User:Neiceylyn/sandbox

Workplan:

Over the next 4 weeks I will be working on improving this article as a part of my curriculum. As a brief overview I will begin by focusing on the references during the first week.

First paragraph needs revising, not succinct, brings in Texas.... figure out how to smoothly incorporate that part. Acronyms need to be explained. Read through the references and determine if they are appropriate. Expand on what preventable causes attributed to 50% of deaths. Restructure so the timeline makes more sense. Restructure sentences to make more sense, the wording is confusing and makes other suggestions. Make better groups and headings and arrange them in a decent order. Find better pictures regarding childbirth and pregnancy. Have an image that corresponds to some of the factors that cause higher rates of mortality. Possibly include a map showing the differences between states. Clean up and expand the comparison between countries and states. Expand both the cause and prevention sections as they are the most important to the topic. I intend to use this first week to look up the sources already presented within the article and determine their significance. As important words or topics arise, I will hyperlink them accordingly. Since there are no specific signs and symptoms I will have to do more research on the topic to figure out what would be appropriate to include in the article. I will have to find a good balance between the medical side and the public health aspect as this is a mix between the two. I plan to have mothers I know who are not within the medical field to review the page to ensure everything makes sense from their point of view.

Go through Talk page and browse those potential references and get ideas based off of what has already been discussed.

Historical images section seems out of place. Possibly add maternal mortality in history section and include images there; include practices to combat maternal mortality in history. Include a section on the trends and its comparison to the rest of the world. Search for research on health disparity regarding MM and how to combat. Make sure none of these are principal articles and have a consensus among multiple professionals.

Towards the end I will focus more on retracting things, such as, decreasing the focus on measurement and data collections, as that does not seem to be of high importance.

Possible References:

http://accessmedicine.mhmedical.com/content.aspx?bookid=710&sectionid=46796902

Maternal and Child Mortality section. (Chapter 1.)

Lead
Maternal mortality refers to the death of a woman during her pregnancy or up to a year after her pregnancy has terminated, if the death was related to her pregnancy. The United States Centers for Disease Control and Prevention (CDC) monitors maternal death per 100,000 live births. The CDC reported a baseline maternal mortality ratio (MMR) of 18.8 maternal deaths per 100,000 births in 2016, which was higher than anticipated. In 2014 there was a 26.6% increase representing 23.8 maternal deaths per 100,000 births. Maternal mortality as well as maternal morbidity has been increasing over the last several decades in the United States, with an estimated 50% of deaths due to preventable causes.

The CDC reports maternal mortality as a ratio of maternal deaths per 100,000 births.

By 2010, although the United States was spending more on healthcare than any other country in the world, more than two women died during childbirth every day, making maternal mortality the highest in the United States compared to 49 other countries in the developed world and three times higher than neighboring Canada. In 2016, as many as 900 women between the ages of 16 and 43, died from pregnancy- and childbirth-related causes. The Centers for Disease Control and Prevention (CDC) declares that 60% of these deaths are preventable.

In the U.S., hospital bills for maternal healthcare costs over $98 billion, and concerns about the degradation of the MMR resulted in a state-by-state breakdown. Race, location, and financial status all contribute to how maternal mortality affects women across the country, but Texas has the worst MMR, which caused the Department of State to create the Maternal Mortality and Morbidity Task Force in 2013.

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Maternal mortality refers to the death of a woman during her pregnancy or up to a year after her pregnancy has terminated; this only includes causes related to her pregnancy and does not include accidental causes. Some sources will define maternal mortality as the death of a woman up to 42 days after her pregnancy has ended, instead of one year. In 1986, the CDC began tracking pregnancy related deaths to gather information and determine what was causing these deaths. The CDC reported a baseline maternal mortality ratio (MMR) of 18.8 maternal deaths per 100,000 births in 2016, which was higher than anticipated. In 2014 there was a 26.6% increase representing 23.8 maternal deaths per 100,000 births. The United States Centers for Disease Control and Prevention (CDC) monitors maternal death per 100,000 live births. Maternal mortality as well as maternal morbidity has been increasing over the last several decades in the United States, with an estimated 50% of deaths due to preventable causes.

By 2010, although the United States was spending more on healthcare than any other country in the world, more than two women died during childbirth every day, making maternal mortality the highest in the United States compared to 49 other countries in the developed world and three times higher than neighboring Canada. In 2016, as many as 900 women between the ages of 16 and 43, died from pregnancy- and childbirth-related causes. The Centers for Disease Control and Prevention (CDC) declares that 60% of these deaths are preventable.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001799/

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Maternal mortality refers to the death of a woman during her pregnancy or up to a year after her pregnancy has terminated; this only includes causes related to her pregnancy and does not include accidental causes. Some sources will define maternal mortality as the death of a woman up to 42 days after her pregnancy has ended, instead of one year. In 1986, the CDC began tracking pregnancy related deaths to gather information and determine what was causing these deaths by creating the Pregnancy-Related Mortality Surveillance System. The CDC reported an increase in the maternal mortality ratio in the United States from 18.8 deaths per 100,000 births to 23.8 deaths per 100,000 births between 2000 and 2014, a 26.6% increase.

