"So, part of how your horseless carriage can travel quickly and smoothly is that its wheels have tubes which get inflated with air. A 'flat tire' means the air has come out of one of the tubes. Trying to drive like that is a bad idea. You might have a spare tire stored in your carriage to replace it with, but that would take work, which is easier with more than one person. 'Roadside assistance' would likely be an organization you paid in advance to come help you if this kind of thing happens, or maybe one you have to pay now, if you didn't pay in advance."

"I don't want anyone to drive their car into me while my own is disabled and I can't escape. How expensive is roadside assistance, and how much faster than replacing the tire alone? Can I use a device to alert someone I want to speak to, to bring their own car here and help me?"

"People probably aren't going to drive their car into you on purpose. According to some random source I don't really trust, if you paid in advance, it might be 68 to 170 dollars a year, and if you paid after an incident, it might be 75 to 250 dollars? But if you get lots of car problems, places you pay in advance for would probably charge you more next year. And you can probably use a device to alert someone you want to speak to to bring their own car there and help you. That's how you'd get commercial roadside assistance, probably, but it would work for a friend too. I don't know how long it would take to change a tire. Probably a while if you haven't done it before."

"I know that it's unlikely that someone with a grudge against me will notice my vulnerability and act on it inside the window, and, perhaps in Spinworld, where I'm not a queen and was never an Arvanxi, if I keep my head down, there might not be anyone who especially wants me dead. And I know it is unlikely that I'll be driven into by a robber in my own neighborhood, and unlikely that I'll be threatened with being driven into by a mugger or rapist. I know it's unlikely, on any given day, to die. I don't know how long I could wander Korvosa unarmed and unaccompanied and survive completely unharmed, but it would probably be for longer than it takes to change a tire. I still worry."

"I suspect if someone wanted to mug or rape someone stuck on the roadside with a damaged car they'd initially offer to drive the person somewhere and then drive to a different location, not, uh, threaten to hit them with a car. I, uh. I'm not quite sure how that would work in the rape case, in order to rape someone you tend to need to make physical contact with them and that seems pretty hard to do if you're sitting in the driver's seat and they're in front of or behind the car."

"And I would expect a robber to not want to drive into the car, because the car itself is likely the most valuable item you brought along, and it loses a lot of that value if damaged."

"Well, you could threaten to drive your car into a pedestrian if they don't drop their coin purse or bind their own hands - " that's not what's important, what's important is, "it doesn't sound like you expect people to drive their cars into pedestrians? Are cars easier to avoid on foot than I'm imagining, and motor vehicle crashes are mostly between two cars?"

"If you stop moving to yell a coherent threat to a pedestrian, the pedestrian will probably run away from the road, where your car will have more trouble traveling than they do."

"And I think it's most common for crashes to kill drivers. Some crashes are from drivers driving into large animals or trees or walls or such, so the only people who could die are people in the driver's car. People mostly don't crash their cars on purpose. They often do it because they were driving too quickly to stop for a pedestrian, or they weren't paying attention to the road, or their car is too tall and the pedestrian is a child they didn't notice, or they were too drunk to control the car, or such. I admit I don't have exact statistics about how many fatal car crashes are murder, though, because it's one of the contexts where it's easier for people to claim it was an accident."

"If people don't crash their cars on purpose, how in the world is it the leading cause of death for young adults?"

"Young adults mostly don't die!"

"Young adults die all the time! How are accidental car crashes more common than death in battle or in childbirth. Why do Spinworlders drive these things?" 

"The relevant country isn't having any big wars and the maternal mortality rate is around 18 deaths per 100,000 live births, which plenty of citizens complain is too high compared to other reference countries. You're probably wondering if the death rate for stillbirths is higher, but I really think I would have heard of it if so, and there's technology that lets people notice a dead or obviously doomed fetus and deal with it early, which I expect would help."

"Eighteen in one. Hundred. Thousand?"

"Yes! And the babies die a lot less too."

Childbirth is dangerous. Ileosa doesn't have memorized numbers for how dangerous, but she has qualitative impressions and intuitions, and those qualitative impressions say that eighteen deaths in a hundred thousand is absurd. 

(If you made an attempt to list one hundred thousand people for any purpose at all, Ileosa would be exasperated but not amazed to learn that merely doing so precipitated eighteen of their deaths!!)

