June 16, 2022 • 22 mins
Mexico’s handling of the pandemic has been largely driven by its president, Andrés Manuel López Obrador, and his desire to keep the economy open. That’s meant few restrictions and a “return to normal” even before vaccines. The approach hasn’t come without costs, particularly to the country’s health care system. During the first year of the pandemic, maternal mortality rates spiked 60%. In this episode of The Pay Check, Equality reporter Kelsey Butler travels to a rural part of Mexico’s Yucatan Peninsula to get to the bottom of how that happened — and find out how to fix it.
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Episode Transcript
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Speaker 1 (00:05):
It's ninety degrees out and I'm covered in bug spray,
lying on the dirt floor of a hut with a
roof made of palms. A woman is pressing hard on
my stomach. She's telling me something is wrong. Look here, hey,
hap happy? The woman forcefully massaging my belly is She's
(00:30):
a a kind of traditional healer in the Yucatan region
of Mexico. Pregnant women come to her from nearby to
make sure that the whole childbirth experience is safe, kind
of like a duela. The massage she's giving me is
one of the sort of services she performs for her clients.
It does a bunch of things, including putting the baby
(00:51):
in a head down position for labor or calming the
client's nerves. Okay, that this massage, though it did not
exactly call my nerves while massaging me, tells me that
something of mine called isn't where it should be. This
(01:14):
probably isn't a body part you've ever heard of, but
in my own culture, here is an organ believed to
be found in your mid section. After you have a baby,
a time where your organs are really shifted around. You're
supposed to come back twelve days after delivery to get
a massage from someone like During that she makes sure
(01:36):
that your sto is where it should be and massages
it back into place if it isn't. The belief here,
though it isn't backed up by modern medicine, is that
with it out of place, you can experience back pain,
stomach issues, and anxiety. They believe you can pass along
some of those issues to your baby if you breastfeed too.
I'm way past that twelve day mark. How to baby
(02:00):
a year ago? So why am I hair exactly? I'm
Kelsey Butler, a reporter on Bloomberg's A Quality Team. When
I got pregnant in the middle of the pandemic, I
was living in New Jersey. The state was one of
the highest maternal mortality rates in the US, and the
(02:23):
numbers were the worst for women like me, who are black.
The death rate was made even scarier by the prospect
of getting COVID, which I knew made the chances of
complications for both me and my baby even higher. I
thankfully had a mostly complication free birth. My son turned
one last month, but it got me thinking about maternal health,
(02:45):
and when I started looking into it, I found an
even more shocking statistic, just a little bit south. For years,
maternal mortality had been improving in Mexico. Then the pandemic
hit and the rate for maternal deaths climbed over sixty.
So I jumped on a plane to Mexico to find
out what happened. Jobless claims coming in, I mean really
(03:09):
jumping from the week before, pretty brutal. Three point to
a million records. Six point six million Americans filed for
unemployment last week. Indian working women were the worst impacted
by the pandemic. If so divid like Umia, Well, now
to the billionaire boom. According to Bloomberg's super yacht charters
(03:31):
are up over three hut and a billionaire was created
every twenty six hours during this pandemic. It is time
for a wealth tax in America. Welcome back to the paycheck.
I'm Rebecca Greenfield. Among the many things that have determined
(03:53):
how a country has fared economically during the pandemic is
how government's decided to manage the virus that's off. Some
places opted for a COVID zero strategy, going to extreme
lengths to keep the virus out of their borders. Others
had more of a letter rip strategy, keeping the economy
and businesses open with little regard for the virus itself,
(04:17):
and many places where somewhere in between. Each approach comes
with costs, though some are much higher than others. Mexico
is a country that chose its economy over everything else.
A few months into the pandemic, the government slowly started
lifting restrictions. That's my colleague Andrea Navarro. She's a reporter
(04:38):
in Mexico City. We were one of the few places
in the world where we never really had any travel
restrictions of any kind. So things went back to normal
relatively quickly. Here Andrea usually covers Mexico's economy, but for
the last two and a half years she's been covering COVID.
