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poppyseeded132 karma

I love your questions an would like to answer thoughtfully.

Maternal mortality happens on a spectrum. When women die it is often after an array of failures at many levels. Be Her Village is NOT the answer to completely solving the maternal mortality crisis. This crisis is rooted in racism, inequity, and a healthcare system that emphasizes reducing liability over improving maternal health. Our platform is designed to increase access to many of the services that we see in other countries that have falling maternal mortality rates. Where in those countries women are routinely provided with a postpartum in-home doula or nurse, seen by pelvic floor therapists, and receiving midwifery care, we have a system here in the US that does not provide or reimburse for many of these services. Paired with a non-midwifery friendly hospital culture and you have a recipe for women struggling for basic support plus facing a system that is intervening with dangerous procedures more often than needed. There is not enough research done here on how the services on Be Her Village impact outcomes, and that is part of the work we hope to do with our sister non-profit Maternal Spotlight.

As far as the toxic wellness culture---I'm right there with you. I actually just spoke about this yesterday in a Facebook live recording with a mental health provider about birth trauma (you can find this on our fb page if you have any interest). Basically we have two things happening: a "natural" birth community who sees the systemic issues, the interventions, the climbing mortality rates, and there is a huge amount of calling that out, pushing back, arming women with information, and pointing out that much of the death and bad outcomes for women is actually caused by the current practices in the OB community. It's a fine line to walk though because while we need to raise awareness it should NEVER be at the judgement of someone's individual choice. Do I think that doctor's need to do less cesareans, absolutely. Do I think that a woman who chooses to give birth with an epidural, or an ob, or at a hospital, or via cesarean should get flack or feel judged by anyone else? Of course not. And perhaps there needs to be more consciousness about talking about systemic causes versus attacking women who are opting into the birth that feels right for them.

I want to specifically address the question about home birth increasing your maternal mortality rates. There is a lot of information that supports the idea that home birth has equal or less risk for babies and less risk for mothers when compared to hospital births. Part of home birth or out of hospital care is about assessing risk along the way and transferring to a higher level of care during pregnancy, birth, or postpartum as needed. The way that home birth works best is when it is done in collaboration with local doctors and hospitals. When we think about how as a country we can reduce maternal mortality midwives are the obvious answer that almost every other country is using with wonderful results. Home birth will never be for everyone. And actually I was "against" it as a concept until a few months before I chose it for myself. I think above all else we need to be careful about supporting individuals without judgment so that people are not feeling shamed or attacked by the natural birth community. It's one of the reasons I don't actually consider myself a member of that community and I'm careful to always let people know that my goal is to have people feel empowered in their choices, not to have a certain type of birth or experience.

poppyseeded130 karma

Great question! It's not just one thing.

some aspects of the problem:

  1. Lack of midwives and non-high risk providers. In other countries with lower maternal mortality rates everyone sees a midwife or births in birth centers or low risk settings and only sees an OB if they have a medical need to see a surgeon.
  2. Lack of postpartum care. In the US women are monitored so closely at the end of pregnancy and then during labor. Once they go home they are on their own. Many of the deaths are postpartum due to clots, pre-eclamsia, bleeding, or other preventable health issues that could be caught by earlier intervention. For reference I just found out that in Switzerland you see a midwife 16 times between birth and your 6 weeks visit. Many of those visits are in the home.
  3. Litigious culture: Because we don't have a social safety net we must sue if we are injured or incur damages to ensure our financial well-being. Doctors and hospitals are terrified of being told they didn't do enough, so they almost always opt into the highest level of intervention (cesarean, typically) and that is very dangerous for the mother compared to a vaginal delivery. 1 in 3 women are having cesareans in our country.

poppyseeded87 karma

Great question! Thanks so much for checking out our site. Right now our team and platform is small enough that we are meeting with each business that signs on and ensuring they are an active and upstanding member of their communities. As we grow we are exploring ways to make sure that this sort of high-contact interaction are happening. One of the ways we have been thinking about is engaging community by community to have leaders/connectors in each area to help us grow responsibly and ethically.

poppyseeded77 karma

Absolutely! We have licensed mental health providers, support groups, and other mental health services. It's so important to consider mental health when we are thinking about moms.

We also know that one of the reasons that moms struggle with Postpartum Mood and Anxiety Disorders (PMAD) is because of a lack of support. Our aim is to help reduce mental health struggles through access to the types of services on our platform.

poppyseeded68 karma

I am fully vaccinated, my kids are as fully vaccinated as I could get them. I was first in line for the covid vaccine. And I find it difficult to find my own peers (not in business but as a mother) who care about their kids, want to be conscious parents, don't want to feed my kids junk, but also fully believe in science.

I appreciate the question minus the snark and find myself often walking the line between addressing the "natural" crowd who are tuned into these supports and seeking them out and also wanting to very much bring these sorts of things into the mainstream with the evidence to back them.