From Atul Gawande, writing in The New Yorker.
How childbirth went industrial.
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In a sense, there is a tyranny to the score. Against the score for a newborn child, the mother’s pain and blood loss and length of recovery seem to count for little. We have no score for how the mother does, beyond asking whether she lived or not—no measure to prod us to improve results for her, too. Yet this imbalance, at least, can surely be righted. If the child’s well-being can be measured, why not the mother’s, too? Indeed, we need an Apgar score for everyone who encounters medicine: the psychiatry patient, the patient on the hospital ward, the person going through an operation, and the mother in childbirth. My research group recently came up with a surgical Apgar score—a ten-point surgical rating based on the amount of blood loss, the lowest heart rate, and the lowest blood pressure that a patient experiences during an operation. We still don’t know if it’s perfect. But all patients deserve a simple measure that indicates how well or badly they have come through—and that pushes the rest of us to innovate.
