Wednesday, September 18, 2013

This isn't the third world - so why adopt maternal health policies that pretend it is?

I think the level of health care access and health outcomes for mothers in developing countries is nothing short of atrocious. It is a tremendous tragedy when women and children die preventable deaths every day while giving birth. It is heartbreaking to think of conditions that have been obliterated in the developed world, being common place in the developing world (ie. obstetric fistula). Access to safe cesarean section and epidural pain relief, is simply beyond the reach of what can be offered to those mothers - the resources are simply not there. When thinking of the stark reality of birth, for many women who truly have no choice in the matter, what we have access to here - IS amazing. There is nothing romantic or empowering about the situation. It needs to be addressed - and I applaud the many organizations that are working on addressing and improving maternal health in developing countries.

However, it is a real shame that the deplorable conditions in developing countries are used as some kind of excuse for denying and ignoring the needs of mothers in developed countries. This is because failing to address the needs of Canadian mothers does nothing to address the needs of mothers in developing countries (newsflash: the government won't be sending the money they didn't spend on your healthcare to a provider in a developing country) and it also ignores the responsibility and desireability of actually meeting the needs of mothers in developed countries. The mentality that one should be grateful for what they have, ignores the need for improving upon the status quo. It's great that we do better than the developing world - but is that really the comparator that we want to use?

Setting health policy according to the lowest common denominator - particularly with regards to women and their health issues should be deplored. We don't set health policy for diabetes care or cancer care according to what is accessible in the developing world - so why are we keen to do so when it comes to issues around pregnancy and childbirth? Why are we keen to oversell vaginal unmedicated delivery and breastfeeding to mothers in the developed world while ignoring the valid choice of cesarean delivery and formula feeding? Why are we so keen to discount the value of being free to make such decisions in the first place? Policies to discourage cesareans absent medical neccessity and to encourage breastfeeding -might make a lot of sense in the developing world, but we should be strongly questioning such policies in the developed world as they may be costing many mothers very dearly in terms of their health and wellbeing.

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