Posts Tagged ‘ childbirth ’

Maternal Deaths Rise in the U.S., Decline Globally

Wednesday, May 7th, 2014

American mothers are more likely to die during childbirth than they were twenty years ago, data released by the World Health Organization shows–but globally, maternal death rates have fallen by almost half in the same period of time.  Reuters has more:

The WHO tracks maternal mortality as one of the “Millennium Development Goals” that the United Nations set for 2015. Death rates have fallen by 45 percent globally since 1990, to an estimated 289,000 women in 2013.

Giving birth in the United States remains far safer than in most countries, with only 28 maternal deaths per 100,000 live births in 2013. But that is 136 percent higher than the 1990 mortality rate, when only 12 mothers died for every 100,000 births, the data showed.

No other country recorded such a large percentage increase, although a few other rich countries also failed to keep maternal mortality in check. In Canada, deaths rose from 6 to 11 per 100,000 births between 1990 and 2013. Many European countries and Japan have mortality rates in single figures.

China has cut its rate by two-thirds since 1990, with 32 women dying for every 100,000 live births in 2013.

WHO experts said the increase in the U.S. mortality rate may be a statistical blip. Or it might be due to increased risks from obesity, diabetes and older women giving birth.

Marleen Temmerman, the director of reproductive health and research at WHO, said more analysis was needed.

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Delayed Cord-Cutting Method May Be Easier

Monday, April 21st, 2014

Delaying the cutting of the umbilical cord is regarded in many medical circles as beneficial for babies at the moment of their birth, but the method generally advised for maximizing the benefit–holding the baby at the level of the mother’s vagina for more than a minute so gravity can help blood flow from the placenta into the baby’s system–awkward and unappealing.  But a new study has found that placing the baby on the mother’s stomach after birth may have the same benefits, as The New York Times reports:

Babies who were placed on their mothers’ stomachs before clamping fared just as well as those who were held lower, the researchers found.

“They found no difference whether the baby was at abdomen level or on the chest, or the baby was held at the vagina,” said Dr. Tonse Raju, the chief of the pregnancy and perinatology branch at the National Institute of Child Health and Human Development, who wrote a comment accompanying the study. “It made no difference in terms of extra blood the baby got.”

The authors hope their finding will convince doctors reluctant to delay cord clamping to start the practice.

“A mother would prefer to have the baby on top of her,” Dr. Néstor Vain, the lead author and a professor of pediatrics at the University of Buenos Aires in Argentina. “And that doesn’t change the amount of placental transfusion, and facilitates the procedure for the obstetrician.”

The study assigned 194 healthy full-term babies to be placed on their mother’s abdomen or chest for two minutes and 197 babies to be held at the level of the vagina for two minutes. All of the newborns were still attached to umbilical cords, and weighed before and after the allotted time.

The group placed on their mothers’ abdomens gained 53 grams of blood, while the babies held lower gained 56 grams.

Delayed clamping of the cord remains underused despite mounting evidence that it helps reduce iron deficiency in babies and poses no added risk of maternal blood loss.

Image: Clamped umbilical cord on newborn baby, via Shutterstock

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Cost of Childbirth Varies Widely, Without Apparent Explanation

Friday, January 17th, 2014

The cost of having a baby ranges from $3,000 to $37,000 in the state of California, a new study published in the journal BMJ Open has found, with no apparent logical explanation for the wild range or the high costs.  The study highlights some of the issues with soaring health care costs in the U.S.  More from NBC News:

“Even after adjusting for patient characteristics like their length of stay and their age and even adjusting for hospital characteristics and things like the cost of living, we found significant variations in price,” said Dr. Renee Hsia of the University of California, San Francisco, who led the study.

For a simple, uncomplicated vaginal delivery, prices ranged from $3,296 to $37,227, Hsia’s team found. For a C-section, women were billed between $8,312 and nearly $71,000.

“This is, unfortunately, the appalling state of affairs of health care in the United States,” Hsia said.