Ileosa doesn't know off the top of her head how likely you are to die in childbirth if there isn't a healer on hand, or if there is, and doesn't know how often for most people there's a healer on hand. And the intuitions she does have, might be wrong outside Cheliax, since Chelish priests are only better at everything except for healing. (That's an uncomfortable thought. Oh, but actually, Cheliax has more wizards and witches than most places, in addition to having clerics, so probably Cheliax has more healing spells for childbirth. Ileosa is reassured.) But her general impression is: if there isn't a healer you're in for a lot of pain and will die on a critical failure; if there's a witch or cleric with stabilize prepared you're in the clear unless Pharasma really hates you; if you're relying on a limited number of prepared healing spells or spontaneous slots, you're probably going to live but should pray to all the gods that you don't start bleeding again after the spells run out. If Ileosa had to put numbers on her qualitative impression, she'd say that getting pregnant without knowing what your healing situation is going to be nine months down the road is the sort of thing that kills you one time in a hundred. (Which doesn't sound like a lot, at first, until you realize you'll need eight brats just to break even because half of them will get sick before they're five and half of the other half will be killed in battle or eaten by monsters, and until you realize that a fourth of pregnancies end in miscarriage or stillbirth and those can be lethal too. Hence why Ileosa expects high single-digit or low double-digit percentages of women to die in childbirth.)

Apparently on Spinworld, practically no one dies in childbirth. Which is very cool. Ileosa has so many questions.

"If no one dies in childbirth, I can see why accidental car crashes kill more people than childbirth does, but why are more people dying in accidental car crashes than monster attacks and intentional murders? And, and this I really must know, how do you heal people by spinning them?"

"A lot of this involves alchemy and I'm sure spinning things and lightning helps with the alchemy, you can separate substances with spinning sometimes and transform things like water with controlled lightning and of course it's good to not need to hand-mix things, but you have to understand I'm not an alchemist, ok? We generally don't spin the patients."

"My understanding is a lot of the causes look like blood loss, infections, high blood pressure, and the baby not coming out right."

"For blood loss, a lot of the time the issue is the uterus not contracting enough, and for that we have a drug that makes it contract more. The usual drug needs to be kept cold, and we have a system involving lightning and spinning parts for that. One of the simpler things we do involves putting a sterile balloon in the uterus and inflating it with sterile saltwater, presumably to use pressure to keep the blood in?"

"For high blood pressure, we use drugs to lower it and sometimes drugs to make the baby be born sooner, but of course if the baby is born too soon it can be in pretty bad shape, so it's complicated."

"For infections, we have some drugs. We also make sure things that touch the patient, like hands and surgical implements and bedding, are really clean."

"And for the baby not coming out right, we do surgery, often a c-section, which is much safer I think because we're better at preventing and treating infections, and because we've gotten better at some details of incision and stitches. I'd bet the stitches are also alchemical. And we can do blood transfusions if necessary."

Alchemical marvels of Spinworld!

It sounds like Spinworld has a huge number of alchemists, and consequently a huge variety of mundane alchemical items, drugs and water balloons and healing stitches, easy to use and stored at home. (Presumably they also have any number of healing potions, but potions will never sell for less than the cost of the reagents, so it makes sense that mundane alchemical items are also popular.) There's even a device for transferring blood from one person to another! It doesn't sound like Spinworld has anything that'd make a difference for a Golarion noble, but Ileosa is hugely pleased on behalf of her hypothetical Spinworld commoner self; between her own arcane healing and the drugs, balloons, stitches, and blood transfusion device in her medicine cabinet, neither Ileosa nor her wife are in much danger. (Eighteen chances in a hundred thousand!) 

Or at least, neither of them are in much danger from childbirth.

"Spinworld sounds amazing in every respect except the frequency of car crashes. I understand that the relevant country is not in any desperate and existential war against a rival polity, but I remain disturbed that lethal motor vehicle accidents are more common than death at the hands of highwaymen, or at the jaws of monsters, or in scraps and duels with peers and enemies."

"The police go after highwaymen, they don't have the really powerful monsters Golarion does and people in fact killed so many wolves and such that now they're trying to restore the relevant population a bit though this gets pushback from ranchers, and they banned dueling."

"How terribly unreasonable of the ranchers, I can't imagine what they're thinking. How many young adults die in motor vehicle accidents?"

"Presumably the ranchers are thinking they don't want to lose any cattle and they don't really care as much about the effects of deer and elk overpopulation. Anyway. I think around 15 per hundred thousand in the relevant country? I'm calling people ages 15-24 young adults, though they only get permission to drive on their own starting at 16 and the vote and a bunch of other rights at 18."

"Asmodeus keep us from an overpopulation of deer and elk," Ileosa agrees, agreeably. 

Restricting the vote to those eighteen years old or older is a perfectly sound policy, as far as Ileosa is concerned. Abyss, you could restrict it to twenty.

"So in Spinworld, young adults... mostly don't die." 

...That's the exact same thing that the Spinworlder said earlier. Ileosa is going to keep talking in the hopes that they don't point it out. 

"If you live to adulthood, you're almost certain to see the age of twenty-four, or thirty, forty." That sure is a thing to wrap her head around. "And the population quadruples every generation?"

"It went up a lot in the past century, and people got concerned that there would be too many people and a lot of starvation, but now people are having fewer kids everywhere. Sometimes not enough to replace the existing population. There's a lot of drama about it."

This makes no sense, but, "Are too many people getting same-sex married?" 

"No. A lot of people aren't getting married at all and some aren't having kids when they do, there's cheap effective contraception."

"...Why not? When it's not going to kill you?"