High-Tech Is Not Necessarily Safe

To have your baby in a high-tech environment does not mean that you and your baby are any safer. According to the National Center for Health Statistics, 99% of the 4,021,726 births in 2002 took place in a hospital35. In 2002 the United States spent $5,267 per person on healthcare, more money per person than any other nation22 and we are one of the most technologically advanced countries on the planet. However, in worldwide statistics of developed nations, the United States ranks:

The United States of America

 28th in infant mortality in 1998 (7.0/1000 live births)36
The infant mortality rate in 2002 was 6.8 per 1000 live births.23

 15th24 in maternal mortality in 2002 (12 per 100,000 women)25. According to a recent article by the CDC, “Each day in the United States, between 2 and 3 women die of pregnancy-related causes. A pregnancy-related death is one that occurs during pregnancy or within 1 year after pregnancy and is caused by pregnancy-related complications. The risk of pregnancy-related complications has not decreased since 1982.” 26

 According to the CDC, 7.8% (281,520) of the babies born in 2002 were low birth weight (5.5 pounds or less), the highest rate in three decades!35. In 2001 18% of the babies born very preterm (less than 32 weeks) did not survive the first year of liffe. 1% of the babies born moderatly preterm (32-36 weeks) died before their first birthday. The CDC reports a link between "Changes in the management of labor and delivery influenced at least in part by the increased use of medical technologies"(ultrasound, PROM, induction of labor and ceasarean surgery)27.

Approximatly 1 in 12 women who have vaginal delivery in a hospital without instrumentation experience perineal or cervical laceration or other obstetric trauma. Compared to 1 in 4 women who have a vaginal delivery that includes use of instruments, such as forceps or vacuum extraction32.

The most common diagnosis for hospitalization among all women is trauma to perineum due to childbirth32.
North Carolina

 in 2002 there were 117,307 babies born in North Carolina38

North Carolina’s infant mortality rate in 2002 was 8.6 of every 1000 live births (1,102 died before their first birthday) and 9.0% (1 in 11) of the babies were born low birth weight.37

 In North Carolina in 2002 13.3% of live births (1 in 8 babies) were born preterm. Between 1992 and 2002 the rate of infants born pretern has increased more than 6%28

 North Carolina’s maternal mortality in 1999 was 14 women.29

To contrast these statistics
In the Netherlands (Holland) 40% of the women give birth at home with a midwife. The hospital is reserved for women with risk of developing complications during birth.30 The infant mortality rate in 2002 in Holland was 4.3 per 1000 live births.31 That is 60% lower than our national average!

The Cost of Giving Birth in a U.S. Hospital 32

In 2002 the cost for a hospital birth in the U.S. varied depending on the type of delivery:

Vaginal Birth - $5,200
Primary Cesarean - $10,200
Repeat Cesarean - $8,300
VBAC - $5,800

The average length of stay and total charges are over 40% higher for repeat Cesareans than for a VBAC.

Women who have primary Cesareans incure the longest stay, 4.1 days and the highest total charges, $10,200

Women with private insurance have the highest Cesarean rate (24.4%). Women without insurance are less likely to have a Cesarean (18.6%)

For additional information - Effects of Hospital Economics on Maternity Care

NOTES
1 "Home Birth Versus Hospital Birth: Comparisons of Outcomes of Matched Populations." By Dr. Lewis Mehl, Presented on October 20, 1976 before the 104th annual meeting of the American Public Health Association. For further information contact the Institute for Childbirth and Family Research, 2522 Dana St., Suite 201, Berkeley, CA 94704]

2 "Outcomes of intended home births in nurse-midwifery practice: a prospective descriptive study." By Murphy PA, Fullerton J. Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. pam15@columbia.edu http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=9721790&dopt=Abstract

3 World Health Organization's Care in Normal Birth: GENERAL ASPECTS OF CARE IN LABOUR WHO/FRH/MSM/96.24
http://www.who.int/reproductive-health/publications/MSM_96_24/MSM_96_24_Chapter2Part1.en.html

4 American Public Health Association, "Increasing Access to Out-of-Hospital Maternity Care Services through State-Regulated and Nationally Certified Direct Entry Midwives (Policy Statement)." American Journal of Public Health, Vol. 92, No. 3, March 2002http://www.mana.org/APHAformatted.pdf

5 "Five Standards for Safe Childbearing." By David Stewart, PhD. http://www.napsac.org/

6 Ina May's Guide to Childbirth published by Bantam Books Copyright 2003 by Ina May Gaskin page 174

7 Ina May's Guide to Childbirth published by Bantam Books Copyright 2003 by Ina May Gaskin page170-171

8 "Simulated home delivery in hospital: a randomised controlled trial." By MacVicar J, Dobbie G, Owen-Johnstone L, Jagger C, Hopkins M, Kennedy J. Department of Obstetrics & Gynaecology, Leicester Royal Infirmary, UK. British Journal of Obstetrics Gynaecoyl. 1993 Apr;100(4):316-23.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=8494832&dopt=Abstract

9 "The Ideal Caesarean Birth" by Robert Oliver, M.D. http://www.eheart.com/cesarean/oliver.html (34)

10 "Cesarean Section – A Brief History." By The U.S. National Library of Medicine
http://www.nlm.nih.gov/exhibition/cesarean/cesarean_4.html (6)

11 North Carolina Center for Health Statistics "The Baby Book - Basic Automated Birth Yearbook North Carolina Residents, 2001" http://www.schs.state.nc.us/SCHS/births/babybook/2001/ (26)

12 A Good Birth, A Safe Birth by Diana Korte and Roberta M. Scaer Third Revised Edition Harvard Common Press Boston, Mass copyright 1992, Page 115 (35)

