Julia Montminy is waiting at one of those chain restaurants near The Shoppes at Buckland Hills. In the dim light, the server greets Montminy and another woman with “Welcome, ladies,” then does a double-take, and apologizes. “Welcome, sir and ma’am. My mistake.”
Montminy, a slight woman in leopard-print jeans, follows the server to her table and says nothing. If someone doesn’t know her preferred pronoun, she says, not everything requires a fight.
The Connecticut Childbirth & Women’s Center in Danbury is a 50-minute drive from Evelyn DeGraf’s home in Westchester. Pregnant with her second child, the 37-year-old didn’t hesitate to make the drive—she wanted her birth to be attended by a midwife, not a doctor. DeGraf believed midwifery care to be more personal and less rushed than that delivered by obstetrics/gynecologists (OB/GYNs). She also knew an OB/GYN would deem her relatively advanced maternal age and previous cesarean section history too high-risk to attempt a VBAC, or vaginal birth after cesarean section. But she had to drive roughly 35 miles to find a midwife because there aren’t many of them.
The United States’ maternal mortality rate is abysmal, and women of color are particularly vulnerable. No amount of fame or fortune can run interference when it comes to mothers dying or at-risk during pregnancy, childbirth, or early motherhood. And that holds especially true for African American women. At 26.4 per 100,000 live births, the U.S. has the worst rate of maternal death in the developed world—by several times over. Even more disquieting, the U.S. rate rose by 136 percent between 1990 and 2013.
In May 2017, Maura B. Gallagher entered Stamford Hospital for a Cesarean section for her unborn fraternal twins. According to a lawsuit filed by her family, Gallagher was 38 and an avid skier who was dedicated to her family, which included her fiancé, Max Di Dodo. There were signs that her pregnancy was challenging. At a little over 37 weeks, Gallagher, of New Canaan, showed signs of a low platelet count. The condition, known as thrombocytopenia, affects 7 to 12 percent of pregnant women.
Women (particularly Democrats) are running for political office in record numbers. After the recent primary elections (including one in Connecticut), voters will choose from an unprecedented number of female candidates—198 in the U.S. House, 19 in the U.S. Senate, and 13 gubernatorial candidates. So, if a change is gonna come, it will need to include some much-needed renovations in the halls of power. Last-minute meetings make it difficult for people responsible for child care to attend. Caucuses at 2 a.m. have the same effect.
New Haven resident Kimberly Streater was pregnant with her third of six children when she called her friend for a ride to the hospital after sustaining a hit to her stomach by her then-husband. When she reached the hospital, Streater, not yet 28 weeks pregnant, alerted personnel that her baby was coming—now. “They said, ‘No, no, he’s not coming,’ after I told them he was,” she recalled. Minutes later, Howie was born at 3 pounds and 1.5 ounces in the admitting area of the hospital, just as Streater had predicted. Statistically, the preterm birth of Streater’s baby does not come as a surprise.
Why do so many pregnant women and young mothers die? Your guess is as good as our government’s. We simply don’t know. Even the statistics we have aren’t current, though from all indications the U.S.’s mortality rate is rising, as it is in Afghanistan and Sudan. But in the U.S., the rate has risen by 136 percent between 1990 and 2013.
Among women, those who are low-income or minority are less likely to get treatment for depression, according to multiple studies. A report by the Connecticut Behavioral Health Partnership found that women were underrepresented in Medicaid-funded behavioral health services in the state even though research shows that women suffer from the most commonly diagnosed mental health disorders more frequently than men. Racial and ethnic disparities, while still considerable, are decreasing in some physical illnesses. “But in mental health care, in the last 10 years, we see those disparities widening,” said Megan Smith, associate professor in the Departments of Psychiatry and in the Child Study Center in the Yale School of Medicine, who runs the Mental health Outreach for MotherS (MOMS) Partnership®, a program that offers mental health services to “overburdened and under-resourced mothers.”
In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses the hurdles to mental health care and the programs breaking barriers to care with Yale’s Megan Smith and UConn Health’s Dr. Sarah Nguyen. Lack of insurance coverage, the cost of treatment, a shortage of qualified clinicians, stigma and even fear of losing custody of their children can keep women from seeking help, Smith said.
As fertility rates fall nationwide, Connecticut continues to rank among the lowest in the country—a trend doctors attribute to women here delaying childbearing. In 2016, the most recent year for which state-level data is available, Connecticut had 53.4 births per 1,000 women ages 15 to 44, compared with a national average of 62 per 1,000 women, according to data from the Centers for Disease Control and Prevention (CDC). Just four states had lower rates than Connecticut in 2016, and all are in New England: Vermont at 50.3 births per 1,000 women, New Hampshire at 50.9, Rhode Island at 51.8 and Massachusetts at 51.9. The states with the highest fertility rates in 2016 were South Dakota at 77.7, North Dakota at 77.3, Utah at 76.2 and Alaska at 76.1, the CDC reports. Unlike birth rates, which take an entire population into account, fertility rates reflect the share of babies born to women of childbearing age. Connecticut typically ranks low on the list, along with other “high achievement, high education states,” said Dr. Harold J. Sauer, chairman of obstetrics and gynecology at Yale New Haven Health’s Bridgeport Hospital.
Depression is the leading cause of disability worldwide, according to the World Health Organization, and affects women at about twice the rate that it does men. In Connecticut, 21.4 percent of women report experiencing depression, compared with 13.4 percent of men, according to 2015 Department of Public Health data. Millennial women in the state experience depression four more days in an average month than their male counterparts, the Status of Women data project reported this year. Women are more likely to use mental health services than men, but studies consistently show that the majority of Americans with depression go untreated. In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses depression and pathways to better mental health with Yale’s Carolyn Mazure, and NYTimes best-selling author Luanne Rice.