Pregnancy, Parenthood & Playtime

Today The March of Dimes released its annual report card which looks at The United States, and at individual states across our country to see how we are doing in terms of premature birth rates, health conditions and behaviors that may increase premature birth, and medical procedures that are electively delivering babies prematurely.

The article published in HealthDay, pinpoints several different factors for our babies being born prematurely.

Each year, the March of Dimes ranks each state according to its rate of premature births — babies born before 37 weeks of gestation. Preterm births contribute to infant mortality and can put children at risk for lifelong problems, including cerebral palsy and developmental disabilities. The U.S. premature birth rate was 12.7 percent in 2007 (the year the birth data was collected), nearly twice the goal of 7.6 percent set by the federal government’s Healthy People 2010 campaign.

Connecticut, among the states with a premature delivery rate of over 10%. Many will go on to say it is because in Connecticut we have two major fertility labs, one affiliated with the UCONN medical center, and the other at Yale, and the increased amount of multiples is a risk factor in these numbers, but not according to this report. While further looking into Connecticut’s”report card” from this study, I noticed that while we may not score a D on the overall report card, a C is not much better.

A couple of the risk factors that were looked at in Connecticut were the number of uninsured women, women who smoke during pregnancy, and late pre term birth which is described as

“The rise in late preterm births (34-36 weeks) has been linked to rising rates of early induction of labor and c-sections. We call on hospitals and health car professionals to voluntarily assess c-sections and inductions that occur prior to 39 weeks gestation to ensure consistency with professional guidelines.”

Not too long ago, I wrote about hospitals starting to crack down on elective inductions before 39 which was contributing to these numbers, as well as elective cesarean sections which could be non medically necessary primary cesarean sections or repeat elective cesarean sections with no medical reason.”
When the study looked at the number of uninsured women, Connecticut is moving in the right direction. The previous uninsured rate for pregnant women in Connecticut was 13.5% which dropped to 12.2%. While it is a small jump, it is still a step into the right direction. Any improvement is improvement that will impact our children and that is a good thing.

Unfortunately the study see’s a negative in the other numbers. The amount of women who continue to smoke cigarettes while pregnant went from 16.7% to 18.7% and while it does not seem like a big increase, when over 40,000 babies were born in Connecticut in 2007, that is over 7000 babies.  As well as a small but significant increase in the late pre term babies, from 7.1% to 7.2%. I fully believe more guidelines being put into place regarding elective inductions and cesarean sections will help to curb this number in the future.

While there were some improvements on a national level in other states such as Arizona, the March of Dimes is concerned that the small amount of progress we made from 2007-2008 will drop from the economic climate which started to take a dive in 2008 and continued to impact families in 2009.

“Howse said she was concerned that the recession, including job losses and loss of medical benefits, could reverse the trend when the birth statistics from 2008 and 2009 are analyzed. “I think we’re moving in the right direction, but I am worried we are going to see slippage,” Howse said.”

I personally do not see the loss of insurance as a reason to not receive pre natal care because of all the programs put in place to aid people in these situations. Our babies should be more important to us than bills, especially when the economy is slowly increasing. I am not being pushy or putting others down, as someone who has been there, I simply find no excuse to gamble with my child’s health. No one should!

Another thing that we do see here in Connecticut that may or may not contribute to our late pre term baby numbers are elective cesarean sections before 39 weeks gestation. Earlier this year there were several reports not only from ACOG but also from the March of Dimes encouraging providers to wait until their patients are atleast 39 weeks gestation before an elective cesarean section. Yet we continue to see elective cesarean sections taking place at 37, and 38 weeks still. The same goes for labor inductions.

“The March of Dimes recommends babies not be delivered by elective C-section or induction before 39 weeks.”

As I spoke of above, the number of twin and triplet pregnancies increasing is also adding to these risks. Maybe not as much in Connecticut, but as a whole in the United States it is starting to have an impact.

“In New Jersey, a key reason for premature births is the number of twins, triplets and higher-order multiples being born as a result of invitro

procedures, Perl said. Twins are delivered on average, at about 35 weeks, triplets at 33 weeks, and quadruplets at 29 weeks, according to the American College of Obstetricians and Gynocologists”

I think that the number of multiples also calls for a national standard in IVF and other types of fertility treatments, like the calls we saw earlier in the year after the famous Octomom case. While there may not be extreme cases like that woman, there are still some Doctors who may not be practicing as ethically as they should be.

“Perl recommends fertility doctors follow American Society for Reproductive Medicine guidelines that call for implanting no more than two embryos at a time for women under 35, and no more than three for women with poorer chances of becoming pregnant. About 540,000 babies are born prematurely in the United States each year, costing more than $26 billion in additional health care costs. “

As pointed out in this same article, it is no wonder the United States is ranked 30th in infant mortality behind many other developed or developing countries. This number has risen over 30% since 1986. We are not taking steps forward with all of the medical advances that we have had in the past 2 decades in many cases and our statistics continue to show this.