iron infusion access would help so many people.

[@rachelbroughton6457]

Yes I was going to mention this in the comments. Iron tablets are so horrible to take! I had never experienced constipation like that before in my life, I’m thankful to hav been give an iron infusion during pregnancy

[@TheEliseRodgers]

I have autoimmune diseases. I Wasn’t pregnant either, but IV iron was a lifesaver.

[@fionafiona1146]

The Soviets had bovineblood candy bars, that won't help India but could cut down on current waist and improve absorbtion

[@debbiregnerus8824]

I have no experience with this, but I have heard of people cutting raw beef liver into pill size, freezing them, then swallowing the frozen “pill”. I believe beef (especially grass fed) is quite similar to our own body so our body shouldn’t have a bad reaction to it.

[@fionafiona1146]

@@debbiregnerus8824 Sounds like a risky pathogen vector. Anything closely related to us (including all mammals) can carry diseases and putting anything (not specifically clinically approved and tightly regulated) past your stomach acid (that's the purpose of pill capsules) is highly risky

[@Kristina-ek8yt]

''...but it doesn't have to be this way.'' And that is true for so many other deaths in healthcare arena too! From tubercolosis and very expensive tests and meds, to covid and flu and bad ventilation and refusal to mask, to air pollution, to sepsis and suboptimal hospital and infection control, etc. Ugh, we have solutions to so many things. It's sad we don't want to implement them.

[@_Julia.K_]

I agree to what you wrote except "refusal to mask". Read more about masking, what it does to our body, especially immune system (weaken a lot) and lungs (microplastic from masks inside lungs), and to our collective immunity (RSV epidemic with tons of bad cases in children last fall after 2 years of masking. And RSV is usually a very mild cold). And now we have studies showing how useless that mandatory masking was. It did not prevent viral spread. Not only is masking useless, it is dangerous to our health.

[@yellowishgreendragon.-.]

You're on a Page with someone who specialises in Pregnancy Care and Delivery. Expect the main focus to be this area of health.

[@Kristina-ek8yt]

@@yellowishgreendragon.-. All of it intersects. Those who work in pregnancy care and delivery should call for better infection control. Pregnant people can easily get sepsis for example. Masking would cut down on many hospital-acquired infections, which there is A LOT of. Pregnant people in general are at a higher risk of bad outcomes from any disease since their immune system is suppressed.

[@AmandaBoysenberry]

This is why your “I didn’t know I was pregnant” videos are so wonderful. Those people are living a fantasy that the rest of us would love to have, not even knowing they are in danger. When I was in labor with my son, I was in a world class university teaching hospital on continuous monitoring and they still didn’t notice that the placenta had abrupted for hours.

[@TellyKNetic]

I was septic once. Not due to pregnancy, but rather a kidney infection. I remember going to the ER, they found the infection in my urine, gave me medicine and sent me home. A few hours later, I got a phone call. "We found it in your blood, get back here." I spent five days in the hospital hooked up to IVs.

[@abbyredrose128]

Not to be that person not trying to 1 up you or anything but you are lucky they just gave you meds. if it is bad enough they put neophostomy tube's in (drainage tube's coming strait out of your kidneys) I had mine in for a whole month my friend had to have them in both for 2 months. I say this in part to warn people if you have a kidney infection the sooner you go the better!five days in the hospital might seem like something you want to put off but trust me it will be alot longer and worse if you do.

[@SonjaHamburg]

​@@abbyredrose128and when you want to compare, then maybe compare your experience to people without access to healthcare in other countries or our ancestors back in time. You were really lucky because many others just would have died

[@abbyredrose128]

@@SonjaHamburg I'm fully aware how lucky I am I would have been dead before I even made it out of high school. Like I said I wasn't trying to one up I was just sharing my own exspirence and warning people with access to health care to get that sort of thing checked out as soon as possible because I don't want others to end up like me because if it and my other kidney issues had been believed sooner and not chalked up to back pain by my parents then not just would I not have had to had a tube in me for a month I wouldn't have permanent urinary retention issues that make my issues worse and cause me to nearley die multiple times a year... I am fully aware that even with access to health care one day I might not make it soon enough and more than likely my kidneys will one day kill me. I haven't been septic once i'v been hospitalized for sepsis 3 times just this year...