She told me as early as before vaccines, Mexico is
(05:00):
open for business. To understand this approach, Andrea says, you
have to understand Mexico's president. Andrea's Manuel Lopez Obrador, who's
known more colloquially as Amlo. Amlo can be described as
a populist, and what that means is that he will
basically say and do anything that he says will be
(05:20):
popular with his base, which is very big. Am Lo
caters to Mexico's poorest people, many who work in the
informal and service economies, the people who run things like
street cards, and if they aren't allowed to operate or
all their customers are stuck in quarantine, they can't earn
a living, and unlike richer countries, Mexico didn't have the
(05:42):
money to just pay people to stay home. Plus, am
Low hates debt, so he basically let COVID run free
and the hopes that the economy would survive. Andrea says
the strategy allowed Mexico to keep a balanced budget. The
paso has also remained relatively stable, and there are no
worries about the country defaulting on its debt. But it
(06:05):
also had some nasty knock on effects, particularly on Mexico's
health care system. It's safe to say that the healthcare
system collapsed, Andrea says. During the worst wave, ambulances would
circle all night looking for empty hospital beds. So far,
Mexico has lost three people to COVID, which is high
(06:26):
enough on its own, but it lost another five hundred
thousand people to what are known as excess deaths, people
who shouldn't have died but couldn't get the care they
needed due to COVID, and among those were many pregnant
and childbearing women. Before the pandemic, Mexico's maternal mortality rate,
while still high, had been moving in the right direction.
(06:50):
Over two decades, it had dropped by half. The pandemic
erased most of those games. About two thousand women have
died in childbirth or soon after Mexico since the start
of the pandemic. My colleague Kelsey went down to Mexico
to investigate back to her for the story. I ended
(07:14):
up in Mexico after I heard the story of getting
Viejo Costito in January getting checked into a hospital in
Baja California to have her second baby. She was a healthy,
thirty one year old woman getting had a c section.
They're common generally speaking, but they're especially popular in Mexico,
which has one of the highest c section rates in
(07:36):
the world, and during the pandemic, the c section rate
jumped even higher. Hospitals were too maxed out and short
on time to let labor happen on its own. The
rates in the first year of the pandemic were more
than three times what the World Health Organization recommends. Because
c sections, though life saving and necessary in some cases,
(07:59):
carry greater risk of complications like infections or blood cloths
then giving birth the old fashioned way. It's also major
surgery and recovery is tougher to Just after gett in
c section, her family was sent home and told to
come back later. Everything seemed fine. They were told she
just needed some rust. But when Gatton's family returned, she
(08:23):
was dead. Her sister, Anna Maria Vaejo found her in
her hospital room. I talked to Anna on the phone
about this, which she described was heartbreaking. Anna says that
when she went to touch her sister, Gaydon was freezing.
(08:44):
Her arms dropped to her side, completely limp. It was
as if she had been dead for hours. The official
cause of death was listed as a hemorrhage or excessive bleeding,
one of the top causes from maternal death in Mexico
right now, just ahead of COVID. But Getton's family didn't
understand how things went so wrong. So quickly Anna told
(09:10):
me she asked the doctors how in the world that happened.
The family filed an official complaint, which triggered an autopsy,
but when her body was delivered to the medical examiner,
they were told they wouldn't be able to give the
family any answers because her organs were already removed from
her body. That's really odd. An official at the Medical
(09:32):
Examiner's office said it was the first time he had
seen something like that. The hospital, meanwhile, said it followed
protocol and removing Giddon's organs during its own autopsy. The
family wonders if doctors were trying to cover something up.
News outlets started picking up the story getting by that
(10:00):
is Eli. The story went viral locally. The pictures of
getting from her social media accounts put a face to
the brutal details. Women shared their own stories of mised appointments, negligence,
and bad treatment during their pregnancies. In February, people protested
(10:21):
in the streets. So that's almost gidding. We are all gidding.
