Austin Midwife Weighs In On Rising Maternal Mortality

A recent study suggests Texas may be leading a disturbing upward trend in pregnancy related deaths here in the United States, where 4 million women give birth each year.

Heather Satterfield, a Certified Nurse Midwife working with high-risk communities in Austin, sees the problem as part of a larger whole. “It’s a chronic health issue,” Satterfield says, “women already sick with obesity, diabetes and hypertension, who aren’t getting proper medical care to begin with, are in greater danger when they become pregnant.”

A maternal mortality task force in Texas recently found the leading cause of pregnancy related death was due to cardiac problems in black women, followed by drug overdoses; hemorrhage and blood transfusions. The state’s rejection of Medicaid Expansion under the Affordable Care Act could account for a portion of those deaths; of the 400,000 mothers receiving benefits, 60 percent died six weeks or more after delivery, at the same time their coverage was terminated. Texas has one of the largest uninsured populations in the country and the shuttering of women’s health clinics, including Planned Parenthood, during the 2011–2012 legislative session, may have put women who depended on clinics for basic health services at greater risk.

Working 15-hour shifts at St. David’s Medical Center, Satterfield delivers anyone who walks in their door, whether they have health insurance or not. The labyrinthian process of securing Medicaid is a serious obstacle. “Many simply give up trying or don’t get the help they need in time.”

Some will not see a health professional until they are five or six months pregnant. Others don’t make it to a clinic until they are in labor, and by then, they are often in critical shape. “There is a need for education,” Satterfield says. “You would not believe how many teenagers are coming in — ages 13, 14. I delivered a 12-year-old yesterday. In certain communities it’s culturally accepted.”

Then, too, many teens will deny being pregnant altogether, forgoing pre-natal care completely. Often, women do not receive healthcare between babies, ensuring pre-existing health concerns that can lead to high-risk pregnancies continue to fester.

Satterfield wants to connect with each patient regardless of who they are or where they come from — and the spectrum is wide. “Modern society has wonderful advantages but we tend to treat women symptom by symptom instead of taking a holistic approach — considering the mental, spiritual and physical combined. I was stunned to hear about a mother who died in a Texas hospital last week. It wasn’t due to medical negligence. The woman had uncontrolled diabetes before she got pregnant. The takeaway? Regardless of where you are on the socio-economic spectrum, all mothers want the same things: healthcare, respect, money to get by, love, laughter…A lot are fortunate to have those things in this country, and a lot aren’t.”

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