Not for the Faint of Heart

This is my second week in the Philippines. And already, I feel so many changes. I have already had life altering experiences, things that I will never forget. And I will never be the same.

One of the things I have experienced here is something I heretofore only understood as a statistic. In the Philippines, 4000 women a year die in childbirth. The rate for infant mortality is even higher. Not even two days in, I saw this statistic first hand. I saw a brave, strong mother labor until she couldn’t anymore—and two hours after she arrived at the hospital, she and her baby both died. She was so thin. I could see all the muscles, veins, tendons under her skin as she strained to push her baby out. Even during pregnancy, she gave all she had to her baby and her three young children (all under the age of five). This woman worked so hard, but she could not overcome poverty and circumstance. She could not overcome oppression.

In the US, I’ve heard so many times, “what happens if the baby doesn’t come out?” We say “oh, they always come out” or “that’s why we have C-sections”. But the reality is, we are lucky to live in a country in which we can have a c-section ready in less than 20 minutes; in which we can get to the hospital in enough time to save lives. Here in the Philippines, the ambulance is so slow that it makes more sense to take a taxi or have someone drive you, and even then if traffic is bad it can be a long ride. There is only one hospital in the area that has a 24 hour on call anesthesiologist so that a c-section can be done. And sometimes, as in the case of this mother, women have to wait up to an hour or more for emergency care. That’s just in Manila. In the provinces and more rural areas, access to these services is even harder to come by. And all of this is compounded by poverty—if she doesn’t have enough money when she arrives at the hospital, a woman can be refused care. Here, when the baby doesn’t come out, death of mother and child is a reality not just a statistic.

And I have to remember, that it is also a reality for so many Native American and African American women and babies in the US. Black babies in the US die at a rate that is two to three times higher than white babies. For Native Americans, that rate is 1.6 times higher. Maternal mortality rates for Black women are three times higher and Native American women are 1.7 times higher than white women in the US.

When I think about all of this, all these women and babies dying, I can’t help but ask why. Why is it so different? Why can’t we just get these women the care they deserve? And I know that sometimes, it can’t be helped. Sometimes, in rare cases, women and babies just die. Death is a part of life. However, when a woman and her baby die because they waited for over an hour for care in the hospital it seems like more than just the circle of life. Where is that disconnect?

As I move forward through my time here, I am learning a lot about the cycles of oppression, and what they look like for these people. I understand that what I am doing here is only a Band Aid on a much larger problem. It is not enough to provide free services. There has to be a real education and change on the part of the people who have more privilege. I need to think not only about how I can share what information and wealth I have, but also how it can be spread equally between people in the first place. Women need to be supported and empowered to help themselves, in their own way. How do I, as a white, middle-class woman from the US, know anything about what a poor Filipina needs? I don’t. Only she knows what she needs, and maybe just maybe I can help her find it.

One of the things I will take home from this experience is this—that the best I can do is offer my service with a humble heart. I can’t tell other women what they should or shouldn’t do. I can’t even hope to understand how to navigate their lives. But I can give them some information that can empower them to find a way. I can support them. And I can understand how my actions, ALL of my actions, affect them by virtue of being a member of this planet. I can look at my class, my social standing, the privilege that comes with the color of my skin and I can see how I can use those things to make life better for all of us. And I can hope beyond hope that some day all women will have access to the care that they need. I can look forward to the time that death can go back to being part of the cycle of life, instead of a result of the cycle of oppression that plagues our time. And I can do my very damnedest to offer excellent midwifery care to all families who want it; to make sure that I never see another woman and/or baby die from childbirth again.

2 Replies to “Not for the Faint of Heart”

  1. Hey Sky, heartbreaking post. Wow.

    Just a small detail: the mortality figures that you use for the US aren’t quite correct.
    “Black babies in the US die at a rate that is four times higher than white babies. For Native Americans, that rate is nine times higher. Maternal mortality rates for Black and Native American women are at least two times higher than white women in the US.”

    In fact:

    African American babies die at 2-3 times the rate of white babies (in 2008, the ratio was 2.3:1).

    Native American and Alaska Native babies die at about 1.6 times the rate of white babies.

    Maternal mortality rates for African American moms are over *3 times* the rate of whites, and for Native American moms the rate is about 1.7 the rate of white moms.

    Click to access deadlydeliveryoneyear.pdf

    (pg. 5)

    The maternal mortality rates, moreover, probably underestimate the actual numbers.

    We are completely agreement that these are such outrageous and tragic statistics, words cannot do justice. But it’s good to keep the numbers clear.

    All the best,

    1. Thanks so much for the corrections Annie. I’ll make sure to update the post. And I agree, keeping the numbers correct is an important part of truthfully telling these women’s stories.

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