'Nuff Said

US Maternal Mortality Rate Increasing
The maternal mortality rate in the US is the highest it has been in decades, according to statistics released in August by the National Center for Health Statistics. The US maternal mortality rate was 13 deaths per 100,000 live births in 2004, compared to 12 in 2003, which was the first year the maternal death rate was more than 10 since 1977. The major direct causes of US pregnancy-related deaths are blood clots, hemorrhage, complications of medical conditions, and eclampsia and pre-eclampsia.

The report says the increase in maternal deaths "largely reflects" more states' use of a separate item on the death certificate indicating pregnancy status of the woman. A rise in the number of caesarean sections could be a factor in the increased maternal mortality rate, some experts said. Race and quality of care also factor into the maternal mortality rate. The maternal mortality rate among black women is at least three times higher than among white women. Three studies have shown that at least 40% of maternal deaths could have been prevented with improved quality of care. The rise in obesity might also be a factor. Finally, more women are giving birth in their late 30s and 40s, when risks of pregnancy complications are higher.

The report is available online at www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_19.pdf

Yes, Chinua, Things do fall apart

Watch this on NY Times.com.
It is a short news blurb on the women of the Congo.
Some of the women I worked with in Uganda were refugees from the Congo. I feel anxious when I think about how big, how long, how devastating this war has been to so many thousands of people.

With the recent peace talks I wonder who will be the first to surrender. Surrender in Military definition is when soldiers or nations stop
fighting and become prisoners of war. Of course, nobody every mentions
that the white flag is usually conditional. There is always something
we just can't give up. Something we will still die to hold onto. And
what happens if there are multiple truths, perspectives, ideas we are
all clinging to the death for? Who surrenders what? So we negotiate
surrender. I'll give this up if you give that up, and then are we
even? Men sit around in suits and sign pieces of paper that are
contracts on other peoples lives. Surrender becomes the compromise,
and at once, the center of the story.

Its kind of like, Yes, Chinua, Things do fall apart: I can't talk my
way out of it. or into it. Just have to lay still and accept the
uneasiness as it washes over my broken body. a wave, pushing over
sand. And sometimes, when I wake, I am no longer who I thought I was
At ALL. I am only the pieces held together with blood and piss and
tears. Chaotic energy sparking into ash at your feet, blending into
the Earth as a molecule of something bursts into nothing and is gone.

Women of East Africa. Women all over who have been violated in the name of a battle being waged by men. Women who give birth and die for political violence.
I offer you my hands. My heart. My voice, which I am so privileged to have been taught how to use.
And yet I feel as powerless as you. When one woman is violated, we all are. Rape as a tool of war makes all of us prisoners. How do we shift what has already devastated? In the hearts of the men who rape. In the boys who are now growing and being raised by mothers who conceived and gave birth in violence. How do we shift the cycle?

These photos were taken by me in Uganda. Child Mothers to the left, and a TBA with a child she caught in an IDP camp to the right.

The 'Best'

I want to dialogue with the idea of 'the best' doctor.
I hear that a lot. It seems everyone has found 'the best' doctor to fit their needs.
"They have to operate, but he has the best heart surgeon in the United States".
"My gynecologist is rated number one in cervical cancer treatment".

First of all, who is doing the rating?
Second of all, what are they basing the ratings on? Lowest number of patient deaths? Highest level of training? Best bedside manner? (highly doubtful), Sexiness? (more likely.)
A small amount of research has led me to believe they base it on statistics which show the most performance with the best outcomes for the least amount of money paid by insurance companies.

It certainly is a comforting thought. Having the best.
We all want the best, but clearly, by nature of the word itself, only one person can inhabit that position. You are either 'the best' or you are not.
Seems like a strange binary for a field that needs to heal an entire world of people.

Read Rafael Campo's book 'Desire To Heal'.
It is a poetic look into empathy and the twisted business of being 'the best' doctor.

I love this belly. So often what is right beneath the skin seems so far away, so unimaginable, so un-real. And then you see the contours of a foot, skin pressing up against skin, and the distance is lessened, the body understood, everything just makes a little bit more sense.

Uter-"I"

What is a uterus?

"Uterus: 1. In the primates; The organ in which the young are conceived, developed, and protected till birth; the female organ of gestation; the womb. b. In other animals: The matrix; the ovary 1753. 2. Bot. a. = PERICARP 1676. b. In fungi: The envelope of the sporophore 1829." -- Oxford English Dictionary.

Uterus, then, appears to be a medical or botanical term. My uterus is there to perform a reproductive function, as in other animals (and fungi), and in some ways it is not dissimilar to a nut shell (pericarp -- the pod, husk or shell of a fruit). This description does seem to lack depth and breadth, being purely about physical form and function, but then that's exactly why I recognize it as a scientific definition.

So aside from its nutshell function, the cultural relationship of uterus to 'woman' is an interesting one to explore. What happens when our uterus betrays us by not holding life? Or when we lost it to illness? Or what happens when a perfectly functional uterus turns fifty and stops serving its life purpose? I am interested in a discussion of uterus vs femininity or gender roles in particular. I am most interested in an international discussion because I am sure it varies - I mean, shit, it probably varies from brownstone to brownstone here in Brooklyn.