[@marymecham6582]

I love the awareness you're bringing to this topic! My partner works for a drone company called Zipline International, which has helped to reduce the maternal mortality rate due to postpartum hemorrhage in Rwanda by more than 80% by increasing access to blood and medications they need. Being pregnant myself has really changed the awe I have for that statistic. I really hope that more companies can focus on the importantce of this in the future so we can actually reach the goal.

[@angela_flute52689]

I saw a Mark Rober video about that (or something very similar) and it's amazing. What an incredible resource saving countless lives!

[@Discrete1998]

I had a postpartum hemorrhage due to a cervical tear with my second baby, and am grateful to the amazing team that found the tear in a hard spot then whisked me away to the OR. I’m not gonna lie, it’s incredibly painful to have people elbow deep and scooping out your insides. They saved my life. I’m here today to raise my 2 year old son and 8 month old daughter thanks to them! ❤️

[@beckymunson2252]

I was born in 1952 at my aunts home, and my birth mother died from placenta previa. She had an older daughter who is 12 and I was born and the next all this was seven. So between the ages of seven and a newborn baby she had six children. I was born at 10 o’clock in the morning and she died at noon. It took her two hours to bleed to death. 😢

[@daisykid3]

24 weeks here and maternal mortality has been the thing I'm most afraid of for years. I didn't even want to get pregnant for years because I was so scared. Learning as much as I can while I can from people like you so that god forbid something goes wrong I can advocate for myself in that delivery room.

[@hannahk1306]

I hope your birth goes well. It's probably a good idea for your partner (or whoever you want at the birth) is also well informed so that they can advocate for you in a situation where you can't or if your medical team won't listen.

[@katherinep708]

This reminds me I had a c-section and my OBGYN who performed the surgery didn’t prescribe me the anticoagulant injections that I had to take for 7 days after c-section before he left. Thankfully another OBGYN at the hospital asked me whether I was given the prescription for the anticoagulant injections before I left the hospital. And I just realized now, the OB who did my surgery was a white male and the OB who asked me about the prescription was a male person of color. I’m Southeast Asian living in Eastern Europe if anyone wondering.

[@judith8161]

This hits very hard. I could have lost my mom when I was less than 2 years old because she lost a lot of blood upon giving birth to my little sis. Since her blood type is quite rare, the hospital didn't have the corresponding blood bags, so they had it delivered by ambulance. My dad almost fainted from seeing so much blood. My mom says the only thing she really recalls is being incredibly tired and cold. I'm so sorry for all those children who have to grow up without their mom 😢

[@Emerii1]

I had placenta acretta with my 1st. No previous c-section, no previous pregnancy. I was truly the 1%. I can't blame my doctors for not checking for this issue but I'm glad I'm still here. I had so much pain from 25 weeks on, it felt like something near my pubis bone was ripping at me with a stabbing pain. It was not the 'wrap around' pain that pregnant people normally get from the growing belly and I knew it wasn't. The day I went into the ER for early contractions I visited a specialist for my preeclampsia. As he was doing my 3D sono, he suggested I just 'sit on the couch and watch netflix' for my excrutiating pain. He could have checked my uterus not just the baby, but he didn't.. I know it's really hard to detect without an MRI but I didn't realize how close my baby and I were close to dieing at any given moment, especially if it ruptured at my house which only has halo flight available. My baby was born 3 days later at 33 weeks and because i went to the ER early he got both the sterroid shots and was only in the NICU for 10 days!

[@Zeyev]

Thank you. I contribute to DFTBA's goal of reducing maternal and child mortality in Sierra Leone. I know it's only one country but the Green brothers appear to making a positive impact. That makes me believe that targeted efforts elsewhere can also work.

[@mousestripedgrass2123]

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[@Pysslis]

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[@Astra_the_dragon_uwu]

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[@felskypredator]

Here in the state of Georgia USA ,the rates are abyssmal.

[@cassidybrewer]

As someone who had a postpartum hemorrhage, I regularly think about how I could have died if I had given birth hundreds of years ago or even in the modern day but without proper intervention. It makes me really grateful to be here to raise my son.

[@jfinney225]

Thank you for this info! I’m 5 1/2 months pregnant so this was a little scary to watch but I also have other health issues going on right now that will increase my chances of infection and sepsis. I’m also a little concerned about my iron levels. So I will be bringing these concerns- AND ARMED WITH INFO TOO- to my next OB appointment. I appreciate everything you do!

