How Can We Address Growing Health Risks for New Moms in the U.S.?


January 7, 2016

This post is the first in a new series called “Global Moms, Global Recipes,” a chance for moms around the world to share their experiences and exchange recipes.

Imagine living in a world where conversations around pregnancy and childbirth was part of the daily routine. In my family, it was.

Lisa_and_baby-2-300x274When I was growing up, you couldn’t ask my mother about her day at work without discussing the challenges in childbirth and childbirth education. My mom, Lisa-Marie Cook, RNC-OB, is a high-risk labor and delivery nurse at George Washington University Hospital. She’s been delivering babies for nearly 30 years and now teaches other nurses about birth and complications that can arise during the birth process.

As someone new to the health issues faced by women who are pregnant or delivering a baby, my mom was the first person I called to learn more about the challenges mothers are facing in the United States (US), and my top choice to help kickoff the “Global Moms, Global Recipes” series.

Why did you decide to become a labor and delivery nurse?

As a young nurse I was excited to play a small part in somebody’s birthday, and I still am. The motivating force behind my passion for high-risk pregnancies began after my first patient died. I’ll always be haunted by that first death. We did everything we could to save her but she died due to complications from sepsis, which is an overwhelming bodily response to infection. I realized at that point how important it is for new nurses to be aware of the signs of complications and understand how to care for high-risk patients.

In the U.S., the rate of women dying from complications in pregnancy and childbirth, is on the rise. Have you noticed any new efforts to try to protect mothers?

Lisa-Teaching-in-Seattle-300x224Every year between 700 and 800 women in the US die during childbirth. That’s a huge number. Our mortality rates have doubled since 1987. Organizations are doing the best they can to decrease these death rates with research and evidence based practices.  With new findings they’ve been able to create guidelines that implement awareness of complications and rapid response for better outcomes.

Unfortunately, these are not national standards and hospitals don’t provide the same quality of care. AWHONN  – a nursing organization I belong to are developing policies and standards but these practices haven’t been adopted in every hospital.

For example, California Maternal Quality Care Collaborative (CMQCC) developed toolkits for implementation to improve systems, but this isn’t being used nationally yet. It can take years for policies to be implemented and it shouldn’t. We need to find a way to bridge that information gap in order to help mothers get the best possible care, whether it’s training for nurses or perhaps better medical assistant programs, adopting standardized policies, or other ways of communicating safer practices.

Do you have any examples of how access to new policy has made a difference for patients?

Yes, in Canada and the United Kingdom (UK) the maternal death rate is much lower than the US. Why is that? 1) Women in those countries have free access to healthcare before they deliver. 2) Their hospitals share the same standards. In the UK when a hospital recognizes a systemic problem, they circulate the new information to all of the hospitals. Everyone across the board has access to the newest policies to help implement the best possible solution when complications occur in practice.

A healthy delivery is more than just birthing a baby; it’s about becoming a parent and leaving a legacy.

What are some other medical challenges that new mothers are facing today?

Women are having to return to the workforce immediately after delivery and this is impacting breastfeeding. Only 13 percent of moms are exclusively breastfeeding for six months and only two percent for a full year. A lot of research is looking at infant gut microbiome and we, as a country, are doing a disservice to infants by not encouraging mothers to breastfeed.

We’ve also seen a shift in demographics for new mothers; about 15 percent of new mothers are 35 and older and around half of new mothers are overweight. This impacts their health during the pregnancy and affects birth outcome.

In addition, about a quarter of pregnant women are not getting adequate access to prenatal care even with the 2010 Affordable Care Act. Women without access to prenatal care are 5.3 times more likely to die during childbirth than those that receive prenatal care. Black, Hispanic, and native American communities are still underserved and are at higher risks. Healthcare should be accessible to everyone and we have to encourage women to receive the prenatal care they need.


Is there anything else that you would like to say to the Global Moms Challenge community?

Having a healthy delivery is more than just birthing a baby; it’s about becoming a parent and leaving a legacy. Parents have to be the cheerleaders for their children, that’s how we’re going to make the world a better place. Be involved in your children’s lives.

Here in America women need to work towards implementing change for better birth outcomes. Healthcare professionals are aware of your concerns, but change in birth practices won’t happen without your voice.

Globally, decreasing maternal death should be on the agenda of every country, women are dying in childbirth– one every minute. I’m glad that the United Nations continues to see this as a concern as it impacts all of us.

Here are some additional resources for information on childbirth and breastfeeding in the US:

  • Agrawal, Priya.”Maternal mortality and morbidity in the United States of America.” Bulletin of the World Health Organization 2015;93;135.
  • Bingham, D. Strauss, N. Coeytaux, F. “Editorial: Maternal mortality in the United States: a human rights failure.” Contraception 83 (2011)189-193.
  • Maron, Dina. “Has Maternal Mortality Really Doubled in the US?” Scientific American. June, 8, 2015.
  • Nour, N.”An Introduction to Maternal Mortality: Reviews in Obstetrics and Gynecology. Vol 1. No. 2. 2008.

As part of the “Global Moms, Global Recipes” series, we’re sharing food recipes along with our stories to help you learn about global issues and get a sense of place. Lisa-Marie Cook wanted to share her favorite, and a popular appetizer at family parties, Filipino spring rolls.


How to Make Filipino Spring Rolls (Lumpia)

This was a holiday favorite in my household that drew on my Filipino roots. The recipe I’m currently using is a derivative of the one uploaded by LLQTPINAY23 on allrecipes.


1 pound ground pork or chicken (optional if veggie)
2 cloves crushed garlic
1/2 cup chopped onion
1/2 cup minced carrots
1 cup thinly sliced green cabbage
30 lumpia wrappers
2+ cups vegetable oil


1 handful of chopped cilantro
1 teaspoon ground black pepper
1 teaspoon salt
1 teaspoon garlic powder
1 teaspoon soy sauce (or oyster sauce)

  1. First you want to cook your pork and vegetable filling.
    Place your wok or large skillet pan over high heat and pour in one tablespoon of vegetable oil. Pan fry the pork, stirring frequently, until fully cooked. Remove the cooked pork from pan and set aside. Drain the grease from the pan, but leave a thin coating. Cook the crushed garlic and chopped onion using the same pan. It should only take a few minutes, then add the rest of your filling ingredients: cooked pork, carrots, green onions, and cabbage. Season the filling with pepper, salt, garlic powder, and soy sauce. Remove from heat, and set aside until it’s cool enough to wrap.

  1. Place the cooked pork filling into the egg roll wrappers.
    Put three large tablespoons of filling in the center of the wrapper in a diagonal line near one corner of each wrapper. Leaving a 1.5 inch space at both ends to fold properly. Fold the side along the length of the filling over the filling, tuck in both ends, and roll neatly. Try to keep the roll tight as you assemble, otherwise it will fall apart when frying. Moisten one side of the wrapper with water to seal the edge. You can cover the rolls with plastic wrap to retain moisture or start frying.

  1. Fry them and enjoy!
    Over medium heat, add half an inch of oil to a heavy skillet. Heat the pan for five minutes then add a few egg rolls, three or four at a time, into the oil. Fry the rolls for one to two minutes, until all sides are golden brown. Drain on paper towels. Serve immediately—and be careful not to burn your tongue.

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