2020年经济学人 疫情使美国产妇做出新选择(2)（在线收听）

Beyond the pandemic, American women face two problems that licensed midwives can help with. First, America is one of only 13 countries where the maternal mortality rate increased between 2000 and 2017, putting it in the august company of Venezuela and Syria. The risk of dying during childbirth can be exacerbated by a lack of trust between patients and health workers. In America that is especially true for black women, who die from pregnancy-related complications at more than three times the rate that white women do. Midwives cannot perform complex surgery or deliver babies for women with certain chronic health problems. But they can support low-risk women through labour. That frees doctors to do the harder stuff.

除了这场疫情，美国妇女们还面临着两个有执照的助产士可以帮忙解决的问题。首先，美国是仅有的在2000年至2017年之间孕妇死亡率上升的13个国家之一，是委内瑞拉同叙利亚的八分之一。由于病人和卫生工作者之间缺乏信任，分娩期间死亡的风险可能会加剧。在美国，黑人妇女尤其如此，她们死于妊娠相关并发症的比率是白人妇女的三倍多。助产士不能为患有某些慢性健康问题的妇女进行复杂的外科手术或分娩。但是他们可以帮助低风险的妇女分娩。这样医生就可以做更难的事情了。

Second, because midwives’ callingcard is not intervening in labour, collaboration between midwives and obstetricians has been shown to lower the number of Caesarean sections. Nearly a third of babies born in America each year are delivered by c-section. But the WHO reckons that the necessary rate hovers between 10% and 15%. Caesarian deliveries can be life-saving for new-born babies and mothers, but they are major surgeries. They increase the risk of infection, haemorrhages and blood clots. George Washington University Hospital introduced midwifery services a decade ago, and has since seen its c-section rate drop by nearly 6%.

第二，因为呼叫助产士不会干预分娩，助产士和产科大夫的合作被证明可以减低剖腹产的数量。每年在美国出生的婴儿中，近三分之一是剖腹产。但是世卫组织估计，剖腹产的必要率徘徊在10%到15%之间。剖腹产可以挽救新生儿和母亲的生命，但这是大型手术。会增加感染、大出血和血栓的风险。乔治华盛顿大学医院10年前推出了助产服务，此后剖腹产率下降了近6%。

Will the interest in midwifery outlast the pandemic? It seems likely. The practice was growing even before the virus started to spread. And collaboration between doctors and midwives can prove effective. “Our doctors were willing to learn from our midwife colleagues,” says Dr Gaba. “If other places could do something like that, I think women would really benefit.”

美国人对于助产的兴趣会延续到疫情之后吗？似乎很可能。甚至在病毒开始传播之前，助产就在不断发展。产科医生和助产士之间的合作也证明很有效。“我们的医生愿意向助产士同事学习，”加巴博士说。“如果其他地方也能做这样的事情，我认为女性会真正受益。”