[@heather486]

So many hugs. As she said it takes a long time on iron to get your levels up so definitely if you are low at your next test start oral iron as prescribed. If you have cast iron cook everything on it. Eat high iron foods and if it doesn't make any difference by the next blood draw there might be something else going on and you definitely need to push your doctor for answers. They should want them too.

[@brittniep9219]

Yes! and please, if you have gastro distress and feel awful taking oral iron, push for the IV iron infusion.

[@_Julia.K_]

Iron pills sometimes don't work and you have to find the ones that work for you, and it takes a lot of time. Push for IV iron if it's low. You don't have time to raise iron orally

[@stefani.m.1987]

I also had a traumatic birth experience, resulting in a blood transfusion and me not having a memory of the first two days of my sons life. So it’s so important that people are paying more attention. The hospital didn’t recognize my blood loss until day 2. Really don’t know how they missed that. My partner knew something was wrong before they did.

[@tangoseagull4966]

Just finished my OB rotation for nursing school. The hospital does a PPH risk assessment on every patient and plan accordingly. Each nurse also has their own hemorrhage kit that they keep stocked and updated.

[@yippee8570]

I had placenta praevia with my middle child. I started bleeding and they performed an emergency c-section under general anaesthetic. I lost a litre of blood and the baby was 'in distress' but of course I knew nothing about it until hours later. I will be forever grateful to the obstetricians who saved both me and my beautiful baby and to the NHS which performed it all at no cost to me. The doctors and midwives were superb and I have never forgotten the gentle kindness of the auxilliary nurse who gave me a bed bath the next day. Truly some remarkable people! Thanks, NHS 🌈

[@themudgirl]

I love hearing about this. Also love that you presented female doctors. From my personal expérience I feel that #1 on the list should be "Listen to the patient!" I had late onset HELLP Syndrome. Upon arriving at the hospital, the nurses Said I was hysterical because it was my first baby. This was months before my 40th birthday. They hooked me up to the first blood pressure machine and the blood pressure was 250 over I don't remember what. They laughed and said the machine was broken. When the second machine displayed the same blood pressure, they started arguing as to where to send me. Emergency, or maternity? I told them I'm having a baby, send me to maternity. From that moment forth and throughout my recovery I was treated as a hysterical female. No one listened to me. After my emergency C-section, they left me in bed for nearly a week, so I never healed properly. This was confirmed for months postpartum, when I paid for my own ultrasound because no one was listening. It was too late to do anything. I also ended up with an abscess the size of an egg in my c-section scar. My doctor reprimanded me for not saying anything. I sternly told her that something popped inside my incision on the second day and that no one had been listening to me since. For référence, I'm in Canada. The trauma and neglect that I endured has stayed with me for 7 years now. From my experience, male doctors do not listen to women. Female doctors only do slightly better

[@_Julia.K_]

There is no such thing as a paid ultrasound in Canada. You need a doctor's referral for that and it's free of charge for residents. Or did you go to US for an ultrasound? I'm so sorry for your traumatic experience 😔

[@themudgirl]

@_Julia.K_ You pay for it in a private clinic and get reimbursed by insurance. No referral needed. You can feel free to Google it, since my own personal experience must be a lie. Kind of you to take the time to contradict me, despite my information being 100% accurate. Who cares what I was traumatized again and again during my birth experience and Recovery. Who cares that there were multiple ways for me to die, as my doctor reminded me for months afterwards. What's important here is for you to be right. Guess you have some extra time on your hands? Maybe try volunteering with an organization, rather than leaving useless comments

[@_Julia.K_]

​@@themudgirl I couldn't get a diagnostic ultrasound at a private clinic without a referral - they do it only for non-residents or those who don't have a government insurance like OHIP (and every resident and citizen has it). That's why I asked you. I thought may be I missed important changes in our healthcare, but no, everything is the same, I checked after your kind response. No one wanted to insult you or devalue your trauma.

[@themudgirl]

@@_Julia.K_ I had no referral but had been Seen There previously. Cost me $100 and private insurance paid the rest

[@lauren3173]

I just came from Michelle Khare’s video about her learning about delivering babies. This is the perfect video to follow it up with. The reality of childbirth is amazing and terrifying! Major respect for everyone who has experienced it in any way.

