British Maternal Mortality in the 19th and Early 20th Centuries

Chamberlain, Geoffrey

doi:10.1177/014107680609901113

Cited by 40 publications

(19 citation statements)

References 11 publications

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“…Up to the mid‐20th century, obstetric care was dominated by efforts to improve maternal morbidity and mortality with major medical advances made by safe blood transfusions, antibiotics and effective anaesthesia . The 21st century, with the promulgation of antenatal ultrasound, has provided a visual and philosophical focus on the fetus.…”

Section: Introductionmentioning

confidence: 99%

Distractors in obstetric ultrasound: Do sonographers have safety concerns?

Najafzadeh

Woodrow

Thoirs

2019

Australas J Ultrason Med

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Introduction: Obstetric sonography is a highly skilled diagnostic medical examination. Pregnant women like to socialise their ultrasound experience with family, introducing distractions for the sonographer. Our objective was to survey ultrasound practitioners to identify concerns regarding interruptions and their opinions about socialisation during the examination. Methods: An online questionnaire was disseminated to study the views of Australian and New Zealand obstetric sonographers/ sonologists. It was informed by a pilot study of possible distractors with quality and safety concerns and operator opinions regarding family bonding. Results: The opinions of 393 obstetric sonographers/sonologists informed our results. Distractors with the most negative aspects included disruptive children (93.3%) and mobile phone conversations (84.3%). Most respondents (62%) believed that a distractor only had to be present for 5 min or less to have an impact. Small children were identified by 87.5% of respondents as safety risks to themselves, to the patient and to sonographers. Sonographers were concerned that distractors caused a loss of concentration, interruption to a systematic scanning approach and increased false negatives in screening, missing important diagnoses. Sonographers strongly agreed that obstetric sonography facilitated maternal-fetal bonding, but only 15% thought that siblings bond with the fetus during the scan. Conclusion: Obstetric sonographers in our study are concerned that distractors pose a negative impact on the quality and safety of ultrasound. They also recognise the importance of family bonding. Strategies to bridge the medical and social components of obstetric sonography should be developed to reduce quality and safety threats.

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Section: Introductionmentioning

confidence: 99%

Distractors in obstetric ultrasound: Do sonographers have safety concerns?

Najafzadeh

Woodrow

Thoirs

2019

Australas J Ultrason Med

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“…1 Pressure on blood supply in developed countries is likely to intensify in the longer term with increasing life expectancy, concomitant with greater numbers of surgical procedures in an ageing population and notable rises in the prevalence of cancer. 2 Whilst blood transfusions are a life saving procedure for many, as evidenced by the dramatic fall (~99%) in the number of women dying in childbirth from 1920 to 1950, 3,4 they can pose significant risks. Individuals who require regular transfusions are at risk of adverse reactions following transfusion of mismatched blood.…”

Section: Introductionmentioning

confidence: 99%

Superior survival of ex vivo cultured human reticulocytes following transfusion into mice

et al. 2016

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The generation of cultured red blood cells from stem cell sources may fill an unmet clinical need for transfusion-dependent patients, particularly in countries that lack a sufficient and safe blood supply. Cultured red blood cells were generated from human CD34+ cells from adult peripheral blood or cord blood by ex vivo expansion, and a comprehensive in vivo survival comparison with standard red cell concentrates was undertaken. Significant amplification (>105-fold) was achieved using CD34+ cells from both cord blood and peripheral blood, generating high yields of enucleated cultured red blood cells. Following transfusion, higher levels of cultured red cells could be detected in the murine circulation compared to standard adult red cells. The proportions of cultured blood cells from cord or peripheral blood sources remained high 24 hours post-transfusion (82±5% and 78±9%, respectively), while standard adult blood cells declined rapidly to only 49±9% by this time. In addition, the survival time of cultured blood cells in mice was longer than that of standard adult red cells. A paired comparison of cultured blood cells and standard adult red blood cells from the same donor confirmed the enhanced in vivo survival capacity of the cultured cells. The study herein represents the first demonstration that ex vivo generated cultured red blood cells survive longer than donor red cells using an in vivo model that more closely mimics clinical transfusion. Cultured red blood cells may offer advantages for transfusion-dependent patients by reducing the number of transfusions required.

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“…New methods recording maternal death revealed dramatic increases in maternal mortality in the late 19th and early 20th centuries at the hands of physicians, but these deaths are never considered the fault of medicine's intervention (Chamberlain, 2006). It examines the displacement of birth into biomedical clinical spaces in European and American settings, and explores how this shift facilitated the pathologizing of childbirth globally.…”

mentioning

confidence: 99%

Biocultural perspectives on maternal mortality and obstetrical death from the past to the present

Stone

2016

American J Phys Anthropol

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Global efforts to improve maternal health are the fifth focus goal of the Millennium Development Goals adopted by the international community in 2000. While maternal mortality is an epidemic, and the death of a woman in childbirth is tragic, certain assumptions that frame the risk of death for reproductive aged women continue to hinge on the anthropological theory of the "obstetric dilemma." According to this theory, a cost of hominin selection to bipedalism is the reduction of the pelvic girdle; in tension with increasing encephalization, this reduction results in cephalopelvic disproportion, creating an assumed fragile relationship between a woman, her reproductive body, and the neonates she gives birth to. This theory, conceived in the 19th century, gained traction in the paleoanthropological literature in the mid-20th century. Supported by biomedical discourses, it was cited as the definitive reason for difficulties in human birth. Bioarchaeological research supported this narrative by utilizing demographic parameters that depict the death of young women from reproductive complications. But the roles of biomedical and cultural practices that place women at higher risk for morbidity and early mortality are often not considered. This review argues that reinforcing the obstetrical dilemma by framing reproductive complications as the direct result of evolutionary forces conceals the larger health disparities and risks that women face globally. The obstetrical dilemma theory shifts the focus away from other physiological and cultural components that have evolved in concert with bipedalism to ensure the safe delivery of mother and child. It also sets the stage for a framework of biological determinism and structural violence in which the reproductive aged female is a product of her pathologized reproductive body. But what puts reproductive aged women at risk for higher rates of morbidity and mortality goes far beyond the reproductive body. Moving beyond reproduction as the root causes of health inequalities reveals gendered-based oppression and inequality in health analyses. In this new model, maternal mortality can be seen as a sensitive indicator of inequality and social development, and can be explored for what it is telling us about women's health and lives. This article reviews the research in pelvic architecture and cephalopelvic relationships from the subfields of evolutionary biology, paleoanthropology, bioarchaeology, medical anthropology, and medicine, juxtaposing it with historical, ethnographic, and global maternal health analyses to offer a biocultural examination of maternal mortality and reproductive risk management. It reveals the structural violence against reproductive aged women inherent in the biomedical management of birth. By reframing birth as normal, not pathological, global health initiatives can consider new policies that focus on larger issues of disparity (e.g., poverty, lack of education, and poor nutrition) and support better health outcomes across the spectrum of life for women globally.

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British Maternal Mortality in the 19th and Early 20th Centuries

Cited by 40 publications

References 11 publications

Distractors in obstetric ultrasound: Do sonographers have safety concerns?

Distractors in obstetric ultrasound: Do sonographers have safety concerns?

Superior survival of ex vivo cultured human reticulocytes following transfusion into mice

Biocultural perspectives on maternal mortality and obstetrical death from the past to the present

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