(10:50):
Maternal mortality was already high in Mexico, but a perfect
storm of bad decisions made by the government during the
pandemic created a nightmare scenario for giving birth. The problem
started in the months before the pandemic. Mexico's President m
Low decided to overhaul the country's healthcare system to eventually
(11:11):
make it entirely free for everyone. Plar. The move couldn't
have come at a worse time. The news system wasn't
up and running, were fully funded. When the pandemic overwhelmed
Mexican hospitals, chaos ensued. There were drug shortages and not
(11:36):
enough hospital beds, and then one really bad decision made
it all worse. So when the pandemic started, there was
something called reconversion, hospital re conversion, and I think it
was not the best idea. That's Mina Mendez Dominguez, a
physician and researcher who studies maternal health in Mexico. She's
(11:58):
based in Mediva, a city of one point two million
people on Mexico's You've Got Them Peninsula. But I first
met her at a conference in New York in April.
Nina told me to deal with the influx of COVID patients,
the government decided to convert many big hospitals around the
country into COVID only facilities, meaning no one could be
(12:20):
treated for anything else, not heart attacks, not gunshot wounds,
not even childbirth. It was Nina and her colleagues research
that uncovered that first statistic that really shocked me, that
there had been a sixty jump in the maternal mortality
rate in Mexico during the pandemic. Other countries in Latin America,
(12:40):
like Brazil and Peru also had big jumps. Those COVID
only hospital conversions played a big part in the deaths.
She told me. What happened was that non essential medical
consultations were not available, but also nurses and oldest staff
were moved from certain hospitals to other hospitals. In other words,
(13:04):
even the hospitals that would see pregnant women were short
staffed because their staff had been sent to deal with COVID.
This led to a lot of problems for people with
all kinds of health emergencies, but it was particularly dangerous
for pregnant women, especially pregnant women who lived far away
from a hospital. Outside of the big cities, the only
nearby hospital or health clinic was reserved just for COVID patients.
(13:27):
In the remote region of you got done. Where I
saw someone in labor could be hours from the nearest
place that could deliver a baby or even do standard
pre and postnatal care. The first contact in rural areas
were not priority because they treat very small amount of people,
so then they stopped all the maternal consultations, and women
(13:54):
feared to travel to the urban areas and then go
to the hospital because they knew there were patients that
were sick over there already. Basically, pregnant women who already
lived far from medical care might now be even further
from somewhere that would treat them, and they also might
be scared to go there because there was more risk
(14:14):
of catching COVID. Henny Carrillo, a professor at Texas A
and M University who worked with Nina on the research,
put it bluntly, so what happened pregnant women did not
attend the routine checobs. All these decisions had a repel
effect henn He says not all paternal dates in Mexico
were directly related to COVID inflation, but rather to uncontrolled
(14:36):
conditions during pregnancy due to the limited hay care availability
that these women had to face. Nina told me about
one case while doing her research that's stuck with her.
She told me about a young woman who showed upbout
a remote hospital with a rare, life threatening pregnancy complication
called help syndrome. The first facility she went to didn't
(14:59):
catch it. By the time she got to the next
it was too late. She started bleeding internally and was
taken to surgery. The end result was tragic. She just
passed away, and it was so sad because her family
came after and she was already gone. It's these kinds
of cases that stick with Nina because they're part of
(15:20):
a common pattern unnecessary roadblocks that make it hard for
people to safely have babies. Emergencies were especially dangerous for
women in the thick of COVID because it took so
long for them to get to treatment and be seen
by doctors. It became so difficult for a woman, for
a pregnant woman to move from her house to find
(15:44):
medical attention that it ended up so bad. You get
done where Nina is based, so the highest level of
maternal deaths and more than a decade, it's a problem
that is leaving too many women behind. She says, pregnancy
should be a very positive experience. Bringing children to life
(16:05):
should be such an important event that we should all
enjoy this process and it should be equal for all
women in all the world. But at a virtual event
in February, Zoe Lejano, head of the Mexican Institute of
Social Security, said the country. Strategy had been quote very
(16:29):
very focused on hospital reconversion unquote, so that doctors wouldn't
be forced to decide which COVID patients lived and which died.
