The Deplorable U.S. Infant Mortality Rate

From:  http://www.chiroaccess.com/Articles/The-Deplorable-US-Infant-Mortality-Rate.aspx?id=0000155

Despite great technology, the United States has an infant mortality rate like that of a third world nation.  The procedure intensive approach to childbirth in the U.S. is believed to be a significant contributing factor.  A survey of 1,573 pregnant women reported significant interventions such as “regional analgesia (76%), ruptured membranes (65%), forceful pushing (75%), and cesarean sections (32%). The U.S. rate of cesarean sections in 2005 was the fourth highest among 25 countries. The epidural has many negative features. When used in labor it extends the length of time from 5 to 7 hrs, causes a raised temperature greater than 100.4 degrees C in 15-30% of infants and mothers, and produces a very sleepy baby at birth, irritable and with increased crying for 3 weeks.”

The statistics from research published this year highlight this tragedy:

·  In 1960 the U.S. ranked 12^th among other nations in infant mortality

·  By 2005 the U.S. infant mortality rate had fallen to 30^th  

·  In 2007,  31% of U.S. births were by cesarean section

·  Preterm births in the U.S. have also risen to 36%
Countries using fewer drugs and fewer invasive procedures like Finland and Sweden have the lowest infant mortality rates of industrialized countries.

Academy of breastfeeding medicine founder’s lecture 2009: Maternity care re-evaluated.

Breastfeed Med. 2010 Feb;5:3-8.

Klaus M, Klaus P.
Department of Pediatrics, University of California, San Francisco, USA. phyllisklaus@sbcglobal.net

In the 1990s a rising tide of medical, surgical, and instrumental interventions served to make childbirth almost treated like a disease. This report supports a different approach to childbirth. A case and discussions of induction are presented. A national survey of 1,573 pregnant women throughout the United States was collected. Although most U.S. childbearing women are low risk, childbirth is “procedure intensive.” Women reported significant interventions such as regional analgesia (76%), ruptured membranes (65%), forceful pushing (75%), and cesarean sections (32%). The U.S. rate of cesarean sections in 2005 was the fourth highest among 25 countries. The epidural has many negative features. When used in labor it extends the length of time from 5 to 7 h, causes a raised temperature greater than 100.4 degrees C in 15-30% of infants and mothers, and produces a very sleepy baby at birth, irritable and with increased crying for 3 weeks. The three hormones that relieve pain are turned off by the epidural or a cesarean section. Maternal and infant mortality was doubled as a result of cesarean section. After cesarean sections, subsequent pregnancies have types of abnormal attachments of the placenta to the uterus. British physicians recommend normal birth, defined as labor that starts on its own and uses no analgesia, no inductions, no interventions, no epidurals, and no cesarean sections. The doula’s presence decreases labor length, significantly decreases cesarean sections, means less use of pain medicine, and gives greater breastfeeding rates.

Annual summary of vital statistics: 2007.

Pediatrics. 2010 Jan;125(1):4-15. Epub 2009 Dec 21.

Heron M, Sutton PD, Xu J, Ventura SJ, Strobino DM, Guyer B.
Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA. mheron@cdc.gov

The number of births in the United States increased between 2006 and 2007 (preliminary estimate of 4,317,119) and is the highest ever recorded. Birth rates increased among all age groups (15 to 44 years); the increase among teenagers is contrary to a long-term pattern of decline during 1991-2005. The total fertility rate increased 1% in 2007 to 2122.5 births per 1000 women. This rate was above replacement level for the second consecutive year. The proportion of all births to unmarried women increased to 39.7% in 2007, up from 38.5% in 2006, with increases noted for all race and Hispanic-origin groups and within each age group of 15 years and older. In 2007, 31.8% of all births occurred by cesarean delivery, up 2% from 2006. Increases in cesarean delivery were noted for most age groups and for non-Hispanic white, non-Hispanic black, and Hispanic women. Multiple-birth rates, which rose rapidly over the last several decades, did not increase during 2005-2006. The 2007 preterm birth rate was 12.7%, a decline of 1% from 2006. The low-birth-weight rate also declined in 2007 to 8.2%. The infant mortality rate was 6.77 infant deaths per 1000 live births in 2007, which is not significantly different from the 2006 rate. Non-Hispanic black infants continued to have much higher rates than non-Hispanic white and Hispanic infants. States in the southeastern United States had the highest infant and fetal mortality rates. The United States continues to rank poorly in international comparisons of infant mortality. Life expectancy at birth reached a record high of 77.9 years in 2007. Crude death rates for children aged 1 to 19 years decreased by 2.5% between 2006 and 2007. Unintentional injuries and homicide were the first and second leading causes of death, respectively, accounting for 53.7% of all deaths to children and adolescents in 2007.

Behind international rankings of infant mortality: how the United States compares with Europe.

NCHS Data Brief. 2009 Nov;(23):1-8.

MacDorman MF, Mathews TJ.
Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road, Hyattsville, Maryland 20782, USA.

Infant mortality is an important indicator of the health of a nation, and the recent stagnation (since 2000) in the U.S. infant mortality rate has generated concern among researchers and policy makers. The percentage of preterm births in the United States has risen 36% since 1984 (1). In this report we compare infant mortality rates between the United States and Europe. We also compare two factors that determine the infant mortality rate-gestational age-specific infant mortality rates and the percentage of preterm births. U.S. data are from the Linked Birth/Infant Death Data Set (2,3), and European data for 2004 are from the recently published European Perinatal Health Report (4). We also examine requirements for reporting a live birth among countries to assess the possible effect of reporting differences on infant mortality data. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

The challenge of infant mortality: have we reached a plateau?

Public Health Rep. 2009 Sep-Oct;124(5):670-81.

MacDorman MF, Mathews TJ.
Reproductive Statistics Branch, Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Rd., Room 7318, Hyattsville, MD 20782, USA. mfm1@cdc.gov

OBJECTIVES: Infant mortality is a major indicator of the health of a nation. We analyzed recent patterns and trends in U.S. infant mortality, with an emphasis on two of the greatest challenges: (1) persistent racial and ethnic disparities and (2) the impact of preterm and low birthweight delivery.

METHODS: Data from the national linked birth/infant death datasets were used to compute infant mortality rates per 100,000 live births by cause of death (COD), and per 1,000 live births for all other variables. Infant mortality rates and other measures of infant health were analyzed and compared. Leading and preterm-related CODs, and international comparisons of infant mortality rates were also examined.

RESULTS: Despite the rapid decline in infant mortality during the 20th century, the U.S. infant mortality rate did not decline from 2000 to 2005, and declined only marginally in 2006. Racial and ethnic disparities in infant mortality have persisted and increased, as have the percentages of preterm and low birthweight deliveries. After decades of improvement, the infant mortality rate for very low birthweight infants remained unchanged from 2000 to 2005. Infant mortality rates from congenital malformations and sudden infant death syndrome declined; however, rates for preterm-related CODs increased. The U.S. international ranking in infant mortality fell from 12th place in 1960 to 30th place in 2005.

CONCLUSIONS: Infant mortality is a complex and multifactorial problem that has proved resistant to intervention efforts. Continued increases in preterm and low birthweight delivery present major challenges to further improvement in the infant mortality rate.

ChiroACCESS Article: http://www.chiroaccess.com/Articles/The-Deplorable-US-Infant-Mortality-Rate.aspx?id=0000155

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The article was written by the combined efforts of the ChiroACCESS editorial staff and published on April 26, 2010