text:  but when we look at the other factors that that's what included in this pregnancy time frame we do have to do better because when we impact maternal mortality rates we are not only impacting just that mom and that baby we are impacting communities and also the us at large and so there's such a ripple effect when we think of that there's this issue that could be actually cared for in a way if we did it responsibly then that's where the devastation comes especially for the practitioners that