He went on to say, quote Mexico's model was growing
the capacity for care, so there were zero rejections unquote,
(16:53):
and barras or midwives are stepping in to fill some
of these gaps in a health care system they say
isn't working for women, but they can't fix everything. I
called one of these women who has been delivering babies
for over thirty years. Her name is Guada up She's
the president of the Association of Professional Midwives in Mexico City. Joe,
(17:22):
I have been delivering babies for more than thirty years
outside of hospital settings, in homes or in birthing centers,
under very strict protocols to ensure the security and safety
of both mother and baby. Told me she was afraid
to treat women early in the pandemic, leaving another gap
(17:42):
in the system for rural women. That wasn't the case
for Guada Lupe, who, during the height of COVID saw
double or triple the number of women she normally does.
That's because people either couldn't get care or we're scared
to go to traditional care facilities. See, so it was
(18:03):
very difficult imagine the situation running out of options and
filling on certain women began calling professional meadwifes. Now, she says, fortunately,
the maternal mortality numbers are in a much better place.
The latest government figures show the rate of maternal deaths
(18:23):
is at about thirty one for every one hundred thousand
babies born. That's down from fifty three deaths for every
one hundred thousand berths at the end of last year.
That's in large part because the chaos of the earliest
days of the pandemic and those hospital conversions are in
the past for now, but there's still work to do.
(18:44):
In two thousand, the country committed to decreasing the maternal
mortality rate to twenty two deaths for every one hundred
thousand live births. That's higher than many developed countries, but
lower than the United States rate right now. One way
to achieve eve that, Guada Lupe says, would be to
integrate midwives like herself into the health care system in Mexico.
(19:11):
We think that's what should happen here in Mexico. For starters,
they should insert professional midwives in the multidisciplinary team with
a budget to pay them well to stop treating them
in a denigrading way. There's evidence to back that up.
Researchers say addressing a shortage of global midwives would prevent
(19:32):
two and eighty thousand deaths per year by and the
World Health Organization recommends increasing education for midwives to reduce
maternal and infant deaths. Gualla Lupe says that there should
be more education for women about options outside the traditional
health care system to a system that is overwhelmed just
can't provide care to pregnant women the way they deserve.
(19:57):
Prenatal visit with an O B G y N that
has eighty women to see in a date, you can't
ask for quality of care, not even to give proper
advice or guidance. It's not that they don't want to,
it's that they can't. Right now, one thousand pregnant women
die each year in Mexico. Zoom out, and there are
(20:20):
three hundred thousand more around the world. One of the
lessons of the season for me has been that there's
no escaping the pain of the last two years. Some
places have felt that pain more than others, and in
(20:40):
more traumatic ways through unimaginable death tolls. But even countries
that manage the virus well couldn't fully insulate themselves from
the global shock of COVID. Next week, on The Paycheck,
we had to a place with one of the lowest
death rates in the world, where more and more people
are feeling economic pain. It strikes against the singaple pledge. Right.
