This Memorial Day, I want to remember the dead from a different type of war.
It’s not a form most people think about, but throughout human history the male death totals from combat have generally been equaled by the number of women who have died from complications of pregnancy and childbirth.
It still holds true today. Despite advances in both medical technology and military strategy, it’s still as likely to kill you to serve your country for 9 months as it is to be pregnant once. Admittedly, there are obviously more risky categories of service to ones country in the Armed Forces than others, just as there are high-risk and lower-risk pregnancies. But sometimes what was thought to be a low-risk assignment or pregnancy isn’t. And despite our best efforts, both pregnant women and military servicemembers lose their lives in a war for the future of our nation – different wars, with very different tactics employed, but still wars.
We fought for the right for a pregnant woman to elect to not risk her life in that war for life just because biology made her the unlucky one chosen for it at about the same time we fought against the Draft – being a man who was unlucky enough to have your number drawn early shouldn’t automatically make you have to go off and risk your life for your country against your will. There may have been exemptions for conscientious objection to military service, allowing people who by religious training or true conviction couldn’t take a human life to avoid that “biological destiny”, but simply not agreeing with that particular war wasn’t enough. And… it should have been.
Pregnancy, childbirth, and motherhood should also be on a volunteer basis. “Losing the lottery” by being the one out of 333~ women to conceive on the Pill shouldn’t take away the right to decline that “biological destiny” either.
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Today, I want to honor the over 700 women who die trying to give their children life each year in the US, where ours is the only developed country with an increasing rate of maternal mortality. (I’ll save my post for the 65,000 others that nearly lose their lives but we manage to save for Veterans Day.)
Like Lauren Bloomstein, who died from HELLP Syndrome in 2011. Her doctors said the abdominal pain she was experiencing during labor and after, despite progressing from mild to being rated “10/10” by someone who was a nurse herself, was from heartburn, not the more obvious pregnancy-related reason.
Like Tara Hansen, who died a few months before from a preventable infection of her third-degree tear, sent home from the same hospital despite not feeling well without antibiotics.
Like Shalon Irving and all her sisters of color who, despite multiple encounters with medical professionals, had their concerns dismissed and died from pre-eclampsia and other obvious medical problems. Could institutional racism in the US, and especially how hard intersectionaliy – the mix of having more than one reason a person might suffer even unconscious discriminatory treatment – hits women of color, be why ours is the only country whose maternal mortality rate is continuing to rise? Lauren and Tara’s concerns about their health were dismissed, too – it’s known fact doctors, even female doctors, take men more seriously when they speak up. It’s not *just* a race thing, but obviously women of color are dying in extremely disproportionate numbers.
And all those sons and daughters left behind.
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In 1980, the technology wasn't routinely employed that might have caught the complication, and today ANY woman who is considering a home birth should get a transvaginal Doppler ultrasound to rule out what nearly killed me. Fortunately a routine ultrasound would have kept *her* safe.
But they weren't routine, and her marginal placenta previa (and my accompanying velamentatious cord insertion and vasa previa) weren't detected until she'd progressed far enough in labor for the entire complex to rupture -- her placenta abrupted and tore, and the delicate amniotic membrane that was holding the unprotected umbilical vessels together until they reached the protective cord (when a low-lying placenta "moves" to get better blood flow, it can leave this trail of unprotected vessels) finally burst at the same time. We were both bleeding out.
The reason I harp about ruling this complication out before home birth is that even in the hospital, if a vasa previa isn't detected until the amniotic membrane breaks, mortality rates for the infant today are 50-99%. If they know about the problem, generally she's admitted well before 36 weeks and delivered via C-section as soon as lung maturity is certain. If Mom's water had broken at home, I'd be dead. No question. 100% fatality rate. You can't get processed through the ambulance bay to the OR in time. The baby is dead before they even reach the hospital. If you want to give birth at home vs a hospital, isn't your baby's life worth one more uncomfortable encounter with the Magical All-Seeing Dildo?
Anyway... back to us, in 1980, in the hospital. Mom was dizzy from blood loss, they were wheeling her to the OR. There were several miracles involved in my survival. That we were fortunate enough to be in the best hospital in the state, and that the OB on duty was fantastic. That because it all burst at once and Mom was well-dilated, what could have been an additional life-threatening thing -- what was left of the the umbilical cord still attached to me also prolapsed, uncomplicated cord prolapse is also most likely to occur at membrane rupture -- seeing it was severed showed them exactly what was wrong, and allowed them to try to compress the cord to save my blood. Oxygen was already out the window, it was blood loss that was my danger. And hers.
And the miracle of maternal love, which made her say when asked which life to save if it had to be one or the other, despite my older sister at home... to say "Save my baby!"
We did both survive, with total transfusion volumes so high that despite the relative safety of the February 1980 blood supply in my state, as soon as HIV testing was available my pediatrician (stuck with the same one that saw me as that miracle newborn) had us both tested. I have much less "dain bramage" than predicted, though as I've gotten older we're seeing manifestations that weren't clear before that there was some. I take meds to prevent absence seizures. The rushed cesarean delivery left Mom with sudden severe endometriosis, and she had a hysterectomy as a result.
I love my mama. 
You were the miracle baby for sure.
The cards were mostly in your (and your mother's) favor.
I am so very glad. 
