Tuesday, January 29, 2013

Downton Abbey: A Mountain of Viewer Tears Leads to an Incredible Online Discussion about Maternal Health

Warning: if the January 27, 2013 episode of Downton is still on your DVR- this post contains spoilers!

From the looks of twitter this week, I am not the only person who was devastated by the loss of Lady Sybil on Downton Abbey.  She died of Eclampsia shortly after giving birth to her daughter.  In my house, there was complete silence while we watched Sybil convulsing and struggling to breathe.  After she died, our horror and sadness quickly turned to anger.  There were two doctors in the room (one of whom made the correct diagnosis)- how could this happen?

As I contemplated this question, I was fascinated to see how this story line impacted the public health messaging that started appearing on twitter.  I recognized a few trends:

Making the connection to current women's health issues and debates
There has been much concern about men making decisions about women's healthcare- for example, the comments in 2012 about the definition of rape and the ongoing abortion debate.  Since Sybil's death was largely the result of poor decisions about her health (made by her father and the fancy male doctor consulting on her case), I saw the following post on this topic over and over again:

Identifying a Teachable Moment:  Preeclampsia and Eclampsia Specifically
Like many organizations, the American Public Health Association (APHA) followed up on Monday with this message:

Identifying a Teachable Moment:  Maternal Mortality and Maternal Health Broadly  
I saw many links to organizations such as Every Mother Counts, which focuses on global maternal health advocacy:

In addition to the discussion on social media, many news outlets and foundations also took the opportunity to post information on their websites about the condition that killed Sybil.  For example, ABCNews wrote, "Eclampsia Death in 'Downton Abbey' Highlights Pregnancy's No. 1 Killer".

I would love to see some evaluation data to follow this teachable moment.  Some questions that I have:

  • How many people searched for Preeclampsia and Eclampsia following the episode?  (As a side note, this episode aired months ago in the UK- was there a similar searching pattern?)
  • How many physicians/midwives/clinicians received inquiries from patients following the episode?
  • Beyond knowledge- did this episode change any clinician behaviors?  Did they go back and review a suspicious case after seeing a reminder of the severity of this condition?  Did they perform a more comprehensive screening?
What do you think?
What other evaluation questions should we be asking?
What other trends did you see in the discussion on social media (or in person) following this episode?

1 comment:

  1. I hope part of the discussion revolves around the changes in health care. I watched with my husband who is a nurse and he was commenting on what a thin array of response was available to the doctors (whether they had it right or wrong). They had morphine and one other drug (I forget right now) to ease the convulsions but no remedy for eclampsia other than an emergency C-section, which in the early 20s was also extremely risky. I'd also like to recommend a riveting, heartbreaking book--written by an author whose mother "died in childbirth" in 1950. As an adult, he went back through the records, interviewing people who remembered her, to find out why. Was it a failure of health care? lack of education? I won't give it away but will just say that life is complex... Of Time & Memory, by Don Snyder. Spoiler alert: do NOT read the Wikipedia entry on Don which gives away EVERYTHING about the book, obviously written by an over-enthusiastic fan...