(21:05):
We pledge ourselves to developer justin equal society. If we
don't hold that, then there's something problematic. Thanks for listening
to The Paycheck. If you like our show, please head
on over to Apple Podcasts or wherever you listen to
podcasts to rate, review and subscribe. This episode was hosted
by Me Rebecca Greenfield and reported by Kelsey Butler. It
(21:27):
was edited by Kristin V. Brown with help from Francesca Leavy,
Janet Paskin, Rocksheeta Sluja, and Me. We also had editing
help from Daniel Balby, Shelley Banjo, Gilda to Carly, Nicole Flato,
Elissa McDonald, and Kai Schultz. This episode was produced by
Gildada Carly and sound engineered by Matt kim Our original
(21:48):
music is by Leo Sidron. Special thanks to Magnus Hendrickson, McKinnon,
Da Kuyper, Margaret Sutherland, and Stacy Wong. The voice actor
you heard was Veronica Colloe. Francesca O Leevie is Bloomberg's
head of podcasts. See you next week. H
It's ninety degrees out and I'm covered in bug spray,
lying on the dirt floor of a hut with a
roof made of palms. A woman is pressing hard on
my stomach. She's telling me something is wrong. Look here, hey,
hap happy? The woman forcefully massaging my belly is She's
(00:30):
a a kind of traditional healer in the Yucatan region
of Mexico. Pregnant women come to her from nearby to
make sure that the whole childbirth experience is safe, kind
of like a duela. The massage she's giving me is
one of the sort of services she performs for her clients.
It does a bunch of things, including putting the baby
(00:51):
in a head down position for labor or calming the
client's nerves. Okay, that this massage, though it did not
exactly call my nerves while massaging me, tells me that
something of mine called isn't where it should be. This
(01:14):
probably isn't a body part you've ever heard of, but
in my own culture, here is an organ believed to
be found in your mid section. After you have a baby,
a time where your organs are really shifted around. You're
supposed to come back twelve days after delivery to get
a massage from someone like During that she makes sure
(01:36):
that your sto is where it should be and massages
it back into place if it isn't. The belief here,
though it isn't backed up by modern medicine, is that
with it out of place, you can experience back pain,
stomach issues, and anxiety. They believe you can pass along
some of those issues to your baby if you breastfeed too.
I'm way past that twelve day mark. How to baby
(02:00):
a year ago? So why am I hair exactly? I'm
Kelsey Butler, a reporter on Bloomberg's A Quality Team. When
I got pregnant in the middle of the pandemic, I
was living in New Jersey. The state was one of
the highest maternal mortality rates in the US, and the
(02:23):
numbers were the worst for women like me, who are black.
The death rate was made even scarier by the prospect
of getting COVID, which I knew made the chances of
complications for both me and my baby even higher. I
thankfully had a mostly complication free birth. My son turned
one last month, but it got me thinking about maternal health,
(02:45):
and when I started looking into it, I found an
even more shocking statistic, just a little bit south. For years,
maternal mortality had been improving in Mexico. Then the pandemic
hit and the rate for maternal deaths climbed over sixty.
So I jumped on a plane to Mexico to find
out what happened. Jobless claims coming in, I mean really
(03:09):
jumping from the week before, pretty brutal. Three point to
a million records. Six point six million Americans filed for
unemployment last week. Indian working women were the worst impacted
by the pandemic. If so divid like Umia, Well, now
to the billionaire boom. According to Bloomberg's super yacht charters
(03:31):
are up over three hut and a billionaire was created
every twenty six hours during this pandemic. It is time
for a wealth tax in America. Welcome back to the paycheck.
I'm Rebecca Greenfield. Among the many things that have determined
(03:53):
how a country has fared economically during the pandemic is
how government's decided to manage the virus that's off. Some
places opted for a COVID zero strategy, going to extreme
lengths to keep the virus out of their borders. Others
had more of a letter rip strategy, keeping the economy
and businesses open with little regard for the virus itself,
(04:17):
and many places where somewhere in between. Each approach comes
with costs, though some are much higher than others. Mexico
is a country that chose its economy over everything else.
A few months into the pandemic, the government slowly started
lifting restrictions. That's my colleague Andrea Navarro. She's a reporter
(04:38):
in Mexico City. We were one of the few places
in the world where we never really had any travel
restrictions of any kind. So things went back to normal
relatively quickly. Here Andrea usually covers Mexico's economy, but for
the last two and a half years she's been covering COVID.
