Obstetric care issues locally, globally focus of talk

In the developing world, the life of a mother directly depends on her access to a skilled doctor or midwife.

In Eastern Washington, the stakes may not be so high. But even here, women can’t take for granted they’ll find the obstetrical care they need.

Dr. Deb Harper, a pediatrician with Group Health, will discuss these issues at a dinner celebrating United Nations Day on Tuesday at Mukogawa Commons at Fort Wright Institute.

Her topic will be “Maternal Health and Well-Being: Global and Local Successes and Challenges.” The event is sponsored by the Spokane chapter of the United Nations Association.

The topic of Harper’s talk connects to the United Nations Millennium Development Goal No. 5, which calls for substantially reducing maternal mortality by 2015.

In developing countries, mothers die after deliveries complicated by severe bleeding or infection. When that happens, the baby’s prognosis is also grim.

“The truth is that if the mother dies, the baby will die,” she says. “The child will not survive. For kids under 3 years old, they just can’t.”

Harper also will talk about the health issues facing mothers in Eastern Washington. Here, women struggle with other access issues.

Nine rural counties in the state no longer have physicians providing obstetrical care, primarily because of the high cost of malpractice insurance, Harper says.

“If you live in Lincoln County, Reardan or Davenport, there’s nobody there who is doing OB care now,” she says. “Your choice if you live in one of those towns is to drive over to Wenatchee or to drive clear over to Spokane.”

As more rural women travel to Spokane for care, the number of physicians performing deliveries here also has been declining.

Family practice doctors in Spokane have stopped delivering babies based on the high cost of malpractice insurance. Harper says she’s talked to male family doctors who have been literally in tears over the decision.

“They’ve delivered the last baby they’re ever going to deliver, and it just kills them,” she says.

Meanwhile, there’s a batch of baby-boomer-aged obstetricians in Spokane who are beginning to slow down on deliveries, primarily because the middle-of-the-night calls are so exhausting.

“We have fewer people delivering babies, but our population has grown a bit and now we have women from Lincoln County coming over,” Harper says. “We are really taxing the system with the number of people we have (who are) able to deliver babies.”

Harper is a consultant in child abuse for Partners with Families and Children and an assistant dean and clinical coordinator for the University of Washington School of Medicine’s Eastern Washington region.

She plans also to discuss approaches, both locally and abroad, that have helped reduce premature births and infant deaths.

The United Nations Association meets monthly at the Unitarian Universalist Church of Spokane to increase public awareness of global issues.