Even getting the prices wasn’t easy. Hsia’s team had to tease it out from state data on each patient admission. They figured out which ones were for childbirth, and then eliminated any complicated cases.

“Of course we would expect that if woman is in the hospital for six days as opposed to for two days, she would have larger charges,” Hsia said. “And if you deliver a baby in San Francisco, it will be more expensive than if you deliver in a cheaper suburban area.”

But the prices her team found — they are not naming individual hospitals — varied way more than these differences should account for.

The main problem is that patients do not know how much their insurers are paying on their behalf, and they certainly don’t know the price up front, Hsia says.

“This study shows that the market doesn’t take care of health care the way that we would like,” Hsia said in a telephone interview.

“If I go to buy a dozen eggs at the grocery store, I know if they are cage-free,” she added. “As a consumer, I know what I am buying and why there might be price differences. But as a patient, I don’t even know what things cost.”

Health experts say this is one of the main reason U.S. health care is so much more expensive than in other countries — $8,915 per person in 2012, for a total of $2.8 trillion. Of that, $882 billion is spent on hospitals services, like giving birth.

In May, the federal government said it would start publishing data on hospital charges. Their first numbers confirmed what health reform advocates complained about for years: The charges vary enormously, and for seemingly unclear reasons.

The Obama administration hopes that publishing prices will help force health care providers to be more consistent in their billing.

Image: Woman giving birth, via Shutterstock

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Most Twin Births Don’t Require C-Sections

Friday, October 4th, 2013

A large new study of twin births in the U.S. has concluded that most are safe without requiring mothers to have Cesarean sections.  More on the study from NBC News:

Studies increasingly are challenging long-held beliefs about Caesareans, such as that women who had one need to deliver future babies the same way.

Now doctors are looking hard at C-sections for twin births, which are on the rise because of infertility treatments. Twins have more risk for birth complications and some studies suggest C-sections lower that risk, but this had not been put to a rigorous test.

Dr. Jon Barrett of Sunnybrook Health Sciences Center in Toronto, led a study in 25 countries of 2,800 women pregnant with twins. All of the first of the twins to be delivered were in good position for birth (most doctors still recommend a C-section if the first twin is in feet-first or breech position).

Half of the moms were scheduled to have C-sections and the rest, vaginal births. About 40 percent of the latter group wound up having C-sections, and 10 percent of those scheduled to have Caesareans ended up giving birth vaginally.

About 2 percent of newborns died or had a serious problem, but the manner of birth made no difference. Nor did it affect the rate of complications in moms.

The Canadian Institutes of Health Research paid for the study. Results are in Thursday’s New England Journal of Medicine.

Image: Twin babies, via Shutterstock

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Vaginal Birth Found to Trigger Baby’s Brain-Boosting Proteins

Friday, August 10th, 2012

Babies who are born vaginally have been found in a new Yale University study to have higher levels of important proteins that help their brains begin to grow and develop.  The Huffington Post reports on how vaginal (also called “normal”) birth may be important to brain development, at least according to this preliminary study:

“We were looking at the protein, and we realized that if you take a ‘normal birth’ mouse and compare it to a ‘c-section mouse,’ there are very different levels in the hippocampus,” Tamas Horvath, a professor of biomedical research and chair at the department of comparative medicine at the Yale School of Medicine, told The Huffington Post. The findings were published in the online research journal PLoS One, Wednesday.

The “uncoupling 2 protein,” or UCP2, is important to the development of the circuitry in the hippocampus, which helps with the formation and storage of memory. Development, he said, was “very important for behavior in the long run.”

But because the research was done in mice, it is highly preliminary. The research also looked at vaginal birth broadly, not at whether anesthesia use could influence protein production.

Researchers do not yet know why different delivery modes influence the protein, although Horvath guessed that the pressure and stress of traveling the birth canal may trigger it.

Image: Mother in labor at hospital, via Shutterstock

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