She told me as early as before vaccines, Mexico is
(05:00):
open for business. To understand this approach, Andrea says, you
have to understand Mexico's president. Andrea's Manuel Lopez Obrador, who's
known more colloquially as Amlo. Amlo can be described as
a populist, and what that means is that he will
basically say and do anything that he says will be
(05:20):
popular with his base, which is very big. Am Lo
caters to Mexico's poorest people, many who work in the
informal and service economies, the people who run things like
street cards, and if they aren't allowed to operate or
all their customers are stuck in quarantine, they can't earn
a living, and unlike richer countries, Mexico didn't have the
(05:42):
money to just pay people to stay home. Plus, am
Low hates debt, so he basically let COVID run free
and the hopes that the economy would survive. Andrea says
the strategy allowed Mexico to keep a balanced budget. The
paso has also remained relatively stable, and there are no
worries about the country defaulting on its debt. But it
(06:05):
also had some nasty knock on effects, particularly on Mexico's
health care system. It's safe to say that the healthcare
system collapsed, Andrea says. During the worst wave, ambulances would
circle all night looking for empty hospital beds. So far,
Mexico has lost three people to COVID, which is high
(06:26):
enough on its own, but it lost another five hundred
thousand people to what are known as excess deaths, people
who shouldn't have died but couldn't get the care they
needed due to COVID, and among those were many pregnant
and childbearing women. Before the pandemic, Mexico's maternal mortality rate,
while still high, had been moving in the right direction.
(06:50):
Over two decades, it had dropped by half. The pandemic
erased most of those games. About two thousand women have
died in childbirth or soon after Mexico since the start
of the pandemic. My colleague Kelsey went down to Mexico
to investigate back to her for the story. I ended
(07:14):
up in Mexico after I heard the story of getting
Viejo Costito in January getting checked into a hospital in
Baja California to have her second baby. She was a healthy,
thirty one year old woman getting had a c section.
They're common generally speaking, but they're especially popular in Mexico,
which has one of the highest c section rates in
(07:36):
the world, and during the pandemic, the c section rate
jumped even higher. Hospitals were too maxed out and short
on time to let labor happen on its own. The
rates in the first year of the pandemic were more
than three times what the World Health Organization recommends. Because
c sections, though life saving and necessary in some cases,
(07:59):
carry greater risk of complications like infections or blood cloths
then giving birth the old fashioned way. It's also major
surgery and recovery is tougher to Just after gett in
c section, her family was sent home and told to
come back later. Everything seemed fine. They were told she
just needed some rust. But when Gatton's family returned, she
(08:23):
was dead. Her sister, Anna Maria Vaejo found her in
her hospital room. I talked to Anna on the phone
about this, which she described was heartbreaking. Anna says that
when she went to touch her sister, Gaydon was freezing.
(08:44):
Her arms dropped to her side, completely limp. It was
as if she had been dead for hours. The official
cause of death was listed as a hemorrhage or excessive bleeding,
one of the top causes from maternal death in Mexico
right now, just ahead of COVID. But Getton's family didn't
understand how things went so wrong. So quickly Anna told
(09:10):
me she asked the doctors how in the world that happened.
The family filed an official complaint, which triggered an autopsy,
but when her body was delivered to the medical examiner,
they were told they wouldn't be able to give the
family any answers because her organs were already removed from
her body. That's really odd. An official at the Medical
(09:32):
Examiner's office said it was the first time he had
seen something like that. The hospital, meanwhile, said it followed
protocol and removing Giddon's organs during its own autopsy. The
family wonders if doctors were trying to cover something up.
News outlets started picking up the story getting by that
(10:00):
is Eli. The story went viral locally. The pictures of
getting from her social media accounts put a face to
the brutal details. Women shared their own stories of mised appointments, negligence,
and bad treatment during their pregnancies. In February, people protested
(10:21):
in the streets. So that's almost gidding. We are all gidding.