[@Brklynnoelle]

Im actually doing my Master of Public Health thesis on this issue. its very important that people know about this

[@brittanyhowlett4380]

I had a postpartum hemorrhage with my first baby, the only thing they didn’t give me is 2 from the bundle, my uterus didn’t contract after delivery until they did the fundal massage and give me oxytocin. When I delivered my daughter in our car on the side of the road(we were on our way to the hospital and didn’t make it 😅) I was terrified I would hemorrhage again and terrified I would die if I did since I was in my car and not at the hospital, thank whoever’s out there that I did not hemorrhage this time!

[@julianajuju4917]

Thank you so much for raising awareness about this issue. There are people out there who don't know how dangerous pregnancy and childbirth is. Just because it's so common and happens all the time doesn't mean it can't kill you. Your videos are always educational and extremely helpful. You're amazing Dr. Jones!

[@e.asterbunnymund8148]

MDJ your commitment and work is admirable and I’m so glad you’re discussing this as the numbers DO need to change. I’m extremely lucky to live where I have free healthcare and access to amazing doctors. Earlier this year I had my second (and last) child and was told what to look out for infection wise. I called the RNs when I started to not feel 100% and showed some signs, they told me to get into ED immediately and 12hrs later I was hospitalised and fighting sepsis. I had back to back infections and had to have emergency surgery. Now I’m on the road to a long recovery but my two boys still have a mother ❤ I want that outcome for all people who give birth around the world, not just in places that can “afford it”.

[@kallimari]

Thank you so much for talking about serious issues we need to hear.

[@alyxwithay6516]

I’m glad they’re finally making this a priority around the world!! It always breaks my heart.

[@robyn274]

I found this very interesting and emotional. As someone who is currently heavily pregnant with anaemia and previous birth I haemorrhaged and had suspected sepsis (also was anaemic then too), this concerns myself and the doctors too.

[@IceNixie0102]

If you mention TB in this video, I'm going to assume the script was written by John Green.

[@coleenocasturme]

This is such an incredible project, and I really appreciate you using your platform to highlight the people working on solving these issues around the world. My cousin died shortly after giving birth around 10 years ago. She was in her mid-thirties, in Italy, and it was her first child. She developed a melanoma during pregnancy, and it just moved too fast to be treated. My dad was talking to a dermatologist a little while ago about this, and the dermatologist said it was because of the growth hormones during pregnancy, which can send cancers into overdrive. I have never heard of this from any other source. Have you got information or studies about cancers during pregnancy? Does it have a significant statistical impact on maternal mortality / morbidity?

[@powers1217]

Pretty sad that a private citizen is doing what the government should be. The current US House of Representatives has a stranglehold on our ability to pass bills that help average Americans.

[@puzzlefade]

We had an abruption at my hospital last month. We don't do high risk births (they go to the major women's hospital half an hour away) so this isn't common for us. I was in charge of preparing all of the blood products for the patient and it was a scary situation! I can't imagine being the patient. Luckily, mom and baby both surprised, but it's such a reminder that it's not always such a good outcome. Love that you're doing this.

[@baileywright1656]

I had a pacental abruption during labour and required TXA. Thank goodness my daughter was small and I dialated quickly because it could have turned out so much worse. I am extremely thankful for my delivery team and their quick and professional actions. Its not like stuff like that never happens - my good friend required a transfusion when she had her son. Thank you for bringing awareness to this issue!

[@chnalvr]

I have tremendous respect for the work of the Bill and Melinda Gates Foundation. I am lucky to live in Seattle where the foundation is headquartered and have seen up close the huge amount of funding that is given for advancing the quality of medical care, particularly for populations that are underserved around the world. This is how Bill and Melinda Gate intend to give away the majority of their fortune in their lifetimes.

[@misse7154]

As an international policy specialist, I'm pleased to see you engage on this level. The World Health Organization should hopefully be playing a major role. A big issue is funding. Foundations help a lot, but a bulk should be coming from governments. For many, women aren't important. It's just sexism on an international level.

[@_Julia.K_]

Oh, now I understand why it felt like every nurse on duty was attracted to my room to squeeze my poor sore belly after delivery. I didn't know it was a fundal massage to stop bleeding. It has to be done every 10 min or so for the first hour after birth. Unpleasant but lifesaving.

