One of the saddest songs from the Coen Brothers wonderful new movie “Inside Llewyn Davis” is “The Death of Queen Jane”.
It is a traditional folk song that Davis (Oscar Isaac), on the down and out from the NYC folk scene, chooses to sing in an impromptu audition for Chicago music producer Bud Grossman (F. Murray Abraham). Given that Davis is still mourning the death of his musical partner and reeling from the knowledge that he has fathered a child, the song choice is not surprising. But like almost every choice Davis makes in this movie, it is a poor one.
The song is the legend of King Henry’s second wife Jane Seymour, who died in 1537 after giving birth to Prince Edward I. After laboring for nine days, her attendants so tired that they can no longer attend her, the Queen begs King Henry for a Cesarean section, which he at first refuses for fear of losing both mother and child – “If I lose the flower of England I shall lose the branch too”. But eventually, the Queen swoons, a C- section is done, and later, she dies.
Grossman listens intently as Davis sings (watching Abraham is itself worth the entire film) and when the song is done, utters a single sentence –
“I don’t see a lot of money here.”
He’s right, of course. Maternal death doesn’t sell records. It’s just too depressing.
What is even more depressing than Llewyn Davis’s song choice is the fact that today, almost 500 years since the death of Queen Jane, some 350,000 women worldwide still die each year as a result of giving birth, almost all from preventable causes.
That rate is half what it was a decade ago, but we still have a long long way to go before childbirth is for every woman the joyous event it should be.
Lest you think maternal deaths are Africa’s problem, know that maternal mortality here in the US has actually doubled in the past 25 years. Despite all our advanced and expensive healthcare, the US ranks 50th in the world in maternal mortality, with the highest rate of all the developed countries. The major causes of maternal death in the US are preeclampsia, hemorrhage, embolisms and cardiovascular disease, with death rates 3-4 times higher in African American women. Reasons for the rise are complex, but include increased C section rates, multiple births and higher rates of underlying maternal diabetes and cardiovascular disease.
Approaches to reducing maternal morality here in the US include reduction in C section rates, protocols for rapid response for transfusion for maternal hemorrhage, and team training to respond to obstetric emergencies. Here in New York State, ACOG has instituted the Safe Motherhood Initiative, developing and implementing standardized protocols for tackling maternal hemorrhage, hypertension and venous thromboembolism in hospitals across the state. Using lessons learned from the airline industry, states are beginning to take a centralized approach to data collection and response to adverse events. It’s a multi-pronged approach to a complex problem that has the potential for a real and lasting impact.
Inside Llewyn Davis is a fabulous movie that will be getting lots and lots of press in the upcoming month as Oscars approach. Here’s hoping that some of that limelight will get cast on the problem of maternal mortality, and lead to conversations about more than just folk music.
The Death of Queen Jane
Queen Jane lay in labor full nine days or more
‘Til her women grew so tired, they could no longer there
They could no longer there
“Good women, good women, good women that you may be
Will you open my right side and find my baby?
And find my baby
“Oh no,” cried the women, “That’s a thing that can never be
We will send for King Henry and hear what he may say
And hear what he may say”
King Henry was sent for, King Henry did come
Saying, “What does ail you my lady? Your eyes, they look so dim
Your eyes, they look so dim”
“King Henry, King Henry, will you do one thing for me?
That’s to open my right side and find my baby
And find my baby”
“Oh no, cried King Henry, “That’s a thing I’ll never do
If I lose the flower of England, I shall lose the branch too
I shall lose the branch too”
There was fiddling, aye, and dancing on the day the babe was born
But poor Queen Jane beloved lay cold as the stone
Lay cold as the stone