It's ninety degrees out and I'm covered in bug spray, lying on the dirt floor of a hut with a roof made of palms. A woman is pressing hard on my stomach. She's telling me something is wrong. Look here, hey, hap happy? The woman forcefully massaging my belly is She's a a kind of traditional healer in the Yucatan region of Mexico. Pregnant women come to her from nearby to make sure that the whole childbirth experience is safe, kind
of like a duela. The massage she's giving me is one of the sort of services she performs for her clients. It does a bunch of things, including putting the baby in a head down position for labor or calming the client's nerves. Okay, that this massage, though it did not exactly call my nerves while massaging me, tells me that something of mine called isn't where it should be. This probably isn't a body part you've ever heard of, but in my own culture, here is an organ believed to
be found in your mid section. After you have a baby, a time where your organs are really shifted around. You're supposed to come back twelve days after delivery to get a massage from someone like During that she makes sure that your sto is where it should be and massages it back into place if it isn't. The belief here, though it isn't backed up by modern medicine, is that with it out of place, you can experience back pain,
stomach issues, and anxiety. They believe you can pass along some of those issues to your baby if you breastfeed too. I'm way past that twelve day mark. How to baby a year ago? So why am I hair exactly? I'm Kelsey Butler, a reporter on Bloomberg's A Quality Team. When I got pregnant in the middle of the pandemic, I was living in New Jersey. The state was one of the highest maternal mortality rates in the US, and the numbers were the worst for women like me, who are black.
The death rate was made even scarier by the prospect of getting COVID, which I knew made the chances of complications for both me and my baby even higher. I thankfully had a mostly complication free birth. My son turned one last month, but it got me thinking about maternal health, and when I started looking into it, I found an even more shocking statistic, just a little bit south. For years,
maternal mortality had been improving in Mexico. Then the pandemic hit and the rate for maternal deaths climbed over sixty. So I jumped on a plane to Mexico to find out what happened. Jobless claims coming in, I mean really jumping from the week before, pretty brutal. Three point to a million records. Six point six million Americans filed for unemployment last week. Indian working women were the worst impacted by the pandemic. If so divid like Umia, Well, now
to the billionaire boom. According to Bloomberg's super yacht charters are up over three hut and a billionaire was created every twenty six hours during this pandemic. It is time for a wealth tax in America. Welcome back to the paycheck. I'm Rebecca Greenfield. Among the many things that have determined how a country has fared economically during the pandemic is how government's decided to manage the virus that's off. Some places opted for a COVID zero strategy, going to extreme
lengths to keep the virus out of their borders. Others had more of a letter rip strategy, keeping the economy and businesses open with little regard for the virus itself, and many places where somewhere in between. Each approach comes with costs, though some are much higher than others. Mexico is a country that chose its economy over everything else. A few months into the pandemic, the government slowly started lifting restrictions. That's my colleague Andrea Navarro. She's a reporter
in Mexico City. We were one of the few places in the world where we never really had any travel restrictions of any kind. So things went back to normal relatively quickly. Here Andrea usually covers Mexico's economy, but for the last two and a half years she's been covering COVID. She told me as early as before vaccines, Mexico is open for business. To understand this approach, Andrea says, you have to understand Mexico's president. Andrea's Manuel Lopez Obrador, who's
known more colloquially as Amlo. Amlo can be described as a populist, and what that means is that he will basically say and do anything that he says will be
popular with his base, which is very big. Am Lo caters to Mexico's poorest people, many who work in the informal and service economies, the people who run things like street cards, and if they aren't allowed to operate or all their customers are stuck in quarantine, they can't earn a living, and unlike richer countries, Mexico didn't have the money to just pay people to stay home. Plus, am Low hates debt, so he basically let COVID run free
and the hopes that the economy would survive. Andrea says the strategy allowed Mexico to keep a balanced budget. The paso has also remained relatively stable, and there are no worries about the country defaulting on its debt. But it also had some nasty knock on effects, particularly on Mexico's health care system. It's safe to say that the healthcare system collapsed, Andrea says. During the worst wave, ambulances would
circle all night looking for empty hospital beds. So far, Mexico has lost three people to COVID, which is high enough on its own, but it lost another five hundred thousand people to what are known as excess deaths, people who shouldn't have died but couldn't get the care they needed due to COVID, and among those were many pregnant and childbearing women. Before the pandemic, Mexico's maternal mortality rate, while still high, had been moving in the right direction.
Over two decades, it had dropped by half. The pandemic erased most of those games. About two thousand women have died in childbirth or soon after Mexico since the start of the pandemic. My colleague Kelsey went down to Mexico to investigate back to her for the story. I ended up in Mexico after I heard the story of getting Viejo Costito in January getting checked into a hospital in Baja California to have her second baby. She was a healthy, thirty one year old woman getting had a c section.
