Poverty, Education and Birth Outcomes

I've just finished reading Half the Sky, by Nicholas Kristof and Sheryl Wudunn and am half-way through reading Sex and Suffering, by Janet McCalman and I can't help but dwell on an incredibly disturbing truth about the relationship between poverty, education, women's health and birth outcomes.

In the 1800s in Australia, the vast majority of women were poor, malnourished, over-worked and having no access to contraceptives, found themselves pregnant more times than was good for theirs or their babies' health and well being. The greatest population of women was from Ireland, where many of them had been children during the potato famine. Their bodies were weak and pelvic malformation was common. They suffered horrendously long labours, when they produced babies too large for their pelvises and there was no means of helping them when the baby became stuck in the birth canal.

Doctors performed craniotomies to remove the foetus, dead or otherwise, when it seemed that the mother's life would be at risk, if they let the labour continue. Fistulas were common with such long labours and it wasn't until the late 1800s that doctors learnt how to repair the holes that caused the bladder or bowel to leak uncontrollably.

For non-indigenous women in Australia, these circumstances are a thing of the past. Most women today, enjoy good health and are well nourished. They have access to information about how to eat well and how to look after their bodies during pregnancy. They also have access to a high level of medical care, should they need intervention and technology to prevent poor outcomes. It is a tragic indication of the incredible inequality that exists between indigenous and non-indigenous populations here, however, that problems of malnourishment and high-risk pregnancy still exist in indigenous populations. I talked to a midwife who worked with indigenous communities in remote NT, who explained that most women from her community were automatically flown to a hospital in a large city such as Adelaide, in their 38th week, to prepare for what would more than likely be, a highly medicalised birth, because of the malnourishment and associated risks for these pregnant women.

Half the Sky describes the problems that women in third-world countries face in pregnancy and childbirth and like the women of the 1800s here in Australia and the indigenous women of today, these women suffer conditions such as stillborn babies and fistulas, completely unnecessarily. These are preventable situations. They are prevented with good nutrition, education and good medical care.

When I think about the level of care that I received during pregnancy and labour and the fact that I produced two healthy babies, with no complications of labour, I realise that I am privileged in the world and this is slowly forming a moral imperative to get involved. How can I feel good about this privilege, when women in other communities and other countries, are experiencing childbirth like those of women 200 years ago?