[@emmabunch-benson4795]

So glad your talking about this-lots of things like this regarding pregnancy aren’t talked about & people have this rosy idealistic perception of pregnancy/birth

[@elisharoberts1029]

Sepsis almost got me after my son was born. Mine was caused by my allergies to iodine and chlorhexadine and requiring a cesarean. My Dr was the on call Dr for my OB clinic. My son was born at 5:12 on a Friday afternoon. We didn't even decide a cesarean was needed until 4:40. The anesthesiologist was the one who came up with the surgical plan given my allergies, but somehow the actual OB wasn't told, so he didn't do the antibiotic rinse off my insides before he hurriedly closed me up. My body wasn't helping by repeatedly puking everywhere once the internal organ tugging started. Prior to baby I was hot AF, and I know it's normal, but every day in hospital after I needed extra fans too until my last day. I was actually discharged after going from all the fans and no clothes to all the heated blankets(they seriously ran out), fully clothed, new baby and boyfriend snuggling and was still freezing. I was shivering so much I almost bit off my tongue! Only 20 minutes after arriving home, I demanded to go back because I had a fever of 104.5. The ER took 1 look at me and admitted me back to the L&D unit. I went through days of IV antibiotics and still wasn't improving. After 7 days, they did a revision surgery with my actual OB, and I was placed on a wound vacuum. There was a huge miscommunication on when I needed a shower and a dressing change, and that caused huge issues. I was discharged home 14 days after my baby was born. I lost over 70 pounds and caught C. diff while there, so I could barely stay awake or hold my baby, who was 9 pounds 5 ounces at birth. My son was born in October. I had an open wound requiring wound vac changes almost daily until mid-January. I had a great Dr, a well-known hospital system close to home, and great insurance. I'm white, but also morbidly obese with sleep Apnea, a red head, and I was older than 35 when he was born. We did all the prenatal care because of my 10 miscarriages, weight, and age it was a high risk pregnancy. We did a weekly appt in the 1st trimester with our fertility clinic, then the usual OB appts, and MFM appointments to ensure baby was healthy. I ended up with high blood pressure, but was otherwise the same health wise. I gained less than 15 pounds as per my Dr's orders. We did all the right things, and I still almost died just days after my son was born from the infection and the surgical revision. I almost died on his table, but I refused to leave my new baby and fight like hell to get back. My Dr said he'd never worked so hard in his life to keep a mom alive. There were obviously mistakes made and all involved learned from this, but our lives almost changed so dramatically I'm still terrified by it. My son is almost 5 now and he's counting down the days to his birthday, but this shouldn't be such a common story for women having babies.

[@yeetghostrat]

America spends the most on healthcare, per person, than any other country. Individual citizens and the government pay absurd amounts that are incomprehensible to other countries, and yet we have the highest maternal mortality of the top developed nations. This is a tack on informative comment, not a stab at the video. The topic is world wide rates, not the US.

[@TexasTigerLillyx]

I was almost one of the statistics this year because a male OBGYN dismissed my placental abruption from a subchorionic hemorrhage (complete with blurred vision, lightheadedness, vomiting and more) and round ligament pain 🙃 And it cost us our baby

[@Tegdirb64]

So sorry for your loss

[@Psylaine64]

I felt this was sooo quick so would love and in depth vid of each of the treatments ....

[@megangreene3955]

I suffered post partum hemorrhage in 2016 after the birth of my 7th baby. I went into shock and was in and out of consciousness while they worked to stabilize me. I then spent the rest of my hospital stay alone with just the nursing staff because my husband couldn't stay to help me. I ended up with a catheter for the first day after giving birth and unable to get up or even hold my newborn son. Thank God for the fact that I am still here to tell about it.

[@anahidkassabian4471]

Some of us older folk don’t do social media - I know many do, but I also know many who don’t including me - and I would love to hear about the conference. Would you maybe do a single video when you come back, please?

[@sigridbjergbakkemeyer3653]

Saving the lives of mothers is more important than the newborns. One of many reasons why abortionban is a crime against women

[@_Julia.K_]

Once a baby is born, it is equally important. If it's not born yet mother's life goes first.

[@Respectable_Username]

Great video, thanks MDJ! Would also be fascinated if you were to ever do a video on the work Partners in Health are doing in Sierra Leon (the country with the worst birthing outcomes in the world) to build their Maternal Centre of Excellence which has already reduced the maternal and infant mortality rates in the country. The VlogBrothers, John Green in particular, have been spearheading the awareness campaign and it sounds like the money being donated is being really well spent (is why it's the charity I donate the highest amount to each month). Would love to see you collab, either with PIH directly or via the VlogBrothers, to talk about how each of the measures being built in Sierra Leon work to reduce death from an OB/GYN expertise perspective. Y'know, beyond the obvious having reliable electricity, water, and being a teaching hospital to train more birth care workers who can then go back and support their communities!

