Motherhood and Apple Pie is an idiom used to express a wholesome concept of traditional life in the United States. Unfortunately, times have changed so much over the past 50 years the intended meaning no longer applies. If we look at motherhood and child health over the past 25 years, the US has failed. Maternal deaths are at an all time high. Even with a decline in infant mortality between 1990 and 2010, US infant deaths surpass those of other industrialized countries.
International comparisons of infant mortality show the United States has more infant deaths than most European countries, Japan, Hong Kong, South Korea, Iceland, Israel, Cuba and Canada. Monaco and Japan have the lowest infant death rates in the world.
How can so many mothers and babies be dying in the United States – a country that touts itself as having the best healthcare in the world? Let’s look at some of the reasons.

Cardiovascular disease and infection are the most common causes of maternal death. Because many US women have delayed pregnancy until they are older, they are more apt to have developed chronic diseases including obesity, heart disease, high blood pressure and diabetes prior to their first delivery. All of these common medical problems place additional health risk on both mother and infant.
Medical costs for pre-natal care, delivery and post partum care are high. Choosing to avoid these high costs by delivering at home also places the mother and child at increased risk, especially if urgent interventions for complications become necessary for a safe birth. On the other hand, technology in medical centers has improved treatments to mitigate life-threatening complications such as hemorrhage and obstructed labor requiring C-sections. Going forward, the Affordable Care Act will help participants obtain easier and more affordable access to both maternal and child healthcare.

In reality, the safe, heartwarming values associated with Motherhood and Apple Pie didn’t apply to all mothers even in years past. As recently as the 50’s and 60’s, unmarried girls and women suffered terribly at the hands of society. Young unwed mothers were often whisked off to maternity receiving-homes by their mortified families who wanted to hide the shameful pregnancy. The babies of these young women were typically removed from them in emotionally devastating ways, often not allowing the young mother to even see the infant before the child was placed for adoption. Mothers mourned the loss of their babies. Treatment of many women in that era is found in The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Rove v. Wade, written by Ann Fessler.

According to the data presented in Fessler’s book, inhumane practices during labor and delivery were common. Treatment by medical practitioners, nurses and child welfare services often left the mother with physical and emotional scars that never healed.
Today, many unmarried women are giving birth. Most of them choose to keep their children. In fact, more than half of US births are to unmarried women. These births are often to couples living together. From the National Center of Health Statistics, in 2009, 41% of children were born outside of marriage and 53% of children were born to women under 30, but not all of these pregnancies were unplanned. The stigma of being a single parent has decreased and many women elect to raise a child alone. However, few women disagree that a two parent household is advantageous.

Parenting is supremely important for the emotional, social and intellectual development of a child. Today, more and more grandmothers are filling this important role in childcare by helping to contribute to the care and emotional stability of their grandchildren.
Single low income women with children are at a huge disadvantage in our society. If they can find work, their incomes are often too low to provide adequate housing and appropriate childcare. Sharing households and receiving support from family members who help single parents support their efforts toward the American Dream is helpful, but even with support, the dream has become harder and harder to reach.

Adults provide the role model for children. Raising children with self esteem and confidence contributes to their successes as an adult. Children tend to mirror their parent’s and caregiver’s behaviors so adequate childcare is essential for single parenting to be successful. Encouragement, respect and love can also be provided by extended family members and baby sitters. Studies show even severely abused and neglected children can be nurtured into confident adults by a caring supportive mother figure.
Today, motherhood has huge challenges and little apple pie. With over 8 million single mothers providing sole support for their children, their options to find good paying jobs are few. Single mothers can be just as successful in child rearing as married mothers, but they may need a little help from their friends.
On this Mother’s Day, please honor women and remember the poem written by William Ross Wallace (1819-1881) The Hand That Rocks the Cradle Rules the World.

(Last verse)

Blessings on the hand of women!
Fathers, sons, and daughters cry,
And the sacred song is mingled
With the worship in the sky—
Mingles where no tempest darkens,
Rainbows evermore are hurled;
For the hand that rocks the cradle
Is the hand that rules the world.

References:
Statistical data source: http://www.geoba.se/index.php
Poem of the Week http://www.potw.org

Betty Kuffel, MD
Lipsticklogic.com