(10:50):
Maternal mortality was already high in Mexico, but a perfect
storm of bad decisions made by the government during the
pandemic created a nightmare scenario for giving birth. The problem
started in the months before the pandemic. Mexico's President m
Low decided to overhaul the country's healthcare system to eventually
(11:11):
make it entirely free for everyone. Plar. The move couldn't
have come at a worse time. The news system wasn't
up and running, were fully funded. When the pandemic overwhelmed
Mexican hospitals, chaos ensued. There were drug shortages and not
(11:36):
enough hospital beds, and then one really bad decision made
it all worse. So when the pandemic started, there was
something called reconversion, hospital re conversion, and I think it
was not the best idea. That's Mina Mendez Dominguez, a
physician and researcher who studies maternal health in Mexico. She's
(11:58):
based in Mediva, a city of one point two million
people on Mexico's You've Got Them Peninsula. But I first
met her at a conference in New York in April.
Nina told me to deal with the influx of COVID patients,
the government decided to convert many big hospitals around the
country into COVID only facilities, meaning no one could be
(12:20):
treated for anything else, not heart attacks, not gunshot wounds,
not even childbirth. It was Nina and her colleagues research
that uncovered that first statistic that really shocked me, that
there had been a sixty jump in the maternal mortality
rate in Mexico during the pandemic. Other countries in Latin America,
(12:40):
like Brazil and Peru also had big jumps. Those COVID
only hospital conversions played a big part in the deaths.
She told me. What happened was that non essential medical
consultations were not available, but also nurses and oldest staff
were moved from certain hospitals to other hospitals. In other words,
(13:04):
even the hospitals that would see pregnant women were short
staffed because their staff had been sent to deal with COVID.
This led to a lot of problems for people with
all kinds of health emergencies, but it was particularly dangerous
for pregnant women, especially pregnant women who lived far away
from a hospital. Outside of the big cities, the only
nearby hospital or health clinic was reserved just for COVID patients.
(13:27):
In the remote region of you got done. Where I
saw someone in labor could be hours from the nearest
place that could deliver a baby or even do standard
pre and postnatal care. The first contact in rural areas
were not priority because they treat very small amount of people,
so then they stopped all the maternal consultations, and women
(13:54):
feared to travel to the urban areas and then go
to the hospital because they knew there were patients that
were sick over there already. Basically, pregnant women who already
lived far from medical care might now be even further
from somewhere that would treat them, and they also might
be scared to go there because there was more risk
(14:14):
of catching COVID. Henny Carrillo, a professor at Texas A
and M University who worked with Nina on the research,
put it bluntly, so what happened pregnant women did not
attend the routine checobs. All these decisions had a repel
effect henn He says not all paternal dates in Mexico
were directly related to COVID inflation, but rather to uncontrolled
(14:36):
conditions during pregnancy due to the limited hay care availability
that these women had to face. Nina told me about
one case while doing her research that's stuck with her.
She told me about a young woman who showed upbout
a remote hospital with a rare, life threatening pregnancy complication
called help syndrome. The first facility she went to didn't
(14:59):
catch it. By the time she got to the next
it was too late. She started bleeding internally and was
taken to surgery. The end result was tragic. She just
passed away, and it was so sad because her family
came after and she was already gone. It's these kinds
of cases that stick with Nina because they're part of
(15:20):
a common pattern unnecessary roadblocks that make it hard for
people to safely have babies. Emergencies were especially dangerous for
women in the thick of COVID because it took so
long for them to get to treatment and be seen
by doctors. It became so difficult for a woman, for
a pregnant woman to move from her house to find
(15:44):
medical attention that it ended up so bad. You get
done where Nina is based, so the highest level of
maternal deaths and more than a decade, it's a problem
that is leaving too many women behind. She says, pregnancy
should be a very positive experience. Bringing children to life
(16:05):
should be such an important event that we should all
enjoy this process and it should be equal for all
women in all the world. But at a virtual event
in February, Zoe Lejano, head of the Mexican Institute of
Social Security, said the country. Strategy had been quote very
(16:29):
very focused on hospital reconversion unquote, so that doctors wouldn't
be forced to decide which COVID patients lived and which died.
