A Mother’s Life

Every day, nearly 830 women die from pregnancy-related complications around the world. Health professionals across the globe know how to save nearly all their lives. So, why are these women dying? That’s what Shawn Wick and Kylie Gerstein want to answer.

Wick, assistant professor of sociology, and Gerstein, junior sociology and Spanish major from Iowa Falls, are conducting original research on maternal mortality and its social influences. “We have the medical knowledge to prevent these deaths,” says Wick. “The clinical and technical causes are well known, but maternal death rates are uneven and vary widely between and within countries. Why?”

Several factors are thought to influence maternal mortality, including economic and gender inequality, healthcare infrastructure and access, and the efforts of nongovernmental organizations. But which factors matter most? Wick and Gerstein plan to publish their research answering this question. “Sociology has a lot to offer, to help societies take on significant and complex issues,” says Wick. “Our primary focus in sociology is to explain and address real-world problems.”

Decoding the Data

The World Health Organization, World Bank, UNICEF and other international development organizations have drawn attention to alarming rates of maternal mortality, and reducing maternal deaths is part of the United Nations’ Sustainable Development Goals outlined in 2015.

“Maternal mortality has been on the radar for some time, and progress has been made,” Wick says, “but the global occurrence of maternal mortality remains alarmingly high and uneven across countries.”

Gerstein first investigated this topic in one of Wick’s sociology courses, where she analyzed causes of maternal mortality in Cambodia and developed a proposal to establish a nongovernmental organization to address this problem. Last summer, she and Wick began the collaborative project, compiling data from the World Health Organization, United Nations, Polity Project and other sources to conduct their analysis.

Wick and Gerstein have also worked to measure factors that affect maternal mortality factors by creating new variables covering more than 150 countries. For example, Gerstein created a new variable representing each country’s capacity to train medical professionals, using previously neglected information from the World Directory of Medical Schools.

No Easy Answers

Several factors seem to influence maternal death rates directly, Wick says, but his and Gerstein’s findings show many more complicated patterns. As an example, Wick points to complex relationships between public health spending and economic inequality. Healthcare spending may seem to significantly lower a nation’s maternal mortality rates. However, Wick and Gerstein find the effect of higher government spending disappears when they account for the level of economic inequality in a country. This indicates a country cannot fix its maternal mortality problems by focusing on health spending alone.

“Our findings indicate that economic inequality among a nation’s population undermines access to healthcare systems and significantly affects the likelihood of maternal death,” says Wick. “Improving health outcomes requires not only investment in national healthcare systems, but also investments in the social and economic well-being of individual citizens, families and communities.”

Most maternal deaths occur in developing countries, but Gerstein says many people are surprised to learn how relevant these findings are to the United States. Despite being one of the wealthiest nations in the world, America does not have one of the lowest rates of maternal mortality. The U.S. ranks 46th among the 184 nations with available data, and Gerstein says economic inequality must be a top consideration.

Undergraduate research at Central

• Over 100 students present their work each semester.
• Last summer, 17 students received funding for their research.
• Each year, dozens of students present research at conferences.

What Do You Want to Study?

Wick and Gerstein discovered their shared interest in global health topics through sociology courses at Central and a 10-day study abroad trip to the Yucatán. Last spring, Gerstein returned for a semester in Mérida, taking more healthcare classes and interning in a local hospital. By summer, she and Wick both received support for their collaboration through the Arthur J. Bosch Endowment for Student Research, Moore Family Foundation and academic affairs office. “If I was at a big university, I don’t think I would ever get this opportunity unless I was really focused on the professor’s interest,” said Gerstein. “Shawn asked me what I wanted to do – we’re treating it like grad school. I got to pick my area of interest, and I am invested in the outcomes of the project.”

Wick says research grants give Central professors a chance to work one-on-one with exceptional students — and mentor them throughout the project. By completing this work, Wick says Gerstein will gain advantages beyond most of her peers: advanced research experience, confident presentation skills and an impressive final product.

“Central’s unique funding opportunities for faculty-student research are excellent,” says Wick. “We couldn’t do this work in a focused way without such support. This project is a really important example of what can happen when these resources are available.”

Based on her work so far, Gerstein received the top undergraduate research award at the 8th Annual Global Health Consortium Conference in Des Moines. This conference focuses on ways schools and community groups can improve sustainable global health through education.

“I know I want to be in women’s health,” says Gerstein. “Right now I’m trying to discern whether I want to be in practice or policy.”

Next, Gerstein plans to spend another semester abroad — this time in Granada, Spain. After finishing her degree at Central — complete with a minor in global health — Gerstein plans to complete a nursing degree from Central’s partner in Waterloo, Allen College.

Meanwhile, she’s enhancing her international vocabulary by studying “What to Expect When You’re Expecting” in Spanish.