They're common generally speaking, but they're especially popular in Mexico, which has one of the highest c section rates in the world, and during the pandemic, the c section rate jumped even higher. Hospitals were too maxed out and short on time to let labor happen on its own. The rates in the first year of the pandemic were more
than three times what the World Health Organization recommends. Because c sections, though life saving and necessary in some cases, carry greater risk of complications like infections or blood cloths then giving birth the old fashioned way. It's also major surgery and recovery is tougher to Just after gett in c section, her family was sent home and told to come back later. Everything seemed fine. They were told she just needed some rust. But when Gatton's family returned, she
was dead. Her sister, Anna Maria Vaejo found her in her hospital room. I talked to Anna on the phone about this, which she described was heartbreaking. Anna says that when she went to touch her sister, Gaydon was freezing. Her arms dropped to her side, completely limp. It was as if she had been dead for hours. The official cause of death was listed as a hemorrhage or excessive bleeding, one of the top causes from maternal death in Mexico right now, just ahead of COVID. But Getton's family didn't
understand how things went so wrong. So quickly Anna told me she asked the doctors how in the world that happened. The family filed an official complaint, which triggered an autopsy, but when her body was delivered to the medical examiner, they were told they wouldn't be able to give the family any answers because her organs were already removed from her body. That's really odd. An official at the Medical Examiner's office said it was the first time he had
seen something like that. The hospital, meanwhile, said it followed protocol and removing Giddon's organs during its own autopsy. The family wonders if doctors were trying to cover something up. News outlets started picking up the story getting by that is Eli. The story went viral locally. The pictures of getting from her social media accounts put a face to the brutal details. Women shared their own stories of mised appointments, negligence,
and bad treatment during their pregnancies. In February, people protested in the streets. So that's almost gidding. We are all gidding. Maternal mortality was already high in Mexico, but a perfect storm of bad decisions made by the government during the pandemic created a nightmare scenario for giving birth. The problem started in the months before the pandemic. Mexico's President m Low decided to overhaul the country's healthcare system to eventually
make it entirely free for everyone. Plar. The move couldn't have come at a worse time. The news system wasn't up and running, were fully funded. When the pandemic overwhelmed Mexican hospitals, chaos ensued. There were drug shortages and not enough hospital beds, and then one really bad decision made it all worse. So when the pandemic started, there was something called reconversion, hospital re conversion, and I think it was not the best idea. That's Mina Mendez Dominguez, a
physician and researcher who studies maternal health in Mexico. She's based in Mediva, a city of one point two million people on Mexico's You've Got Them Peninsula. But I first met her at a conference in New York in April. Nina told me to deal with the influx of COVID patients, the government decided to convert many big hospitals around the country into COVID only facilities, meaning no one could be treated for anything else, not heart attacks, not gunshot wounds,
not even childbirth. It was Nina and her colleagues research that uncovered that first statistic that really shocked me, that there had been a sixty jump in the maternal mortality rate in Mexico during the pandemic. Other countries in Latin America, like Brazil and Peru also had big jumps. Those COVID only hospital conversions played a big part in the deaths. She told me. What happened was that non essential medical consultations were not available, but also nurses and oldest staff
were moved from certain hospitals to other hospitals. In other words, even the hospitals that would see pregnant women were short staffed because their staff had been sent to deal with COVID. This led to a lot of problems for people with all kinds of health emergencies, but it was particularly dangerous for pregnant women, especially pregnant women who lived far away from a hospital. Outside of the big cities, the only nearby hospital or health clinic was reserved just for COVID patients.
