A Safe Place to Birth...
The contractions start...the anxious parents-to-be gather up a few last minute things and head off to the hospital--confident that they are going to the safest place in the world to have a baby--after all, it is an American hospital!
Sadly, this is far from the truth. Recently the CIA updated their "World Factbook" statistics on infant mortality. 226 nations are listed, with those who have the highest infant mortality listed first. Given this, most Americans would proudly expect America to rank at least over 200--but certainly over 220--the top of the top!
185.
That's right...if this were a percentile ranking, America would rank in the 81st percentile--18% of the listed nations have a lower infant mortality rate. And this is hardly "news," as our ranking hasn't changed much in a good many years. If the presidential elections don't make you want to move to Canada, then perhaps if you are an expectant parent the infant mortality statistics should--Canada's ranks at 204 with an infant mortality rate 27% lower than that in America.
Now to be certain, we are far from the worst--with an infant mortality rate of 191 deaths per 1,000 live births, Angola tops the list with an infant mortality rate that is nearly 30 times as high as America's rate of 6.5 deaths per 1,000 live births.
But America's rate amounts to 0.65% of all live born babies, which comes to just under 27,000 deaths each year. To put this in some perspective, the CIA reports that 0.6% of Americans are living with HIV/AIDS, and 14,000 Americans die from the effects of this disease each year. Who hasn't heard of the AIDS crisis in America? But who has heard of the infant mortality crisis? Who has heard that if we were more similar to Singapore, which has an infant mortality rate of 2.29, over 17,000 more infants per year in America would celebrate their first birthday? There is a problem when countries such as Cuba, Macau, the Czech Republic, and Hong Kong have lower infant mortality rates than America!
So what are these countries doing different than what we are doing? What technologies do they have that we don't have? Many people might be surprised to learn that it is often the LACK of technology that makes birth safer! The countries that consistently have lower infant mortality rates (and maternal mortality rates as well) than America often have a much higher rate of midwifery care, and a higher rate of out of hospital birth. Many of these countries have midwife attended birth rates of up to 60% vs. a paltry 10% in America, and some have homebirth rates of up to 40%.
How does technology make birth less safe? It's not just having it that makes birth less safe. To be certain, having technology around and available for high risk cases is part of what makes birth safer in countries like England (the United Kingdom), Denmark, Switzerland, and Finland. The problem is when it is "routinely" used. In America we see many forms of technology being inappropriately used on women who do not have a medical need for it. For example, induction of labor is becoming so common that it is almost "routine." Women can frequently ask to be induced for no medical cause beyond being "tired of being pregnant," in many cases their Dr's order inductions without medical cause even when the women do not ask for them. The women are rarely counciled about the increased risk they put themselves and their baby in when undertaking an induction--in fact, many are falsely told that to wait for labor to start naturally is what bears the increased risk! One of my clients was told that to refuse an induction at just 5 days after her "due date" (40 weeks from "last menstrual period"--LMP) for nothing more than being "late" she was risking the death of her baby. She was told this again when she refused at 7 days after her "due date." Why were scare tactics like this used when the average first pregnancy, as measured by a Harvard study, is 41 weeks 1 day after LMP; and her first ultrasound--in keeping with her longer than average cycles--actually set her due date 7 days later than LMP would predict to boot?
As for me, I'll be looking to the countries of my forefathers/mothers for "bragging rights" on infant mortality:
Sadly, this is far from the truth. Recently the CIA updated their "World Factbook" statistics on infant mortality. 226 nations are listed, with those who have the highest infant mortality listed first. Given this, most Americans would proudly expect America to rank at least over 200--but certainly over 220--the top of the top!
185.
That's right...if this were a percentile ranking, America would rank in the 81st percentile--18% of the listed nations have a lower infant mortality rate. And this is hardly "news," as our ranking hasn't changed much in a good many years. If the presidential elections don't make you want to move to Canada, then perhaps if you are an expectant parent the infant mortality statistics should--Canada's ranks at 204 with an infant mortality rate 27% lower than that in America.
Now to be certain, we are far from the worst--with an infant mortality rate of 191 deaths per 1,000 live births, Angola tops the list with an infant mortality rate that is nearly 30 times as high as America's rate of 6.5 deaths per 1,000 live births.