He went on to say, quote Mexico's model was growing
the capacity for care, so there were zero rejections unquote,
(16:53):
and barras or midwives are stepping in to fill some
of these gaps in a health care system they say
isn't working for women, but they can't fix everything. I
called one of these women who has been delivering babies
for over thirty years. Her name is Guada up She's
the president of the Association of Professional Midwives in Mexico City. Joe,
(17:22):
I have been delivering babies for more than thirty years
outside of hospital settings, in homes or in birthing centers,
under very strict protocols to ensure the security and safety
of both mother and baby. Told me she was afraid
to treat women early in the pandemic, leaving another gap
(17:42):
in the system for rural women. That wasn't the case
for Guada Lupe, who, during the height of COVID saw
double or triple the number of women she normally does.
That's because people either couldn't get care or we're scared
to go to traditional care facilities. See, so it was
(18:03):
very difficult imagine the situation running out of options and
filling on certain women began calling professional meadwifes. Now, she says, fortunately,
the maternal mortality numbers are in a much better place.
The latest government figures show the rate of maternal deaths
(18:23):
is at about thirty one for every one hundred thousand
babies born. That's down from fifty three deaths for every
one hundred thousand berths at the end of last year.
That's in large part because the chaos of the earliest
days of the pandemic and those hospital conversions are in
the past for now, but there's still work to do.
(18:44):
In two thousand, the country committed to decreasing the maternal
mortality rate to twenty two deaths for every one hundred
thousand live births. That's higher than many developed countries, but
lower than the United States rate right now. One way
to achieve eve that, Guada Lupe says, would be to
integrate midwives like herself into the health care system in Mexico.
(19:11):
We think that's what should happen here in Mexico. For starters,
they should insert professional midwives in the multidisciplinary team with
a budget to pay them well to stop treating them
in a denigrading way. There's evidence to back that up.
Researchers say addressing a shortage of global midwives would prevent
(19:32):
two and eighty thousand deaths per year by and the
World Health Organization recommends increasing education for midwives to reduce
maternal and infant deaths. Gualla Lupe says that there should
be more education for women about options outside the traditional
health care system to a system that is overwhelmed just
can't provide care to pregnant women the way they deserve.
(19:57):
Prenatal visit with an O B G y N that
has eighty women to see in a date, you can't
ask for quality of care, not even to give proper
advice or guidance. It's not that they don't want to,
it's that they can't. Right now, one thousand pregnant women
die each year in Mexico. Zoom out, and there are
(20:20):
three hundred thousand more around the world. One of the
lessons of the season for me has been that there's
no escaping the pain of the last two years. Some
places have felt that pain more than others, and in
(20:40):
more traumatic ways through unimaginable death tolls. But even countries
that manage the virus well couldn't fully insulate themselves from
the global shock of COVID. Next week, on The Paycheck,
we had to a place with one of the lowest
death rates in the world, where more and more people
are feeling economic pain. It strikes against the singaple pledge. Right.
(21:05):
We pledge ourselves to developer justin equal society. If we
don't hold that, then there's something problematic. Thanks for listening
to The Paycheck. If you like our show, please head
on over to Apple Podcasts or wherever you listen to
podcasts to rate, review and subscribe. This episode was hosted
by Me Rebecca Greenfield and reported by Kelsey Butler. It
(21:27):
was edited by Kristin V. Brown with help from Francesca Leavy,
Janet Paskin, Rocksheeta Sluja, and Me. We also had editing
help from Daniel Balby, Shelley Banjo, Gilda to Carly, Nicole Flato,
Elissa McDonald, and Kai Schultz. This episode was produced by
Gildada Carly and sound engineered by Matt kim Our original
(21:48):
music is by Leo Sidron. Special thanks to Magnus Hendrickson, McKinnon,
Da Kuyper, Margaret Sutherland, and Stacy Wong. The voice actor
you heard was Veronica Colloe. Francesca O Leevie is Bloomberg's
head of podcasts. See you next week. H
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