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Comment by SketchySeaBeast | Hacker News Reader

Right now on Arstechnica there is an article about the ridiculous rate of death during labour in the US: https://arstechnica.com/science/2018/07/why-do-so-many-moms-...

I feel like this is all somehow a strange result of personal responsibility mutated monstrously - society doesn't care about whether you live or die, but it'll do everything in it's power to make sure you're shamed for the slightest screw up.

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That's a great example. I have a family member who works in the health care data field, with the idea that enough data leads to better diagnosis and better outcomes. The topic of maternal mortality came up and how the US, comparatively, is rated worse than every other 1st world nation. His take was that 1) the other countries aren't reporting deaths correctly, 2) the data definition is not the same across nations, and 3) US women entered pregnancy with more comorbidities. So in essence a person in a medical field intended to keep more people alive for longer failed to recognize that systemically the US is doing worse than other nations because "data is deficient" and then blamed the dying women for being fat, old, unhealthy. Read here minorities specifically. Apparently no other nations in the world have old, fat, or unhealthy pregnant women.

That's an excellent example of pushing agency back upon the patient.

And I'm confused how "dying from complications directly caused by childbirth" would be reported differently in other countries. Maybe that's why Sweden has such a low murder rate, it's not "death by gunshot", it's "spontaneous exsanguination during a hospital stay".

I think the US has fairly broad definitions of maternal mortality, i.e. death within 3 months or 1 year of birth or something like that.

Some deaths related to the childbirth happen after the birth is officially over. Think sepsis from c-section complications or untreated post-partum leading to suicide.

Yeah, I took a look and that's exactly it - the US records over a year and the rest of the world a lot lower, so that could pick some stuff up. But I don't think that explains the higher mortality - I imagine the longer one lives after childbirth, the better odds one has that they will continue to live longer, and it certainly doesn't explain why minorities have so much of a higher rate.

My understanding is that mortality for whites is actually comparable to other nations. It is specifically the mortality of nonwhites that is so terrible. It's actually more specific than that: immigrant minorities are fine, but the second generation has the increased mortality of other nonwhites in USA. I heard this on some podcast; it may have been "Reveal"?

While some of these figures might actually be due to faulty data or divergent definitions in other nations, there is another factor that neither you nor your friend seem to be acknowledging - how the high cost of health care in this country is impacting the way women seek care during, before, and after childbirth.

Giving birth in this country is extremely expensive (https://www.theguardian.com/us-news/2018/jan/16/why-does-it-...) and we have a ton of people who are uninsured, underinsured, have high deductible plans, or simply aren't in stable enough financial situations to risk going to the doctor for prenatal/postnatal care when the $40 copayment or $300+ tests the doctor runs could delay their rent check that month.

When you talk about people coming into the hospital with comorbitieis, it's an easy next step to say "eh not our fault, that's on the patient, not on the medical system," but it kind of is on the medical system (or the insurance system, if you choose to differentiate the two) if the inability to afford healthcare is causing so many people to die of secondary causes when something serious enough to warrant it (in this case, pregnancy) forces them to go to a hospital.

I see the same issue inverted when it comes to abortion; millions of people protesting to make sure you don't kill your child before it's born, but hardly anybody there to help you to raise the child after it's born.

Or even during its birth. The water breaking is the beginning of the social darwinism water-slide.

I see this argument made quite frequently online and I don't get it. Isn't it obvious that more people think the state should prioritize preventing murders over helping people raise their children? Isn't the debate over the beginning of life more contentious than the debate over whether we should help raise other people's children?

The issue is the hypocrisy of ensuring that a mother delivers a potential baby and simultaneously removing the social safety net that ensures it will be cared for once it arrives (even if she isn't financially able to).

Many of us don't believe abortion is murder, so we think that it should be left to the woman involved to decide whether her life circumstances are appropriate for raising a(nother) child. If anti-choicers want to insert their own beliefs into someone else's very personal decision, it seems only reasonable to expect them to take some responsibility for the effects of that insertion.

It's because preventing crime ought to include reducing motivation for committing the crime. It's not like before Roe v Wade no abortions happened, and availability of abortions in Canada is probably even easier now than then. If we truly want to prevent abortions, we might want to address some of the causes, which include poor access to birth control and very low state-mandated support for new mothers compared to other wealthy countries.

I've argued in other places that cutting funding to planned parenthood is likely to increase rather than decrease abortions due to the improved access to birth control that PP provides.

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