[@sandyruitenberg2928]

Thank you for spreading this important information. It is so sad that in especially poorer countries there still is a high mortality rate related to birth. And it is also still a dangerous thing to give birth in a western country. Sometimes I think that people forget how dangerous giving birth was for a mother and how many babies died. I myself was luckily not in danger when I gave birth. But I had an emergency c-section where they put me to sleep, because my umbilical cord was collapsed and was stuck between my sons head and my hip bone. I was so lucky to already be in the hospital and how quickly the staff noticed what was wrong. Otherwise my son would not have made it. So I know I am luckily to live in this time and in a rich country. And I wished that all people in the world had such good access to health care. I hope with what you are doing, that more people will get access to better care during labor an delivery.

[@NovaDoll]

The most scary thing is other countries are working on this while in the US we are like hold my beer we can make the rate of women suffering go up... :( so sad.

[@J_a_x_N]

I’m so glad you’re adding your voice to this MDJ. So many things, including your medical skills/experience and your KINDNESS, make you so well qualified. Thank you ❤

[@user-eh5hq4fk3c]

I almost died from a postpartum hemorrhage with my 1st baby. I am so thankful to the nurse on staff, she predicted it even before my son was born and reacted immediately once he was born. I wish I knew her name to thank her in person, she was amazing.

[@caelycat]

and then there's Idaho who litteraly just went "Women and children are dying because of all this? Oh well not our problem sucks to suck losers"

[@bdhesse]

I hemorrhaged with my 1st baby. I remember the drs doing at least 4 of the 5 things you listed (this was back in 2016). With my 2nd baby, I luckily didn't hemorrhage, but I remember them doing those things again to prevent me from hemorrhaging (I was bleeding heavily, but they were prepared given my past history).

[@cherylvl1036]

My gynecologist prescribed me tranexamic acid and mefenamic acid for the treatment of my heavy periods. They have helped a lot.

[@D33nplz]

I had sepsis related to my pregnancy/miscarriage eariler this year, and it was astounding how many times I had to go back to the doctor's office just to catch it-in order to end up with an emergency surgery and IV antibotics after being transferred via ambulance, that could've been avoided had I been listened to. It is incidious and doesn't always present with a" textbook" case. Being adament that something was wrong, and being close to a hospital saved my life. Dizziness and lack of appetite were dismissed at first due to "stress" (Yes, really.) as I had undergone my miscarriage and medication. September is also Sepsis awareness month. You know your body best.

[@Friskyhorton]

I was hours from death from toxemia and had an emergency caesarean at 7 months pregnant. My baby is a huge healthy heavy metal bass player.

[@sarahsexton9004]

Thank you for this. There is some very good info here in the studies you mentioned that I’m going to look up. I’m a midwife working in Chad, and maternity providers in developed countries just can’t even imagine what it is like in these countries with very high maternal and neonatal mortality. We see uterine ruptures every month or two at my little rural hospital, placental abruptions a couple times a month, and very severe anemia from chronic malaria causing any blood loss at birth to become life-threatening to women like you mentioned. We need more skilled providers willing to be a part of this work and education! ❤

[@emilyjost5593]

I don’t think I’ve ever learned so much in such a short amount of time thanks Dr J!

[@jessicastevens5782]

sounds like it's time for a Mama Dr Jones / Vlogbrothers collab to talk about this in conjunction with the PIH's Maternal Center for Excellence in Sierra Leone

[@pattyrobberson4152]

At 42 weeks, 48 hours into an induction, a fever developed overnight and the night nurse never checked my temperature.. finally it was time to push and I only pushed for a few minutes... severe hemmorage and two codes called and a balloon had to be inserted to stop the blood. Then 1.5 years later i was diagnosed with placental site trophoblastic tumor and needed a hysterectomy at 26 years old. Thankful to be alive after hearing these statistics 🙏

[@melodybeats2553]

One of my classmates informed me that they are aspiring to be an OBGYN, but when she tells people about said career goal, they apparently judge her for "wanting to look at v@ginas", I see this as a young woman who wants to help fellow women/AFAB People with an area of health that can be highly intimidating. I feel like she would be a great OBGYN, she's so sweet and I hope she reaches her goal.

