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| No. 10 | 
Nov 05, 2009, 10:38 PM
Updated
Nov 05, 2009 at 10:48 PM by Elvish
 Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
I think this is a state-by-state thing, but in my state, regardless of gestation, if the baby shows signs of life, it is counted as a live birth. Medically for the mother it is counted as a miscarriage but for statistical purposes if there is any movement at all, or a definite pulse, it is counted as a live birth and must have a birth and death certificate. So technically, I guess we have some 15 and 16 weekers figuring into our mortality stats as well. At least in my state.
But without knowing exactly how other countries define this same thing, it's hard to tell whether it actually confounds our statistics or not. I've heard some of the same things already posted in this thread but it would be interesting to find out at what gestation countries like the UK, the Netherlands, Sweden, or heck, even Argentina (just to name a few) resuscitate aggresively or count as a 'live birth.' Interesting topic.
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Nov 06, 2009, 08:51 AM
Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
We need to know where these statistics are coming from: the WHO? If so, wouldn't they have standardized the definition of "stillbirth" vs "live birth"? Worth checking into. However, the U.S. mortality rate is still increased by unnecessary intervention: c-sections, vacuum, induction. Even putting in an IV has serious consequences at the cellular level, which is evidenced in studies & outcomes as well. IVs should not be routine in a normal birth. Hep lock/saline lock at most. Moms need to eat and drink to keep up their blood sugar levels in labor.
Poor nutrition, smoking, and & multiple births also contribute to our higher mortality rate. I would have to say that those having multiple births are probably not cross-tabulated with the poor, as they don't have the finances/insurance to cover infertility treatments. Overall, I hope that we, as nurses (me still a student but am currently a certified childbirth educator, labor assistant, & doula) can affect change for the better! We have come a long way: dads in the delivery room (introduced by Dr. Robert Bradley), mom being awake during the birth, and dramatic decrease in the number of episiotomies & forceps deliveries. Yay!!
| | No. 12 |
Nov 06, 2009, 10:55 AM
Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
Oh, I agree with you, BabyCatchr. I am no proponent of the US system of giving birth. I'm just saying, I wonder how each country reports their own stats, because I think that is what the WHO goes by.
I did some research last night and found some interesting things about how Scandinavia reports their birth stats.
Here: http://www.stakes.fi/EN/tilastot/sta...ionsummary.htm | | No. 13 |
Nov 06, 2009, 11:16 AM
Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say Originally Posted by Elvish  Stillbirth: Birth of a foetus or a child that shows no evidence of life typical of a live birth, but complying with the definition of a birth. The registration criterion is 12 gestational weeks in Norway, 22 weeks in Denmark, Finland and Iceland, and 28 weeks in Sweden. Finland uses the birth weight limit of 500 g as a parallel registration criterion.
This is exactly what I am looking for! 28 weeks?! 28 weekers have a 90% (guesstimation)survival rate on my unit. Even with a one minute apgar of 0.
| | No. 14 |
Nov 06, 2009, 11:31 AM
Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say
I still find it interesting that they use other criteria in other countries and beat us all hollow - 22 weeks in Finland/Denmark/Iceland and 12 weeks in Norway. 28 weeks in Sweden seems to be an outlier.
| | No. 15 |
Nov 06, 2009, 02:50 PM
Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say Originally Posted by dawngloves This is exactly what I am looking for! 28 weeks?! 28 weekers have a 90% (guesstimation)survival rate on my unit. Even with a one minute apgar of 0.
No wonder Sweden has such good numbers. Their cost savings is also remarkable I bet, a very sick less than 28 weeker can be very expensive all their life.
| | No. 18 |
Nov 06, 2009, 08:59 PM
Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say Originally Posted by dancingdoula "So we could be one-third lower, but we'd still be almost twice as high as Sweden... How does that work?"
Sweden also uses far fewer interventions (c-sections, vacuum extractions, etc...) which snowball into complications and most births are attended by Midwives. Docs in this country have a tendency to use techniques that aren't really necessary just to cover their butts. 
Thank you, dancing doula for using your math well, to show that the USA is still having far more infant mortality than occurs elsewhere. We can't pin it all on the increase in c/s rate. H1N1 will show a greater increase in premature c/s. I sure hope we'll focus on assisting the greater number of motherless children as a result of the tragic It's especially interesting to see that money spent on doctors, hospitals, etc. isn't a deciding factor.
Intervention by doing C/S upon request, and justifying it incorrectly is increasing. It would be very interesting (you know where I'm coming from) to keep stats on the number of premies, early and later, that occur among class prepared expectant mothers, and the amount of fluids they drink daily.
We need to study what other countries do that keeps their prematurity and infant mortality rates lower than ours. Diets need to be analyzed, water contents, medication/street drug use in pregnancy, exercise, family histories, and health attitudes, etc. I somehow doubt that resistance to physician, nurse and informed family recommendations, aka noncompliance occurs as much as it does here, elsewhere.  | | No. 19 |
Nov 07, 2009, 09:02 AM
Re: Premature Births Are Fueling Higher Rates of Infant Mortality in U.S., Report Say Originally Posted by dancingdoula "So we could be one-third lower, but we'd still be almost twice as high as Sweden... How does that work?"
Sweden also uses far fewer interventions (c-sections, vacuum extractions, etc...) which snowball into complications and most births are attended by Midwives. Docs in this country have a tendency to use techniques that aren't really necessary just to cover their butts.
I know, it drives me crazy and that's the reason I want to become a midwife. I believe that the reason I ended up with a C-section, due to my daughter being in fetal distress, was because of the medical interventions like breaking my water and use of pitocin. I'll obviously never know for sure, but it is something that's always bothered me. I'm thinking of getting pregnant again but the statistics of our country worries me!  |
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