美国国家公共电台 NPR Focus On Infants During Childbirth Leaves U.S. Moms In Danger

 

DAVID GREENE, HOST:

America is the most dangerous place in the developed world to have a baby. And the rate of women dying from pregnancy¹ complications has been rising. Women here are three times more likely to die in childbirth than women in Canada, and six times more likely than in Scandinavia.

This morning, NPR in partnership² with ProPublica and reporter Nina Martin begin a series that unravels³ why. And just a warning, this story may be hard to hear. Here's NPR special correspondent Renee Montagne.

RENEE MONTAGNE, BYLINE⁴: The sun was just coming up on a winter day in Pensacola, Fla., when Amanda Lauver opened her computer.

AMANDA LAUVER: I enjoy waking up early and drinking coffee and scrolling⁵ through Facebook like it's the morning news.

MONTAGNE: Among other things, she was keeping track of her best friend since junior high, Sara Ruiz. Sara was living in Las Vegas and pregnant for the first time. Her age, 36, automatically put her in the category of high risk. Otherwise, healthy and very excited.

LAUVER: There was a post to Sara's Facebook page from her fiance, Ron. And it said something along the lines of, I will miss you, rest in peace. And I just kept thinking no, this can't be true. This can't be true.

MONTAGNE: Amanda's first thought - a car crash.

LAUVER: It took me a few minutes to say, what about the baby? What about the baby?

MONTAGNE: The baby - he had died. Sara's mother later described to us the chaotic⁶ hours after Sara began vomiting⁸ violently and having contractions⁹. It became so intense her mother called 911. By the time Sara reached the emergency room, she was choking on her own vomit⁷ and went into cardiac arrest.

Sara Ruiz's death was unimaginable to everyone who knew her. Yet every day in the U.S., on average, two or three women die of complications related to pregnancy. That's between 700 and 900 a year.

MARY-ANN ETIEBET: A woman is at her most vulnerable at the time of childbirth. And if she dies, it is a sign that our health system has failed to protect her.

MONTAGNE: Mary-Ann Etiebet runs Merck for Mothers, which is a major corporate-funded effort to bring down the maternal¹⁰ death rate in the U.S. These days, American women die giving birth in ways that have figured in history and literature for hundreds of years - infection, hemorrhage, heart failure, blood clots¹¹ and pre-eclampsia, a condition linked to dangerously high blood pressure. NPR and ProPublica spent six months investigating this surge in maternal deaths at a time when developed countries from Britain to South Korea saw their numbers plunge¹².

What we found included a hodgepodge of hospital protocols¹³ for dealing¹⁴ with potentially fatal complications, allowing treatable conditions to proceed to a lethal¹⁵ level. We discovered hospitals, even those with intensive care units for newborns, woefully unprepared for a maternal emergency. We tracked federal and state funding and found only 6 percent of block grants for maternal and child health actually go for care of the mothers.

We found that in the U.S., some doctors entering the growing specialty¹⁷ of maternal fetal medicine were able to complete that training without ever spending time in a labor¹⁸ delivery unit. And we heard stories of hundreds of women who have died. Among them, Marlene Dominguez-Hicks. A photo taken three days before she died shows her fully¹⁶ pregnant in a cotton sun dress, a garland of flowers encircling her hair. Marlene was the pride of her Filipino-American family, a doctor now on a fellowship in Houston. Her husband, Alex, leans in to kiss their toddler. Their other daughter perches¹⁹ on her knee, and Marlene is the picture of health.

ALYSSA: I'm Alyssa. And I am 5. And this is my sister Alana.

ALEX HICKS: Say Alana.

ALANA: Lana (ph).

MONTAGNE: I visited Alex Hicks and his two little girls in a place he never thought he'd return to - his childhood home in Detroit. His father worked for General Motors. His mother taught school. Bunk²⁰ beds in every bedroom tell the story of a once full house.

HICKS: Well, there were five boys and two girls, so somebody was always sharing a room (laughter).

MONTAGNE: Sitting amid the moving boxes, Alex happily shares pictures of his life with Marlene.

HICKS: It's mother and daughter both wearing cheetah²¹ pants. And there's another one I have where they have their hairstyles the same in a little bun.

MONTAGNE: It's been five, six months now. In their little lives, it's a part of a lifetime.

HICKS: Yeah. It's 159 days to date.