The United States Centers for Disease Control and Prevention (CDC) monitors maternal death per 100,000 live births. Maternal mortality as well as maternal morbidity has been increasing over the last several decades in the United States, with an estimated 50% of deaths due to preventable causes.

By 2010, although the United States was spending more on healthcare than any other country in the world, more than two women died during childbirth every day, making maternal mortality the highest in the United States compared to 49 other countries in the developed world and three times higher than neighboring Canada. In 2016, as many as 900 women between the ages of 16 and 43, died from pregnancy- and childbirth-related causes. The Centers for Disease Control and Prevention (CDC) declares that 60% of these deaths are preventable.

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These are Embolism (20%), Hemorrhage (17%), Pre-eclampsia and eclampsia (16%), Infection (13%), and Cardiomyopathy (8%).

--- expand and define

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Social factors and healthcare access issues also contribute to the maternal mortality rate. In no particular order, these factors include:

African American women are four times as likely to suffer from maternal morbidity and mortality, compared to Caucasian women. and there has been no large-scale improvement over the course of 20 years to rectify these conditions. Furthermore, women of color—especially "African-American, Indigenous, Latina and immigrant women and women who did not speak English" —are deterred from seeking the care they need, due to discrimination.


 * 1) Access to healthcare
 * 2) *Prenatal care
 * 3) ** Doctors may be unwilling or unable to provide care for pregnant mothers, due to high costs. Many women are turned down due to Medicaid fees, as well. Women have also reported access and mobility as reasons why they are unable to seek prenatal care, such as lack of transportation and/or lack of health insurance. Women who do not have access to prenatal care are 3-4 times more likely to die during or after pregnancy than women who do. Access to prenatal care is an essential component for a healthy pregnancy, which decreases the chances of maternal mortality; however, women in America do not have easy and equal access to it.
 * 4) *Insurance
 * 5) ** Insurance companies reserve the right to categorize pregnancy as a pre-existing condition, thereby making women ineligible for private health insurance. Even access to Medicaid is curtailed to some women, due to bureaucracy and delays in coverage (if approved).
 * 6) Discrimination
 * 7) Racial disparity
 * 8) Economic disparity
 * 9) * It is estimated that 99% of women give birth in hospitals with fees that average between $8,900-$11,400 for vaginal delivery, and between $14,900-$20,100 for a cesarean. Many women cannot afford these high costs, nor can they afford private health insurance, and even waiting on government-funded care can prove to be fatal, since delays to coverage usually result in women not getting the care they need from the start.
 * 10) Social disparity
 * 11) * Studies have shown that women are affected by the stress of being lower income, which then affects their pregnancies and unborn babies. In the US, women of color disproportionately experience stress related to financial burdens and racism when trying to gain access to healthcare. These women have a harder time maintaining or gaining access to healthy nutrition and even safe housing. These social factors are directly linked to the outcome of maternal care.
 * 12) Cesarean birth
 * 13) * The Healthy People 2010 goal was to reduce the c-section rate to 15% for low-risk first-time mothers, but that goal was not met and the rate of c-sections has been on the rise since 1996, and reached an all-time high in 2009 at 32.9%. Excessive and non-medically necessary cesareans can lead to complications that contribute to maternal mortality.
 * 14) Postpartum care
 * 15) * Women in the US usually meet with their physicians just once after delivery, six weeks after giving birth. Due to this long gap during the postpartum period, many health problems remain unchecked, which can result in maternal death. Just as women, especially women of color, have difficulty with access to prenatal care, the same is true for accessibility to postpartum care. Also, postpartum depression can also lead to untimely deaths for both mother and child.
 * 1) * Women in the US usually meet with their physicians just once after delivery, six weeks after giving birth. Due to this long gap during the postpartum period, many health problems remain unchecked, which can result in maternal death. Just as women, especially women of color, have difficulty with access to prenatal care, the same is true for accessibility to postpartum care. Also, postpartum depression can also lead to untimely deaths for both mother and child.

Inconsistent obstetric practice (which can allow complications to progress to fatal conditions), increase in women with chronic conditions, and lack of maternal health data all contribute to maternal mortality in the US. According to a 2015 WHO editorial, a nationally implemented guideline for pregnancy and childbirth, along with easy and equal access to antenatal services and care, and active participation from all 50 states to produce better maternal health data are all necessary components to reduce maternal mortality.

Recent improvements in pregnancy-related health care have focused on fetuses and newborns, which has left mothers neglected in comparison. Mothers get 6% of federal block grants in this area, and even hospitals with intensive care units for newborns can be unprepared for maternal complications (like having platelets on hand for bleeding). A significant proportion of physicians in maternal-fetal medicine programs are able to complete a program in without ever attending a labor.

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