[@rebeccastults2138]

After my last delivery I am confident that if my Dr and I were not as prepared I would not be here today. The blood loss that I had post delivery was massive. My placenta was fully integrated into my uterine wall and they were never able to get it all so I kept hemorrhaging. I am so sure that I would have died had I been in a country with a less advanced medical system or had we not been prepared for the possibility.

[@mmwultsch]

During my first pregnancy, I kept telling my docs I was tired, really tired. I was told that was normal, just take my prenatal vitamins, exercise more, and eat less since I was gaining too much weight. I did as I was told. I tried with the exercise but I was really tired. The morning after my c-section to evict my guest who overstayed her welcome, my hgb was 6. Yeah, there was a reason I was tired. IV iron would have been great, if anyone would have listened to me. I have since had issues with anemia that have needed IV iron and blood transfusions, so not just a one time thing, but this was the first time it was this low.

[@TheBeccabus]

You're doing great work. Small steps will make big changes over time! We will get there. Thanks for bringing attention to these important issues

[@KxNOxUTA]

Thank you very much for this amazing work! And big thanks to the amazing women who stepped up to the task and researched these things and figured out approaches to improve accessibility!

[@Anonym1Girl]

Amazing video ! One of the only cases I immediately replayed the video to make sure I retained as much info as possible

[@purplexninjamom]

This is hard to hear, but we owe it to each other to think and talk about these things. Thank you MDJ. Keep fighting the good fight.

[@natalievancouver8188]

I also forgot to add while listening to you I could hear the straining and pain in your voice while speaking about the deaths & disparity around the globe. It’s amazing that you can show how much you care just by listening to you!❤❤❤you’re an inspiration to many! Safe trip for you as well🛫

[@BYS-JS]

It’s the hospitals. Trying to crank everyone in and out on a schedule. Not listening to the mothers, thinking they know what’s going on. I had 2 kids born minutes from each other almost 3 years apart. 2 different nurse practitioners. My babies were born. 7:55am and 7:47am. They manipulated my labors so they could be back to the office on time. One even called in to the office after the delivery to say she was gonna be a little late. I had medicine(mainly pitocin, even though I was progressing wonderfully) and practices forced on me I didn’t want.. so they could be at the office on time.

[@jillisenberg9704]

Love this educational information. Looking forward to hearing more about what you learn.

[@BrittanyRA100]

Thank you so much for helping to educate us. You are a wonderful teacher!

[@Llynnyia]

Maternal morbidity is hardly ever spoken about , thats when moden meicine SAVES the life of a pregnant woman who would have died due to the pregnancy or childbirth. Im one of those . almost 2 yrs ago now i required 2 pints of blood due to hemorrhaging during childbirth. I was warned that if i ever went into labor again away from a hospital setting due to the thinness of the scar tissue holding that specific part of me together that id likely bleed to death before being able to get to one.

[@mv8395]

This is amazing. Excellent way to get the word out. Exited to see what happens next.

[@vsinclair2424]

I had really low iron with all my pregnancies causing some yucky symptoms. My 2nd pregnancy I lost 1L of blood and then required 2 blood transfusions to recover. My 3rd baby I was offered a iron transfusion prior to birth and it made such a tremendous difference! And your right such a simple short thing with big impact.

[@chriscecil5274]

Can we fix leaders who think PMR and PRMR are the same thing?

[@johnchurch16]

I almost died from placenta retention... i delivered at a smaller hospital, and after my son was born, i hemorraged.... due to blood loss, i dont remember most of his delivery.... but the operating room wasn't available right away, and i had an excellent dr from the Middle East, and i thank god every day for her... she actually started the manual procedure of removing pieces of my placenta by hand in the delivery room.... if she would have waited for the or to open, i would have bled out before ever making it there.... and by a miracle, i was able to be rushed in for emergency surgery, and after 6 hours of surgery and 2 blood transfusions, im still here and able to be a mom for my 5 children.... he was my last all my other deliveries for fine.... he is now a happy 18 month old.... his cord was wrapped at delivery he had to be revived, so needless to say, my dr saved both of our lives that day... i had signed a paper to get my tubes tied before.... they were able to avoid doing a full hysterectomy, but due to my hemorrhaging risk, they could not tie my tubes .... she informed me that if i was to conceive again, it would most likely kill me ..... i have an amazing husband who stepped up right away and got fixed, so i support this 100 percent everyone deserves to live and not have to die over sonething that could have been prevented

[@kasha703]

Have a safe and smooth trip! This is such an incredibly important topic, please relay the good vibes to all those experts working hard to make this a better world.