But America's rate amounts to 0.65% of all live born babies, which comes to just under 27,000 deaths each year. To put this in some perspective, the CIA reports that 0.6% of Americans are living with HIV/AIDS, and 14,000 Americans die from the effects of this disease each year. Who hasn't heard of the AIDS crisis in America? But who has heard of the infant mortality crisis? Who has heard that if we were more similar to Singapore, which has an infant mortality rate of 2.29, over 17,000 more infants per year in America would celebrate their first birthday? There is a problem when countries such as Cuba, Macau, the Czech Republic, and Hong Kong have lower infant mortality rates than America!
So what are these countries doing different than what we are doing? What technologies do they have that we don't have? Many people might be surprised to learn that it is often the LACK of technology that makes birth safer! The countries that consistently have lower infant mortality rates (and maternal mortality rates as well) than America often have a much higher rate of midwifery care, and a higher rate of out of hospital birth. Many of these countries have midwife attended birth rates of up to 60% vs. a paltry 10% in America, and some have homebirth rates of up to 40%.
How does technology make birth less safe? It's not just having it that makes birth less safe. To be certain, having technology around and available for high risk cases is part of what makes birth safer in countries like England (the United Kingdom), Denmark, Switzerland, and Finland. The problem is when it is "routinely" used. In America we see many forms of technology being inappropriately used on women who do not have a medical need for it. For example, induction of labor is becoming so common that it is almost "routine." Women can frequently ask to be induced for no medical cause beyond being "tired of being pregnant," in many cases their Dr's order inductions without medical cause even when the women do not ask for them. The women are rarely counciled about the increased risk they put themselves and their baby in when undertaking an induction--in fact, many are falsely told that to wait for labor to start naturally is what bears the increased risk! One of my clients was told that to refuse an induction at just 5 days after her "due date" (40 weeks from "last menstrual period"--LMP) for nothing more than being "late" she was risking the death of her baby. She was told this again when she refused at 7 days after her "due date." Why were scare tactics like this used when the average first pregnancy, as measured by a Harvard study, is 41 weeks 1 day after LMP; and her first ultrasound--in keeping with her longer than average cycles--actually set her due date 7 days later than LMP would predict to boot?
As for me, I'll be looking to the countries of my forefathers/mothers for "bragging rights" on infant mortality:
- Austria-maternal grandparents-4.66 deaths per 1,000 live births
- Germany-paternal grandfather-4.16 deaths per 1,000 live births
- Sweden-paternal grandmother-2.77 deaths per 1,000 live births
posted by Jenn | 3/03/2005 08:33:00 PM
4 Comments:
Hi! I had my first two children with no drugs. Your post reminds me that I'm going to have to start reading more about why it's so great and get myself good and psyched up for this one! I have to admit with the last one I was asking for drugs when we got to the hospital. Little did I know I was in transition and he was born less than 40 min. later! Oh to have a doula and a hospital with a whirlpool tub!
Infant mortality stats are taken from live births, right? I wonder if the number of pre-term births we have in the US influences that at all. These are births that might not even happen in other countries.
I completely agree with the way that inductions are looked at. People don't seem to realize that in most cases the baby will come when it is ready. Not to say that there is not a time when inducing is warranted. But some people I know look at it as just a way to fit the birth into their schedule better.
Sozo,
You are right in a sense--infant mortality it calculated based on live birth, and the biggest cause of infant mortality in America is complications of prematurity.
But that is not to say that these babies "would not be born alive" in other countries. In many of the other countries with better infant mortality stats than ours, they would be born alive--and several weeks further along in the pregnancy.
Thank you for thinking of me Tulip!
Monday morning I woke up (can I say I "woke up" when I tossed & turned all night & didn't really sleep? LOL!) for my "exit interview" and I had a sore throat. By afternoon I had the fever/chills/muscle soreness that my family members had been passing around for the past 2 weeks.
But I only had it for about 15 hours, so I must have built up some immunity during those two weeks! Since then I've just been kind of taking the week off. Need to buckle down and start serious job-hunting mode this coming week. That and house selling mode...did I tell you that the buyer got cold feet? GGGGGRRRR! Had an open house today, 15 people went through.
I just logged on today to type up a blog...
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