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Infant Mortality: U.S. Ranks 29th

U.S. Ties Slovakia, Poland for 29th Place in Infant Deaths
By Daniel J. DeNoon
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 15, 2008 — The U.S. ranks 29th worldwide in infant mortality, tying Slovakia and Poland but lagging behind Cuba, the CDC reports.

The CDC’s latest estimates for international rankings are based on 2004 data. But as of 2005, the numbers haven’t changed much since 2000.

Nearly seven U.S. babies die out of every 1,000 live births. More than 28,000 American babies die before their first birthday.

In Japan, ranked in third place behind Singapore and Hong Kong, the infant mortality rate is 2.8 per thousand live births — less than half the U.S. rate.

In one way, the U.S. has improved since 1960. Back then, 26 in 1,000 infants died. That was good enough to land the U.S. in 12th place.

We’ve advanced since then, but not as fast as many other nations. By 1990, the U.S. had fallen to 23rd place.

“The U.S. infant mortality rate is higher than rates in most other developed countries,” note CDC researchers Marian F. MacDorman, PhD, and T.J. Mathews. “The relative position of the United States in comparison to countries with the lowest infant mortality rates appears to be worsening.”

What’s going on? Racial and ethnic disparities clearly play a role. In 2005, for every 1,000 live births, the infant mortality rate was:

  • 13.63 among non-Hispanic black Americans
  • 5.76 among non-Hispanic white Americans

Premature birth is a factor in more than two-thirds of infant deaths. From 2000 to 2005, the U.S. preterm birth rate went up from 11.6% to 12.7%.

MacDorman and Mathews report the data in the CDC’s October 2008 National Center for Health Statistics data brief, “Recent Trends in Infant Mortality in the United States.”

Infant Mortality Rates by Country

Here is the complete list of infant mortality rates per 1,000 live births for 2004:

1. Singapore 2.0

2. Hong Kong 2.5

3. Japan 2.8

4. Sweden 3.1

5. Norway 3.2

6. Finland 3.3

7. Spain 3.5

8. Czech Republic 3.7

9. France 3.9

10. Portugal 4.0

11. Germany 4.1

11. Greece 4.1

11. Italy 4.1

11. Netherlands 4.1

15. Switzerland 4.2

16. Belgium 4.3

17. Denmark 4.4

18. Austria 4.5

18. Israel 4.5

20. Australia 4.7

21. Ireland 4.9

21. Scotland 4.9

23. England and Wales 5.0

24. Canada 5.3

25. Northern Ireland 5.5

26. New Zealand 5.7

27. Cuba 5.8

28. Hungary 6.6

29. Poland 6.9

29. Slovakia 6.9

29. United States 6.9

32. Puerto Rico 8.1

33. Chile 8.4

34. Costa Rica 9.0

35. Russian Federation 11.5

36. Bulgaria 11.7

37. Romania 16.8

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I finally finished compiling my list of parenting, pregnancy, etc. related books. So, I thought I would share the list with whomever reads my blog. Feel free to recommend additional books…I do love books

Those related to Natural Child Birth and Pregnancy (in no particular order):

  1. Aromatherapy During Your Pregnancy, Fances R. Cliffford
  2. Unassisted Homebirth, An Act of Love, Lynn M. Griesemer
  3. The Thinking Woman’s Guide to a Better Birth, Henci Goer
  4. Birth Over Thirty-Five, Sheila Kitzinger
  5. The Natural Childbirth Book, Joyce Milburn & Lynnette Smith
  6. A Good Birth, A Safe Birth, Diane Korte & Roberta Scaer
  7. The Birth Partner, Penny Simkin
  8. Unassisted Childbirth, Laura Kaplan Shanley
  9. Water Birth Unplugged,Proceedings of the First International Water Birth Conference, Edited by Beverley A. Lawrence Beech
  10. Pushed,, Jennifer Block
  11. Taking Charge of Your Fertility, Toni Weschler
  12. Birthing From Within, Pam England & Rob Horowitz
  13. Hypnobirthing: A Celebration of Life, Marie F. Mongan (2 copies)
  14. Hypnobirthing, Marie Mongan
  15. Heart & Hands, A Midwife’s Guide to Pregnancy & Birth, Elizabeth Davis
  16. Ina May’s Guide to Childbirrth, Ina May Gaskin
  17. Emergency Childbirth, A Manual, Gregory J. White
  18. Birthing From Within, Pam England & Rob Horowitz

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http://www.medicaln ewstoday. com/articles/ 98156.php

Avoiding Induced Labor Is More Beneficial To Moms And Babies

Throughout pregnancy, many women eagerly anticipate the day they finally
will meet their new baby. This is especially true in the last few weeks of
pregnancy when, as a baby grows larger, an expectant mother becomes
increasingly uncomfortable and impatient to finish out her pregnancy.
Despite the anticipation, research shows that allowing labor to start
naturally, rather than induce, is more beneficial to both mom and baby.