[@stephanieronczka7625]

Are frequently doing postpartum hemorrhage drills and simulations on our L+D, Postpartum, and Women's Health floors. Our next drill is in a few weeks! We've stopped using the Bakri balloon (hated that!) and switched to this negative pressure that collapses once it's in the uterus. Seems so much easier and more efficient

[@asappywriter]

800 deaths a day! That is a staggering number. I had no idea.

[@cggc9510]

This was brought up in an early Strong Medicine episode. A mother just gave birth at home and was bleeding uncontrollably. The reason why was because she was anemic.

[@BelleRose11000]

My good friend almost lost his wife when she gave birth to their second child. She lost a lot of blood. They survived, and mother and child are fine to this day, but it was very traumatic for the family. It’s a blunt reminder to me of how close to home this can happen. Never think, "It won't happen to me."😢

[@alanawilson9027]

This video is so interesting! Someone close to me recently had a baby and was bleeding afterward and we did not realise that she had a severe bleed (just thought it was normal post birth bleeding)… so we initially did not think anything of it.. until her plunket nurse came and checked up on her the next day and she was rushed to hospital to have the bleed repaired.. she’s 100% fine now but she’s so lucky! I don’t know how long it would have been until we realised the bleed needed medical care and the outcome could have been much worse!! Thank you for your videos MDJ!

[@rayschoch5882]

Good, vital information. The trick will be getting that information into the right hands, including prospective mothers, caregivers, etc., and then acting on it.

[@veronikachernik7869]

This was an awesome video, thank you for sharing this with us!❤️

[@spokinabout2236]

YOU ARE THE BEST! thank g_d we have you. thanks for all you do.

[@urtelamsodyte]

I had eclampsia luckily it was just after giving birth, thanks to an amazing team of doctors timing induction just perfectly, also 8 days postpartum I was diagnosed with venous sinus thrombosis, luckily I was taken care of very quickly and suffered no consequence. I am thankful to live in a developed nation with free healthcare and I can’t imagine my child growing up without a mother that so many children have to do. We all should talk loader about how dangerous pregnancy and giving birth actually is, it is amazing an joyous but it is also extremely dangerous

[@oliviamay7495]

great video as per usual

[@Rjmaaske]

As a Georgia resident, I know the community needs this so badly.

[@CarolineNotCarolynBoyd]

Yeah...giving birth in Georgia has been interesting to say the least...and that's WITH all the research I've done, resources I have had access to, using the Midwifery care model... it's still abysmal

[@connierobinson1090]

Have you talked with John Green and Hank Green about their efforts related to maternal mortality? They work with Partners in Health in Sierra Leone to work on this topic!!

[@neuroisis85]

Just found out l'm pregnant. I live in GA, USA. Disabled. Heartbeat bill is forcing me to have this baby, when I'm not sure at nearly 40 that l want one. I know I wouldn't be able to keep up with it through playing, etc. That makes me tear up. I'm trying to find another state I can at least have the option to abort if I'm told the disability would be too hard on baby and myself. GA has the worst track record. I'm white, but don't receive adequate healthcare on Medicaid. I'm also very poor. SSI pays $750m( a living wage somehow in their eyes), and maybe if I had a support system(my partner doesn't make much either), I might be able to try. I'm so conflicted. I just want to see someone that would actually be sensitive to my situation, instead of scared to lose their job if they even suggested my body can't handle this. Smdh. I feel trapped.

[@mkuznetsova8704]

Look into the auntie network for help to get an abortion

[@phantomstarsx9343]

A little gruesome but maybe go... enjoy a few days in a hot tub somewhere...

[@natalievancouver8188]

Wow congratulations what an honour and they’re very lucky to have you onboard as well!👏❤️These statistics defiantly need to be addressed and changed as soon as possible. Thanks for the info and have a safe flight to New York🎉 while you’re there will you be collaborating with @Doctor Mike? Or any other ObGyn’s? Hopefully you’ll have time but can’t wait to hear what you’ve learned there❤