Birth, death: a mother's story Risks remain: It's widely assumed women don't die in childbirth anymore. But last year, 11 Maryland families learned otherwise.

February 11, 1996|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

Karen Lynn Moats had been waiting a lifetime for this moment. It was late afternoon July 8 when she reached out to cradle her newborn son.

"Now we've got our family," Karen said to her husband, Todd, as they gazed at their 7-pound, 2-ounce infant and his head of dark hair. They named him Joshua Thomas.

Two-and-a-half days later, Todd Moats stood in the nursery at Hagerstown's Washington County Hospital, holding Joshua and praying as an emergency medical team rushed past in the hall.

His 25-year-old wife was in cardiac arrest.

Karen Moats died from complications of pregnancy and childbirth, joining a surprising and persistent number of women who lose their lives in becoming mothers.

Despite the widespread but false impression that women don't die in childbirth anymore, at least 30 women in Maryland lost their lives this way during the past three years, including 11 in 1995. Nationwide, at least 320 women died of complications from childbirth in 1992, the latest year for which national figures are available.

The rates tell the story: In 1940, the rate of maternal deaths was 364 per 100,000 births nationwide. Since then, the rate has plummeted a remarkable 98 percent. But in recent years, progress has halted, with the rate hovering at about eight per 100,000 births.

"In 1995, I think one or two deaths is almost intolerable, especially with the technology we have today," said Dr. Clarice Green, a medical epidemiologist in reproductive health at the U.S. Centers for Disease Control and Prevention in Atlanta. "We need to really crack down and find out what's going on. Why are infection and hemorrhage still major causes of death?"

In some ways, the advances of the past half-century have fostered a complacency that pregnancy is routine rather than potentially dangerous. But it is a precarious time in which any weakness in the mother's body is exposed. Her cardiac output surges, blood volume increases by about a quarter and blood vessels expand to accommodate the new life. For some women, the strain is too much.

Some experts say care of new mothers in the first few days after the baby is delivered -- at the time they are most vulnerable to blood loss -- has become lax.

"We don't have a continuum of care. As soon as the baby is born, we think it's all done, and we let go of the meticulous monitoring of the mother," said Dr. Dyanne Affonso, dean of the Nursing School at Emory University in Atlanta.

The revolution shaking the country's health care system -- including the overhaul of nursing staffs and shorter stays for new mothers -- also poses threats.

Meanwhile, cases of maternal death are vastly underreported. Death rates two to six times higher than shown in vital statistics reports have been found by various researchers cited in a 1992 CDC review. The gap makes it difficult to track causes, detect trends and train physicians in ways that might save lives.

"There's no national effort to systematically look at these events and say what's happening, and why are they happening, and the societal impact is substantial," said Dr. Jeffrey King, chairman of an American College of Obstetricians and Gynecologists group on maternal mortality. "These are frequently young women who have many years ahead of them, and that is lost."

Maryland victims include:

* Teresa Asid-Oechsler, 33, who died a year ago after suffering complications during the birth of her son, Ryan Alexander. It was the first pregnancy for the Sykesville woman, an engineer at Westinghouse Electric Corp.

* A 35-year-old Baltimore woman, who died Jan. 1, 1995, at the moment her daughter was born. The woman, whose family asked that she not be identified, was in the late stages of her second pregnancy when she began to experience symptoms from an irregular heartbeat, and later developed pre-eclampsia, a pregnancy complication that in rare cases leads to death. Doctors could not stabilize her blood pressure or pulse. Said her husband: "When we went to the hospital, we went there thinking, 'We'll be home soon with the baby.' "

* Susan Moy, a 22-year-old Edgewater woman who died a week after giving birth to her son, Richard III, at Anne Arundel Medical Center in 1986. The family's attorneys charged that two Annapolis obstetricians failed to recognize and treat pre-eclampsia. By the time she was transferred to Johns Hopkins Hospital, she was brain-dead. Her husband has had to live with the words of a Hopkins physician: "If we had her earlier, we could have saved her." A jury in 1992 awarded her husband, Richard S. Moy II, and their son $3.5 million, which the court in 1993 reduced to $1.5 million.

The families are left to care for the infants and to attempt explanations they don't have themselves. At the funerals of several Maryland women, including Karen Moats, hundreds of incredulous mourners asked how the young mothers could have died at the happiest moments of their lives.

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