Labor induction, or artificially initiating labor through the use of
medicine, is performed for a variety of reasons. Today, one of the more
common reasons for induction is “convenience. ” Hospitals can staff extra
nurses, physicians can schedule births for times that are most convenient
for them, and expectant parents can make work and family arrangements in
advance according to their scheduled induction date.

At first glance, labor induction may seem more convenient; however, it’s
important to recognize that induction may lead to a longer labor and overall
hospital stay, more medical interventions, higher costs, risk of potential
for litigation, and adverse outcome for a mother or baby.

In the last weeks of pregnancy, a woman’s body and her baby perform crucial
functions to prepare for birth. The baby’s lungs mature and he or she
develops a protective layer of fat. In addition, the baby drops down into
the pelvis, the cervix tilts forward and softens, and irregular contractions
help the cervix thin and begin to dilate. In most cases, a woman’s body goes
into labor only when her body and her baby are ready.

“Research at The University of Texas Southwestern Medical School suggests
that it is a signal from the baby that starts the process of labor,” says
Debby Amis, RN, BSN, CD(DONA), LCCE, FACCE. “The best way for a mother to
know that her baby is fully mature and ready to be born is to allow labor to
begin on its own.”

Lamaze International recommends
<http://www.lamaze. org/ChildbirthEd ucators/Resource sforEducators/ CarePracticePape rs/LaborBeginsOn ItsOwn/tabid/ 487/Default. aspx>that
a woman allows her body to go into labor on its own, unless there is a true
medical reason to induce. Allowing labor to start on its own reduces the
possibility of complications, including a vacuum or forceps-assisted birth,
fetal heart rate changes, babies with low birth weight or jaundice, and
cesarean surgery. Studies consistently show that inducing labor almost
doubles a woman’s chance of having cesarean surgery.

“By avoiding induction, women are less likely to encounter other medical
interventions, ” says Lamaze International President Allison J. Walsh, IBCLC,
LCCE, FACCE. “Experiencing natural contractions and laboring without
unnecessary medical interventions increases a woman’s freedom to respond to
contractions by moving and changing positions, both of which facilitate the
process of labor and birth.”

Avoiding induction also decreases the likelihood of a premature birth.
Because neither doctors nor mothers can determine a baby’s due date with 100
percent accuracy, babies may be induced accidentally before they reach full
term (at least 37 completed weeks). A scheduled induction at 39 weeks could
result in giving birth to a preterm baby who is only 36 weeks gestation.
Preterm babies miss critical stages of development that take place during
the last weeks of pregnancy and are at risk are for several postnatal
complications. A study published in *The Journal of the American Medical
Association* examined 4.5 million births in the United States and Canada and
concluded that babies born only a few weeks early-at 34 weeks through 36
weeks-were nearly 3 times more likely to die in their first year of life
than full-term infants.

When medically necessary, inducing labor can be a life saving procedure. The
American College of Obstetricians and Gynecologists
<http://www.acog. org/>states
that labor may be induced if it is more risky for a woman’s baby to remain
inside her body than to be born.

Medical reasons for induction include, a woman’s water has broken and labor
has not begun for several hours; her pregnancy is post term (more than 42
weeks); she has pregnancy-induced high blood pressure; she has health
problems that could affect her baby, like diabetes; there is an infection in
her uterus; or her baby is growing too slowly.

First-time mothers are most vulnerable to the risks of inductions. Contrary
to what many believe, suspecting a large baby is not a medical reason for
induction. It is very difficult for a doctor or midwife to determine the
size of a woman’s baby before birth with accuracy, even with the use of
ultrasound. Studies consistently show that inducing for a suspected large
baby increases, rather than decreases, the incidence of cesarean birth.

Lamaze International has developed a care practice paper entitled “Labor
Begins on its Own,”
<http://www.lamaze. org/ChildbirthEd ucators/Resource sforEducators/ CarePracticePape rs/LaborBeginsOn ItsOwn/tabid/ 487/Default. aspx>which
presents the research surrounding labor induction and tips for avoiding
induced labor
<http://www.lamaze. org/ExpectantPar ents/Pregnancyan dBirthResources/ MoreTipsandTools /InductionTips/ tabid/255/ Default.aspx>.