MONTAGNE: And so Alex Hicks begins the story. Marlene was days away from delivering a baby boy upstairs that night, snuggling in bed with the girls.

HICKS: And I just hear two or three just loud thump²², you know, rolling down, boom, boom, boom. And I literally²³ race upstairs. And Marlene is laying on the floor unconscious. And I just get under her. And she's, you know, kind of hissing²⁴. And I was holding her. And I remember her teeth started clenching²⁵. And everything happened so fast, yet so slow.

And watch - watch, like, the paramedics doing CPR on your wife who's 9 months pregnant, it's, I mean, it's like the worst thing in the world, like, just watching her helpless. I mean, you just fast forward in the ambulance. We get into the ER, and I hear them say, we have to deliver the baby. And I knew she was gone. And, you know, that was it.

MONTAGNE: Their baby didn't survive. Marlene died of cardiomyopathy, pregnancy-related heart failure, even though her medical records show normal checked in the box next to heart. As with thousands of others who have died in childbirth, this loss has created an unending pain that radiates through family and friends. It's not clear if Marlene's condition had been detected earlier, she would have lived. But in a recent analysis of maternal deaths, the CDC Foundation found 60 percent were preventable.

And a striking thing about these numbers, it's incredibly difficult to track them through public health records. We found Marlene Dominguez-Hicks on Facebook. We discovered Sara Ruiz on GoFundMe. And Sara's own obituary²⁶ appears typical - long and loving, it devotes just a single line to the news that she passed away during childbirth. Renee Montagne, NPR News.

(SOUNDBITE OF KOMEIT'S "OPAL CITY")

GREENE: And our full investigation²⁷ with ProPublica is on npr.org.

(SOUNDBITE OF KOMEIT'S "OPAL CITY")

1 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

2 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。

3 unravels   

解开，拆散，散开( unravel的第三人称单数 )； 阐明； 澄清； 弄清楚

参考例句：

• Khrushchev's Cold War unravels the tangled contradictions in his leadership of the Communist Party. 赫鲁晓夫的冷战》这本书揭示出赫鲁晓夫作为共产党的领袖，面临着一些棘手的问题。

4 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

5 scrolling   

n.卷[滚]动法，上下换行v.（电脑屏幕上）从上到下移动（资料等），卷页( scroll的现在分词 )；（似卷轴般）卷起；（像展开卷轴般地）将文字显示于屏幕

参考例句：

• Another important detail required by auto-scrolling is a time delay. 自动滚屏需要的另一个重要细节是时间延迟。 来自About Face 3交互设计精髓
• In 2D visualization and drawing applications, vertical and horizontal scrolling are common. 在二维的可视化及绘图应用中，垂直和水平滚动非常普遍。 来自About Face 3交互设计精髓

6 chaotic   

adj.混沌的，一片混乱的，一团糟的

参考例句：

• Things have been getting chaotic in the office recently.最近办公室的情况越来越乱了。
• The traffic in the city was chaotic.这城市的交通糟透了。

7 vomit   

v.呕吐，作呕；n.呕吐物，吐出物

参考例句：

• They gave her salty water to make her vomit.他们给她喝盐水好让她吐出来。
• She was stricken by pain and began to vomit.她感到一阵疼痛，开始呕吐起来。

8 vomiting   

吐

参考例句：

• Symptoms include diarrhoea and vomiting. 症状有腹泻和呕吐。
• Especially when I feel seasick, I can't stand watching someone else vomiting." 尤其晕船的时候，看不得人家呕。”

9 contractions   

n.收缩( contraction的名词复数 )；缩减；缩略词；（分娩时）子宫收缩

参考例句：

• Contractions are much more common in speech than in writing. 缩略词在口语里比在书写中常见得多。 来自《简明英汉词典》
• Muscle contractions are powered by the chemical adenosine triphosphate(ATP ). 肌肉收缩是由化学物质三磷酸腺苷(ATP)提供动力的。 来自辞典例句

10 maternal   

adj.母亲的，母亲般的，母系的，母方的

参考例句：

• He is my maternal uncle.他是我舅舅。
• The sight of the hopeless little boy aroused her maternal instincts.那个绝望的小男孩的模样唤起了她的母性。

11 clots   

n.凝块( clot的名词复数 )；血块；蠢人；傻瓜v.凝固( clot的第三人称单数 )