13 Center for Disease Control National Center for Health Statistics, North Carolina Health Facts
http://www.cdc.gov/nchs/fastats/ncarolin.htm (7)

14 "Indicators for Design, Monitoring and Evaluation of Maternal Mortality Programs." January 2001 By Deborah Maine and Patsy Bailey. Measure Project AMDD Programme, Colombia University Gamily Health International
http://cpmcnet.columbia.edu/dept/sphpopfam/amdd/docs/monitoring.pdf (43)

15 Mayo Clinic: Complete Book of Pregnancy & Baby's First Year By the Mayo Clinic. Published by William Morrow; 1st edition (December 1994) http://www.childbirth.org/section/risks.html (27)

16 "How to Avoid an Unnecessary C-Section." http://www.childbirth.org/section/avoid.html (36)

17 The Expectant Parents Guide to Preventing a Cesarean Section By Carl Jones. Published by Bergin & Garvey; (May 1991). Page 4.

18 "When is Surgery Unnecessary?" By Physicians Committee for Responsible Medicine http://www.pcrm.org/issues/Medicine_and_Society_Curriculum/med_soc_curr_3.html (11)

19 "Common Misconceptions About Birth." By Suzanne Arms on her website, Birthing the Future. http://www.birthingthefuture.com/birthtoday/misconceptions.html (1)

20 Investigation: Unhealthy Hospitals "Lax procedures put infants at high risk." By Michael J. Berens
Published July 22, 2002 in The Chicago Tribune
http://www.vaccinationnews.com/DailyNews/July2002/UnhealthyHospitals21.htm (41)

21 "Potentially fatal germs under fingernails of hospital personnel should be 'eradicated,' study says." Contributing writer Holly Firfer. September 7, 2000 CNN.com Health
http://www.cnn.com/2000/HEALTH/09/07/hospital.bacteria/ (40)

22 Organisation for Economic Cooperation and Development (OECD)
OECD Health Data 2004 : Health Spending in Most OECD Countries Rises, with the U.S. far Outstripping all Others http://www.oecd.org/document/12/0,2340,en_2649_34631_31938380_1_1_1_1,00.html(10)

23 Center for Disease Control and Prevention National Center for Health Statistics Table 22. Infant mortality rates, fetal mortality rates, and perinatal mortality rates, according to race: United States, selected years 1950-2001
http://www.cdc.gov/nchs/data/hus/tables/2003/03hus022.pdf (14)

24 Save the Children USA "The Complete Mother's Index 2002" http://www.savethechildren.org/publications/SOWMPDFfulldocument2.pdf (18)

25 Engender Health "Country by Country: United States"
http://www.engenderhealth.org/ia/cbc/united_states.html maternal mortality (20)

26 "Safe Motherhood: Promoting Health for Women Before, During, and After Pregnancy At a Glance 2003." By the Center for Disease Control and Prevention
http://www.cdc.gov/nccdphp/aag/aag_drh.htm

27 CDC "Supplemental Analysis of Recent Trends in Infant Mortality" by Kenneth D. Kochanek, M.A., and Joyce A. Martin, M.P.H.
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/infantmort/infantmort.htm

28 March of Dimes PeriStats. North Carolina, 2002
http://www.marchofdimes.com/peristats/tlanding.aspx?reg=37&top=1&lev=0&slev=4 (21)

29 "Enhanced Surveillance of Maternal Mortality in North Carolina." By Paul A. Buescher, Ph.D., Margaret Harper, M.D., and Robert E. Meyer, Ph.D. North Carolina Medical Journal March-April, 2002 Volume 63, Number 2
http://www.ncmedicaljournal.com/mar-apr-02/ar030203.pdf (22)

30 "Holland's Lesson." By Suzanne Arms, on her website Birthing the Future
http://www.birthingthefuture.com/birthtoday/hollandslesson.html (45)

31 The CIA World Factbook, 2002 "Netherlands." http://www.cia.gov/cia/publications/factbook/geos/nl.html (46)

32 Healthcare Cost and Utilization Project. Care of Women in U.S. Hospitals, 2002. HCUP Fact Book No. 3. By H. Joanna Jiang, Ph.D.; Anne Elixhauser, Ph.D.; Joyce Nicholas, M.P.H.; Claudia Steiner, M.D., M.P.H.; Carolina Reyes, M.D.; Arlene S. Bierman, M.D., M.S.
 http://www.ahrq.gov/data/hcup/factbk3/factbk3.htm#Stays

33 "Caesarean Depression." By Diana Korte
http://www.parentsplace.com/pregnancy/labor/articles/0,10335,166385_110522,00.html (28)

34 Heart & Hands: A Midwife's Guide to Pregnancy & Birth Third Edition. By Elizabeth Davis. Published by Celestial Arts Berkeley, California Copyright 1997. Page 133. http://www.birth-sex.com/

35 Center for Disease Control National Vital Statistics Report "Births: Final Data for 2002 Volume 51, Number 10." By Stephanie J. Ventura, M.A. ; Fay Menacker, Dr. P.H. ; and Martha L. Munson, M.S.; Division of Vital Statistics
http://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_10.pdf

36 CDC Office of Minority Health "Eliminate Disparities in Infant Mortality" http://www.cdc.gov/omh/AMH/factsheets/infant.htm

37 NC State Center for Health Statistics "NC 2002 Final Infant Death Rates" http://www.schs.state.nc.us/SCHS/deaths/ims/2002/2002rpt.html

38 NC State Center for Health Statistics "Selected Vital Statistics for 2002 and 1998-2002" http://www.schs.state.nc.us/SCHS/vitalstats/volume1/2002/nc.html