The CDC National Center for Health Statistics (NCHS) released a new report this morning which compares infant mortality rates in the U.S. and Europe.
Authors of Behind International Rankings of Infant Mortality: How the United States Compares with Europe explored what they refer to as the recent stagnation in the U.S. infant mortality rate that has generated widespread concern among researchers, policy makers, health care providers and activists.
Using data from the United States? Linked Birth/Infant Death Data Set and the European Perinatal Health Report, authors Marian F. MacDorman, Ph.D., and T.J. Mathews, M.S. of the CDC National Center for Health Statistics found that the main cause of the United States high infant mortality rate when compared with Europe is the ?very high percentage of preterm births in the United States.?
According to the study, while infant mortality rates for preterm (less than 37 weeks of gestation) infants are lower in the United States than in most European countries, infant mortality rates for infants born at 37 weeks of gestation or more are higher in the United States than in most European countries.
Discussions of the U.S. infant mortality rate are often countered with criticism that the U.S. records data differently than other countries, reporting very premature babies as live births. While this is true for five of the 19 European countries whose data was analyzed, 14 of the 19 European countries require that all live births at any birth weight or gestational age be reported.
The United States remains near the bottom of the rankings.
The report states, ?Reporting differences have little effect on the percentage of preterm births because most preterm births occur well after 22 weeks of gestation. For example, the percentage of preterm births for the United States in 2004 was 12.5% when all births were included and 12.4% when births of less than 22 weeks of gestation were excluded.?
MacDorman and Mathews attribute much of the high infant mortality rate in the United States to the high percentage of preterm births. Using the direct standardization method to apply the U.S. gestational-age specific infant mortality rates to Sweden?s distribution of births by gestational age, the NCHS found evidence that lowering the percentage of preterm births could have a dramatic impact on infant mortality in the United States.
November is also Prematurity Awareness Month.? Considering the risks involved in preterm birth, you may be wondering what you can do as a birth activist or as a parent.? Here are some basic things to consider:
- Let labor begin on its own. Without a valid medical reason, let your baby pick his or her birthday for the safest, easiest birth.
- Choose a practitioner with a low induction rate. If you have a midwife or doctor who rarely sees anyone who goes past their due date, it should be a red flag.? Ask the receptionist for her opinion of how many women go past 40 weeks. The answer might surprise you.
- Know the signs of preterm labor. If you think you’re having any of the signs of preterm labor, call your midwife or doctor immediately.? The sooner you get help, the more likely that premature birth can be delayed or stopped completely.
- Be mindful of the risk factors. Face it, you have responsibility for some of the risk factors.? While there are certainly some risk factors for preterm labor that you don’t control, take charge of the ones you can, including prenatal care, good nutrition, not smoking, etc.
Another basic thing to consider: for elective cesareans ie: breech, twins, repeat cesareans that you consider waiting until the 39th week for scheduling the c-sect. It is obvious 1 week can mean alot. Dr. Christiane Northdrup OBGYN suggests even letting the mother go into early labour naturally before doing a cesarean. So that the baby is born when the baby is ready.
AMAZING. But yet . . . not surprising, at least for those of us who have been engaged in birth advocacy.
One immediate thought on the dismal rate of preterm babies: do you think advance knowledge of this report might have something to do with the recent turnaround on induction rates?
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I wonder how prenatal tests and abortion rates might affect the infant mortality rate. After all, if a baby is born with anencephaly, he’s very unlikely to survive past one year of age. If France has 100% abortion rates for anencephaly and other anomalies with high mortality rates, but abortion rates in the U.S. are 95% or less, that might cause some differences. I’ve read that somewhere, about France and Ireland. That might not make all the difference, but it might perhaps be significant.
I know this is not PC to say, but abortion has been found to raise the likelihood of future pregnancies ending in premature birth greatly. Just 1 abortion (any gestational age, any reason) raises future premature birth rates by as much as 70% (depending upon which study you read, some as low as 50%). A woman who has had 2 abortions has a 90% greater likelihood for having a premature birth in furture pregnancies than a woman who has never had an abortion. A huge reason for the continuing high rate of premature births in the US is because woman are being told that abortion is ‘safe’ and, unfortunatley, they are believing it.
How does the infant mortality rate say anything about obstetric care in the US? Is the mortality rate increased for every age, or are there age groups with a higher/lower rate, and if so which one? What are the numbers for neonatal mortality rates, or perinatal. Isn’t perinatal the measurement used to assess obstetric care?
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