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Robert Green
Robert Green

La Maternal (2022)



The screenplay was penned by Pilar Palomero.[5] La maternal (Palomero's sophomore feature after Schoolgirls)[6] is an Inicia Films and Bteam Prods production, with the participation of RTVE, TVC, Televisión de Aragón, and Movistar+ and support from Creative Europe's MEDIA, ICAA and ICEC [ca].[4][7] Julián Elizalde worked as cinematographer.[8][9]




La maternal (2022)



The maternal mortality rate in the United States has for many years exceeded that of other high-income countries. Data from the Organisation for Economic Co-operation and Development and the Centers for Disease Control and Prevention show rates worsening around the world in recent years, as well as a widening gap between the U.S. and its peer nations.


The maternal mortality rate dropped in Australia, Japan, and the Netherlands, although there is currently insufficient research to understand which policy levers may have caused these decreases. Research has shown that in the Netherlands there was an increase in home births and vaginal deliveries and a decrease in cesarean sections (both planned and emergency) during the pandemic. These practices may have contributed to lowering maternal deaths.


There are clear opportunities to put the U.S. on par with other countries that have implemented policies to help reduce maternal deaths. These strategies include: ensuring all women have access to free or affordable primary care; comprehensive reproductive health care before, during, and after pregnancy; a maternal health care workforce mainly comprising midwives covered by insurance; and comprehensive postpartum support.


Taking into account that the total amount spent on health care in the U.S. is greater than in any other country in the world and that U.S. physician salaries rank amongst the highest in the world, the high maternal mortality rate in the U.S. seems especially egregious.


While Louisiana and California have disparate rates for maternal mortality, the two states do have a comparable number of active physicians. A report based on the American Medical Association Physician Masterfile (released in January 2022) shows that Louisiana has 270.1 active physicians per 100,000 residents and California has 287.8.


The standard list of the leading physiological factors that cause maternal mortality typically includes preeclampsia, hemorrhage, cardiovascular and coronary conditions, mental health issues, embolism, and infections. Each of these things comes with warning signs and can be managed during pregnancy or after birth to ensure the health and safety of a mother.


Preeclampsia warning signs, for example, include high blood pressure, blurred vision, headaches, swelling of the face, hands, and feet, upper abdominal pain, vomiting, and shortness of breath. While preeclampsia can be detected as early as 20 weeks for expecting mothers, it is more likely to arise in the final weeks of pregnancy or after delivery. Either way, three basic forms of care are essential to treat preeclampsia and any other standard cause of maternal mortality:


But as the maternal mortality rate in Louisiana reflects, these basic things are not being offered to every expecting mother and local physicians may even lack the basic knowledge on how to treat the standard causes for maternal mortality.


A history of sexual assault is generally not something medical professionals identify as a cause of maternal mortality, nor is it a factor that is considered in how care is offered to a pregnant person. Nevertheless, a history of sexual violence can also lead to health issues during pregnancy.


That is, the current maternal mortality epidemic disproportionately impacting Black women and the current iterations of system racism that plague the maternal health system in such a way that Black women, specifically, are denied educated care can be understood as a direct result of, for example:


Loss of reproductive justice puts pregnant people in danger The way maternal healthcare and reproductive justice are approached shapes a collective understanding and response to violence against women as well as gender-based violence. The higher the collective tolerance for violence against women and the more gender-based violence is deliberately overlooked, the less likely we are to have access to effective reproductive healthcare or any semblance of reproductive justice.


Joshua, who works as a community organizer, knew pregnancy can be dangerous, especially for Black women like herself. She also knew about Louisiana's dismal maternal health statistics: The state has one of the highest maternal death rates in the country, and Black women are at higher risk than white women, according to reports from the state's health department.


In September, at a Louisiana Department of Health meeting, Dr. Joey Biggio, the chair of maternal and fetal medicine with Ochsner Health, Louisiana's largest health system, said some OB-GYN doctors were afraid to provide routine care.