参考例句：

• When you cut yourself, blood clots and forms a scab. 你割破了，血会凝固、结痂。 来自《简明英汉词典》
• Milk clots when it turns sour. 奶变酸就凝块。 来自《现代英汉综合大词典》

12 plunge   

v.跳入，(使)投入，(使)陷入；猛冲

参考例句：

• Test pool's water temperature before you plunge in.在你跳入之前你应该测试水温。
• That would plunge them in the broil of the two countries.那将会使他们陷入这两国的争斗之中。

13 protocols   

n.礼仪( protocol的名词复数 )；（外交条约的）草案；（数据传递的）协议；科学实验报告（或计划）

参考例句：

• There are also protocols on the testing of nuclear weapons. 也有关于核武器试验的协议。 来自辞典例句
• Hardware components and software design of network transport protocols are separately introduced. 介绍系统硬件组成及网络传输协议的软件设计。 来自互联网

14 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

15 lethal   

adj.致死的；毁灭性的

参考例句：

• A hammer can be a lethal weapon.铁锤可以是致命的武器。
• She took a lethal amount of poison and died.她服了致命剂量的毒药死了。

16 fully   

adv.完全地，全部地，彻底地；充分地

参考例句：

• The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气，然后全部呼出。
• They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。

17 specialty   

n.(speciality)特性，特质；专业，专长

参考例句：

• Shell carvings are a specialty of the town.贝雕是该城的特产。
• His specialty is English literature.他的专业是英国文学。

18 labor   

n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦

参考例句：

• We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
• He was completely spent after two weeks of hard labor.艰苦劳动两周后，他已经疲惫不堪了。

19 perches   

栖息处( perch的名词复数 )； 栖枝； 高处； 鲈鱼

参考例句：

• Other protection can be obtained by providing wooden perches througout the orchards. 其它保护措施是可在种子园中到处设置木制的栖木。
• The birds were hopping about on their perches and twittering. 鸟儿在栖木上跳来跳去，吱吱地叫着。

20 bunk   

n.(车、船等倚壁而设的)铺位；废话

参考例句：

• He left his bunk and went up on deck again.他离开自己的铺位再次走到甲板上。
• Most economists think his theories are sheer bunk.大多数经济学家认为他的理论纯属胡说。

21 cheetah   

n.(动物)猎豹

参考例句：

• The cheetah is generally credited as the world's fastest animal.猎豹被公认是世界上跑得最快的动物。
• The distribution of the cheetah ranges from Africa to Central Asia.印度豹的足迹遍及从非洲到中亚的广大地区。

22 thump   

v.重击，砰然地响；n.重击，重击声

参考例句：

• The thief hit him a thump on the head.贼在他的头上重击一下。
• The excitement made her heart thump.她兴奋得心怦怦地跳。

23 literally   

adv.照字面意义，逐字地；确实

参考例句：

• He translated the passage literally.他逐字逐句地翻译这段文字。
• Sometimes she would not sit down till she was literally faint.有时候，她不走到真正要昏厥了，决不肯坐下来。

24 hissing   

n. 发嘶嘶声, 蔑视 动词hiss的现在分词形式

参考例句：

• The steam escaped with a loud hissing noise. 蒸汽大声地嘶嘶冒了出来。
• His ears were still hissing with the rustle of the leaves. 他耳朵里还听得萨萨萨的声音和屑索屑索的怪声。 来自汉英文学 - 春蚕

25 clenching   

v.紧握，抓紧，咬紧( clench的现在分词 )

参考例句：

• I'll never get used to them, she thought, clenching her fists. 我永远也看不惯这些家伙，她握紧双拳，心里想。 来自飘（部分）
• Clenching her lips, she nodded. 她紧闭着嘴唇，点点头。 来自辞典例句

26 obituary   

n.讣告，死亡公告；adj.死亡的

参考例句：

• The obituary records the whole life of the deceased.讣文记述了这位死者的生平。
• Five days after the letter came,he found Andersen s obituary in the morning paper.收到那封信五天后，他在早报上发现了安德森的讣告。

27 investigation   

n.调查，调查研究

参考例句：

• In an investigation,a new fact became known, which told against him.在调查中新发现了一件对他不利的事实。
• He drew the conclusion by building on his own investigation.他根据自己的调查研究作出结论。