It’s a rare individual that doesn’t have someone in their family or social circle of childbearing age (for women, early teens to late forties). Even if they aren’t connected to you personally, they could be in your survival group. If the you-know-what hits the fan long-term, remember that even a little girl will eventually reach the age where pregnancy is a possibility. In such settings, society will be unstable and organized medical care will be spotty at best and nonexistent at worst. When we reach the point that we are scrambling to survive, pregnancy, often a blessing, may be one of the least welcome events you could imagine.
Why Pregnancy is a Problem in Long-Term Survival
When and if society re-establishes itself, survivors will have the responsibility to repopulate the world. Until that time, however, a pregnancy and its possible complications will be a hardship, not only for the woman, but her community as well. It’s best to avoid until things are safer and more stable.
Why? Let’s look at it from a historical standpoint. The death rate among pregnant women (also known as the Maternal Mortality Rate) at the time of the American Revolution was about 1-2% per pregnancy. Given that the average woman in the year 1800 could expect 8-10 pregnancies over the course of her reproductive life, the death rate from pregnancy complications easily approached 10 per cent. Depending on the circumstances, communities saw one out of eight women die due to complications of being pregnant, either early, during the childbirth, or even soon after a successful delivery.
You might ask: Who cares about what happened in the year 1800? In a long-term catastrophe, there may not be either medicine or medical supplies in which to treat pregnancy and childbirth complications, such as bleeding or infection. This would happen at a time that every member of a survival group would have to be productive individuals. Growing food, managing livestock, perimeter defense, and caring for children require the collective energy of all involved.
Medical Complications of Pregnancy
When a pregnancy goes wrong, it takes away a valuable contributor, sometimes permanently, and places additional strain on resources and manpower. Let’s discuss some of the reasons that women could lose productivity (or even fail to survive) during pregnancy or childbirth:
Hyperemesis Gravidarum
Simply put, “hyperemesis gravidarum” is medical-speak for excessive vomiting in pregnant women. Almost everyone will experience nausea and vomiting in the early stages. A small percentage, however, have an exaggerated response to rising levels of pregnancy hormones; They may vomit so much that they become seriously dehydrated.
Today, someone who can’t maintain a reasonable fluid intake receives intravenous hydration. How many survival groups will have access to IV equipment (plus IV fluids will expire) and the know-how to provide IV fluid therapy?
If you look at old medical books from 100 years ago that discuss hyperemesis gravidarum, they relate death rates in 10% to 40% in severe cases. Will we be thrown back that far medically in a true societal collapse? It stands to reason that we will. Simple IV hydration saves lives, but who will be able to provide it?
Miscarriage
Approximately 10-20% of all pregnancies end in pregnancy loss due to miscarriage, many before a woman even realizes she’s pregnant. When a woman loses a pregnancy, she may not pass all of the dead tissue relating to the pregnancy. On occasion, this tissue becomes infected or causes excessive bleeding.
The treatment in this case would be something called a “dilatation and curettage (D&C),” a procedure that uses special instruments to “scrape out” the retained tissue. This will stop the bleeding and prevent infection. Again, how may survival groups have the ability and knowledge to perform this procedure or have access to the antibiotics necessary to treat possible infection?
Hypertension
There is a condition known as Pregnancy-Induced Hypertension (PIH). When a woman reaches the last month or two of (usually her first) pregnancy, she might begin to have elevated blood pressures that cause extreme swelling (called “edema”). Normal pregnancy can cause swollen ankles, but PIH swells up the entire body, including the face. Left untreated, this condition can lead to seizures and become life-threatening.
In long-term disaster settings, the only treatment available would be bedrest, which, at best, takes away a productive member of your group. At worst it may fail to prevent a worsening of the condition.
Childbirth Itself
Let’s say the pregnancy itself was uncomplicated. The birth process, while usually perfectly natural and routine, could also present some dangers. Every childbirth, for example, involves some bleeding. It could be a little; it could be a lot. It might be caused by lacerations from the passage of the infant through the vaginal canal or from a stubborn placenta (afterbirth) that does not expel itself spontaneously soon after delivery.
When a childbirth is associated with excessive bleeding, certain procedures and maneuvers are performed by trained midwives or obstetricians to stop the hemorrhage. When hemorrhage occurs and no trained individuals are present at the birth, the bleeding may not stop before major damage has been done to the mother.
Sometimes it’s necessary to actually reach into a woman’s uterus, feel for the placenta and remove it with your (gloved) hand from the uterine wall, especially when part of the placenta is “retained”. If a portion of the placenta is “stuck”, this tissue prevents the uterus from contracting (which is the natural way that bleeding stops). Of course, retained tissue could become infected, also. Your group needs the knowledge, equipment, and medications to safely get a woman through childbirth. Few, however, would know what to do.
After Childbirth
Conditions in the delivery room after a societal collapse could be conducive to the development of infections, even if the delivery goes without a hitch. This was a major cause of maternal mortality before modern medical care and antibiotics became available.
As well, a woman who has a major hemorrhage during childbirth could be so weakened by a low red blood cell count (also known as “anemia”) that she is unable to return to normal activities for a very long time.
Be Fruitful, Wait To Multiply
No one is saying all women will die during their pregnancy. The fact, however, is that not everyone is prepared to obtain the knowledge and resources to deal with the complications that could occur. Even experienced survivalists haven’t taken the time to consider the risks involved.
Think about it: If road warriors are prowling the streets and your garden isn’t doing so well, do you really need to add a newborn baby to your list of responsibilities? In the early going of any collapse, it’s important to keep all the members of your survival group in top condition and at 100 percent work efficiency.
Future articles will discuss strategies to hold off on creating pregnancies you’re not ready to deal with, how to safely care for pregnancies that do occur, and, yes, how to deliver a baby in austere conditions.
Joe Alton MD
Joe Alton MD
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