First 5 LA received $420,000 from Blue Shield of California Promise Health Plan for its Welcome Baby and Select Home Visiting programs, which help improve maternal and infant health outcomes in the diverse communities of Los Angeles.


For The Village received $100,000 from the nonprofit health plan to help improve maternal and infant health outcomes in the diverse communities of San Diego by offering culturally competent, inclusive, and responsive care.


Objective: Clamping of the umbilical cord is part of the third stage of delivery. Delayed cord clamping (DCC) is recommended due to its contribution to prevention of anaemia. There is no evidence on the effect of DCC on maternal satisfaction. The aim of this study is to evaluate the effect of different sociodemographic and obstetric factors, including the timing of cord clamping, on maternal satisfaction with the birth experience in our healthcare system.


Key conclusions: Maternal satisfaction with the birth experience varies with the age of the childbearing woman, and some intrapartum factors and the result is not influenced by the time of clamping of the umbilical cord. Therefore, this component of the physiological management of childbirth provides additional benefits for the health of the neonate, without negative consequences on the final perception of the maternal health care received.


Implications for practice: If there are no reasons that justify an early umbilical cord clamping, delaying it brings benefits to the neonate, without negatively affecting the maternal assessment of the experience of childbirth.


The findings in this report are subject to at least seven limitations. First, VE could not be assessed directly against specific variants. Second, the sample was too small to assess VE by pregnancy trimester of vaccination, and the small sample size resulted in wide confidence intervals for some estimates that should be interpreted with caution. Third, the analysis did not assess whether pregnant women were infected with SARS-CoV-2 before or during pregnancy, which might have provided maternal antibodies. Fourth, residual confounding such as additional differences in behaviors between vaccinated and unvaccinated mothers, including whether mothers had prenatal care, that might affect risk for infection cannot be excluded, and potential confounders (e.g., breastfeeding, child care attendance, and prematurity) could not be accounted for in the model because this information was not available for all infants. Fifth, because this analysis included self-reported data for a few participants, maternal vaccination status might be misclassified for a few infants, or there might be imperfect recollection of whether the mother completed COVID-19 vaccination during pregnancy. Sixth, immunocompromising maternal conditions were not collected to determine whether mothers needed an additional mRNA COVID-19 vaccine dose to complete their primary series. Finally, VE of maternal booster doses received during pregnancy could not be assessed because of small sample size.


The Medicaid program finances about 4 in 10 births in the U.S. Federal law requires states to provide pregnancy-related Medicaid coverage through 60 days postpartum. After that period, some postpartum individuals may qualify for Medicaid through another pathway, but others may lose coverage, particularly in non-expansion states. To help improve maternal health and coverage stability and to help address racial disparities in maternal health, a provision in the American Rescue Plan Act of 2021 gives states a new option to extend Medicaid postpartum coverage to 12 months via a state plan amendment (SPA). This new option took effect on April 1, 2022 and is available to states for five years. The Centers for Medicare and Medicaid Services (CMS) released guidance on December 7, 2021 on how states can implement this new option.


Maternal mortality refers to deaths due to complications from pregnancy or childbirth. The U.S. maternal mortality rate measures the rate of deaths from any cause related to or aggravated by pregnancy childbirth, or within 42 days of termination of pregnancy.


The United States has the highest maternal mortality rate of any developed country and the maternal mortality rate is higher than it has been in decades. Based on the most recent data from 2018 the maternal mortality rate in the U.S. is 17.4 deaths per 100,000 births. The United States is also the only developed to country see maternal mortality rates rising. This is attributed to a few findings in an NPR report, including that hospitals are generally unprepared or underprepared for maternal emergencies during childbirth. Additionally, some doctors entering into maternal-fetal medicine were able to complete their training without training in a labor-delivery unit.


Recently, states have passed legislation leading to stricter abortion laws, which opponents worry could result in higher maternal mortality rates. They argue that because doctors are concerned about losing their licenses, they might hesitate to perform an abortion on a patient even it is a medical emergency. Additionally, mothers might turn to illegal, unsafe abortion options to circumvent the new restrictions. 041b061a72


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