In the remote region of you got done. Where I saw someone in labor could be hours from the nearest place that could deliver a baby or even do standard pre and postnatal care. The first contact in rural areas were not priority because they treat very small amount of people, so then they stopped all the maternal consultations, and women feared to travel to the urban areas and then go to the hospital because they knew there were patients that
were sick over there already. Basically, pregnant women who already lived far from medical care might now be even further from somewhere that would treat them, and they also might be scared to go there because there was more risk of catching COVID. Henny Carrillo, a professor at Texas A and M University who worked with Nina on the research, put it bluntly, so what happened pregnant women did not
attend the routine checobs. All these decisions had a repel effect henn He says not all paternal dates in Mexico were directly related to COVID inflation, but rather to uncontrolled conditions during pregnancy due to the limited hay care availability that these women had to face. Nina told me about one case while doing her research that's stuck with her. She told me about a young woman who showed upbout a remote hospital with a rare, life threatening pregnancy complication
called help syndrome. The first facility she went to didn't catch it. By the time she got to the next it was too late. She started bleeding internally and was taken to surgery. The end result was tragic. She just passed away, and it was so sad because her family came after and she was already gone. It's these kinds of cases that stick with Nina because they're part of a common pattern unnecessary roadblocks that make it hard for
people to safely have babies. Emergencies were especially dangerous for women in the thick of COVID because it took so long for them to get to treatment and be seen by doctors. It became so difficult for a woman, for a pregnant woman to move from her house to find medical attention that it ended up so bad. You get done where Nina is based, so the highest level of maternal deaths and more than a decade, it's a problem that is leaving too many women behind. She says, pregnancy
should be a very positive experience. Bringing children to life should be such an important event that we should all enjoy this process and it should be equal for all women in all the world. But at a virtual event in February, Zoe Lejano, head of the Mexican Institute of Social Security, said the country. Strategy had been quote very very focused on hospital reconversion unquote, so that doctors wouldn't be forced to decide which COVID patients lived and which died.
He went on to say, quote Mexico's model was growing the capacity for care, so there were zero rejections unquote, and barras or midwives are stepping in to fill some of these gaps in a health care system they say isn't working for women, but they can't fix everything. I called one of these women who has been delivering babies for over thirty years. Her name is Guada up She's
the president of the Association of Professional Midwives in Mexico City. Joe, I have been delivering babies for more than thirty years outside of hospital settings, in homes or in birthing centers, under very strict protocols to ensure the security and safety of both mother and baby. Told me she was afraid to treat women early in the pandemic, leaving another gap
in the system for rural women. That wasn't the case for Guada Lupe, who, during the height of COVID saw double or triple the number of women she normally does. That's because people either couldn't get care or we're scared to go to traditional care facilities. See, so it was very difficult imagine the situation running out of options and filling on certain women began calling professional meadwifes. Now, she says, fortunately, the maternal mortality numbers are in a much better place.
The latest government figures show the rate of maternal deaths is at about thirty one for every one hundred thousand babies born. That's down from fifty three deaths for every one hundred thousand berths at the end of last year. That's in large part because the chaos of the earliest days of the pandemic and those hospital conversions are in the past for now, but there's still work to do.
In two thousand, the country committed to decreasing the maternal mortality rate to twenty two deaths for every one hundred thousand live births. That's higher than many developed countries, but lower than the United States rate right now. One way to achieve eve that, Guada Lupe says, would be to integrate midwives like herself into the health care system in Mexico.
We think that's what should happen here in Mexico. For starters, they should insert professional midwives in the multidisciplinary team with a budget to pay them well to stop treating them in a denigrading way. There's evidence to back that up. Researchers say addressing a shortage of global midwives would prevent two and eighty thousand deaths per year by and the World Health Organization recommends increasing education for midwives to reduce
maternal and infant deaths. Gualla Lupe says that there should be more education for women about options outside the traditional health care system to a system that is overwhelmed just can't provide care to pregnant women the way they deserve. Prenatal visit with an O B G y N that has eighty women to see in a date, you can't ask for quality of care, not even to give proper advice or guidance. It's not that they don't want to, it's that they can't. Right now, one thousand pregnant women
die each year in Mexico. Zoom out, and there are three hundred thousand more around the world. One of the lessons of the season for me has been that there's no escaping the pain of the last two years. Some places have felt that pain more than others, and in more traumatic ways through unimaginable death tolls. But even countries that manage the virus well couldn't fully insulate themselves from
the global shock of COVID. Next week, on The Paycheck, we had to a place with one of the lowest death rates in the world, where more and more people are feeling economic pain. It strikes against the singaple pledge. Right. We pledge ourselves to developer justin equal society. If we don't hold that, then there's something problematic. Thanks for listening to The Paycheck. If you like our show, please head on over to Apple Podcasts or wherever you listen to
podcasts to rate, review and subscribe. This episode was hosted by Me Rebecca Greenfield and reported by Kelsey Butler. It was edited by Kristin V. Brown with help from Francesca Leavy, Janet Paskin, Rocksheeta Sluja, and Me. We also had editing help from Daniel Balby, Shelley Banjo, Gilda to Carly, Nicole Flato, Elissa McDonald, and Kai Schultz. This episode was produced by Gildada Carly and sound engineered by Matt kim Our original
music is by Leo Sidron. Special thanks to Magnus Hendrickson, McKinnon, Da Kuyper, Margaret Sutherland, and Stacy Wong. The voice actor you heard was Veronica Colloe. Francesca O Leevie is Bloomberg's head of podcasts. See you next week. H