Childbirth education classes, such as Lamaze, provide women with the tools
and information they need to make educated choices during labor and birth.
To find a Lamaze class in your area, visit http://www.lamaze. org.

*About Lamaze International *

Since its founding in 1960, Lamaze International has worked to promote,
support and protect normal birth through education and advocacy through the
dedicated efforts of professional childbirth educators, providers and
parents. An international organization with regional, state and area
affiliates, its members and volunteer leaders include childbirth educators,
nurses, midwives, doulas, lactation consultants, physicians, students and
consumers.

Lamaze International <http://www.lamaze. org/

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I have alot more to say about the new movie The Business of Being Born, but this youtube video says alot:

http://www.youtube.com/swf/l.swf?video_id=bm77ZujkTbw&rel=1&eurl=http%3A//us.mg1.mail.yahoo.com/dc/blank.html%3Fbn%3D818.31&iurl=http%3A//i.ytimg.com/vi/bm77ZujkTbw/default.jpg&t=OEgsToPDskKnfEJiOIf9dcZ6AwiOyYwG&#038;

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http://www.greenjournal.org/cgi/content/full/108/1/12

of which there were some surprising results, this especially:

” In all adjusted models, multiple prior cesarean delivery was not associated with an increased risk for uterine rupture.  “

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As part of my plan to be as healthy as I can be during this pregnancy and birth, I have decided to commit to the Dr. Brewer’s Diet.  You can learn more here: http://www.blueribbonbaby.org/

Basically, this Dr. is convinced that diet has more to do with maternal and infant health than we are being led to believe.

here is an exerpt:

Toxemia. Pre-Eclampsia. HELLP Syndrome. Premature birth.
Low birth weight. Intrauterine growth retardation.

It’s not genetics. It’s not random. The cause is NOT unknown. Toxemia CAN be stopped. PreeclampsiaA-toxic-condition-developing-in-late-pre... CAN be stopped. Best of all, YOU can stop it!

HOW? All the scientific research being done on toxemia and preeclampsia these days is focusing on treatment, and none of it is promising. But the research has already been done, many times and many ways in the past 50+ years, and we know that you can PREVENT this from happening to you in the first place, no matter what your personal history may be. The simple answer? GOOD NUTRITION.

Common sense tells you to eat right when you’re pregnant, and traditional wisdom says you’re “eating for two“. So why are doctors telling you to cut out salt, avoid gaining too much weight, and giving you little or no information about what IS a good diet for pregnancy? Why is the medical community so disinterested in this information? As one doctor put it, “No one is going to make any money off good nutrition.”

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J Epidemiol Community Health. 1998 May;52(5):310- 7. Midwifery care, social
and medical risk factors, and birth outcomes in the USA.

MacDorman MF, Singh GK. Centers for Disease Control and Prevention,
National Center for Health Statistics, Hyattsville, MD 20782, USA.

STUDY OBJECTIVE: To determine if there are significant differences in birth
outcomes and survival for infants delivered by certified nurse midwives
compared with those delivered by physicians, and whether these differences,
if they exist, remain after controlling for sociodemographic and medical
risk factors.

DESIGN: Logistic regression models were used to examine differences between
certified nurse midwife and physician delivered births in infant, neonatal,
and postneonatal mortality, and risk of low birthweight after controlling
for a variety of social and medical risk factors. Ordinary least squares
regression models were used to examine differences in mean birthweight after
controlling for the same risk factors.

STUDY SETTING: United States.

PATIENTS: The study included all singleton, vaginal births at 35-43 weeks
gestation delivered either by physicians or certified nurse midwives in the
United States in 1991.

MAIN RESULTS: After controlling for social and medical risk factors, the
risk of experiencing an infant death was 19% lower for certified nurse
midwife attended than for physician attended births, the risk of neonatal
mortality was 33% lower, and the risk of delivering a low birthweight infant
31% lower. Mean birthweight was 37 grams heavier for the certified nurse
midwife attended than for physician attended births.

CONCLUSIONS: National data support the findings of previous local studies
that certified nurse midwives have excellent birth outcomes. These findings
are discussed in light of differences between certified nurse midwives and
physicians in prenatal care and labour and delivery care practices.
Certified nurse midwives provide a safe and viable alternative to maternity
care in the United States, particularly for low to moderate risk women.

PMID: 9764282 [PubMed – indexed for MEDLINE]

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