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'Thanksgiving' - A Commentary

By Jennifer Nagorka, KERA 90.1 commentator

Dallas, TX – The "Safe Delivery Kit" has perched on top of the file cabinet for more than a year. It's a large, Ziploc-type plastic bag, distributed by the United Nations Population Fund. It contains just a handful of items: plastic sheeting, a bar of soap, a surgical blade, umbilical tape - which looks like slender cotton shoelaces - and a few gauze bandages. That's it. The kit is supposed to help women and babies survive childbirth in active war zones or after a natural disaster, in places where there is no medical care.

Gathering dust alongside that delivery kit is a package of not-yet-filled-in birth announcements for our twins. They were born six weeks early, after a perinatalogist, reading my weekly ultrasound, told us our son was in trouble and the babies needed to be out within a couple days.

I delivered in a sterile surgical suite, surrounded by all the sophisticated healthcare an industrialized nation and good insurance can provide. Two doctors and various nurses and assistants sliced and stitched me. Each baby had an entire team of neonatalogists and nurse specialists. We needed the crowd. Our son weighed less than four pounds at birth, and both kids had problems typical of premature infants. Ten days after the C-section, I was driving and pretty much back to normal. Our kids are 20-pound bundles of smiles.

I can't imagine how any of us would have survived if we had been forced to rely on that safe delivery kit to see us through childbirth.

This Thanksgiving, I am grateful not only that my children are alive and healthy, but that I am, too. Pregnancy and childbirth remain deadly in much of the world.

For me, pregnancy meant a time of pleasant expectation. In Afghanistan, where one out of seven women died from pregnancy-related causes in the mid 1990's, it must be a time of terror. According to the United Nations Population Fund website, one of every 16 women in sub-Saharan Africa died as a result of childbirth or pregnancy during that same period.

The major causes of death - uncontrolled bleeding, serious infection, unsafe abortion, obstructed labor, and pregnancy-related hypertension - are all avoidable or treatable in the United States. We have 12 maternal deaths per 100,000 live births. The least developed nations have 1,100 such deaths per 100,000 live births.

When women can't get medical care, babies don't do well either. So it's no surprise that in Yemen, where only 16 percent of women have skilled attendants during childbirth, the infant mortality rate is about 74 deaths per 1,000 live births. In Nepal, only 8 percent of pregnant women have skilled help during delivery, according to the United Nations website. The infant mortality rate there is 82 deaths per 1,000 live births. In industrialized Japan, the rate is 3 per 1,000.

Our babies are, literally, happy and fat. This year, as I sit down to a plate piled high with turkey and dressing, I will give thanks for their good fortune and mine. But my thoughts and prayers - and some of my money - will also be with the women for whom childbirth means a little kit with a bar of soap and a surgical blade.

 

Jennifer Nagorka is a writer from Dallas.