A few 2007 birth statistics

I’m not bored, but I did wake up at 4am which led me to the CDC.  Under “What’s New” at the NCHS page I read, “Twin Births Remain Stable, New Report Shows”.  Ok, so I was a bit disappointed that it wasn’t an entire report about multiple birth, but since I still hadn’t actually read the 2007 birth report, I suppose it was good that I took a peak.  If you’re interested to see what I posted about multiple gestation and birth as well as a collection of other data points that I found interesting, have a look here.

I browsed the site further and found some interesting statistics.  I was particularly looking for information on multiple gestation, of course, and was disappointed not to find method of delivery stats readily available for multiple gestation sets.  I did create a little spreadsheet though for 2007 births by gestational age and method of delivery.

I only looked at 34+ weeks gestation.  Information from 20-33 weeks gestation is available, but since I know less about those groups, I didn’t include it.  It is possible that premature babies are more at risk of dying during vaginal delivery than cesarean, I don’t know for certain, and I’m sure that parents need to consider their options carefully, if options are given.

ATTENTION!  Notice that the nation 2007 cesarean rate was 31.8% in 2007, another all-time high.  The World Health Organization suggests that a cesarean rate of 10-15% is indicative of a birth reality that is consistent with science and good practice as measured by healthy birth outcomes for mom and child(ren).  Get above that 15% range, and THE RISKS BEGIN TO OUTWEIGH THE BENEFITS.  I repeat . . the risks outweigh the benefits outside of the cesarean rate range of 10-15%.

So let’s extrapolate a bit . . .
You’re the MOST likely to birth vaginally if you make it to 40 weeks.  Problem is that most OBs do not encourage women to gestate to 40 weeks and a high number of elective cesareans take place in the 39th week.  If your baby comes before 37 weeks, look out . . . 41% of all live US births between 34 and 36 weeks gestation happened via cesarean surgery.  We need to be asking . . . WHY.  And why are nearly 1/3 of all babies being born via major surgery.  Why are so many women having their babies surgically extracted from their bodies, especially when subsequent pregnancies will even more likely end with a repeat cesarean?  WHY WHY WHY!!!!!

ASK SOMEONE WHY!

WHY 32% . . .

Underreporting in 2007

Happy New Year!  I am hoping and praying that 2008 will be better for me.  I hope that 2008 is your best year ever!

Yesterday, I was notified about a really great post on NoWombPods - “Top 5 Most Underreported Birth Stories of 2007” – and when it appeared in my google alerts this morning, I remembered that I wanted to link to it here.

I wouldn’t myself call them underreported simply because they found their way into the mainstream press.  I am sure there are other iatrogenic catastrophes that were NOT reported at all.

What really annoys me about the CDC preliminary data release notice is that it embeds the 31.1% cesarean rate in a press release about teen pregnancy!  So while these stories may not totally qualify – in my definition – as underreported, per se, these stories and the ones that didn’t even receive media attention did not make the impact on the general population that they should have.

Then there’s this morsel (link goes to abstract) that appeared in my google alert this morning.  Postmortem cesarean?  Mother killed herself in labor??  Thank God the child is physically sound at age 4.  I wonder how he is doing emotionally?  Maybe he doesn’t know his birth story yet. 

Montana birth stats revisited

In September I posted twice about local birth statistics.  You can read them here and here.  Since the CDC released a preliminary report for 2006, I thought I should review some interesting data from 2004 and 2005 (source).

Montana (state-wide) cesarean rates:
2004 – 25.3%
2005 – 25.7%
2006 – 28% (preliminary estimate)
I find it interesting that 85% of Montana cesareans in 2004 and 86% of cesareans in 2005 took place in counties with 100,000 or more residents.  Granted, high-risk pregnancies would transfer to larger hospitals and might be more susceptible to cesarean delivery.

Montana (state-wide) VBAC rates:
2004 – 1.4%
2005 – n/a
2006 – n/a (yet?)
I’m not sure why the CDC didn’t provide the 2005 VBAC figures.  Could it be that VBAC is so rare that it was statistically insignificant to report?

Only 16 VBACs took place at Missoula’s Community Hospital in 2006.  That was about 1% of their live birth population.  Yikes!  Double yikes when you consider that Community is one of a small handful of hospitals across the state that still allow VBACs.

Place of delivery (2005):*
57 of 1850 births in Missoula County took place outside of a hospital.  And I’m not sure that the Birth Center was even up and running at that time.  This accounts for 3.1% of the live birth population.  This slim percentage is at least twice the national average, from what I’ve heard.
44 of 240 births (18.3%) in nearby Ravalli County took place outside of a hospital.  Now I call that statistically significant!
The state out of hospital rate was 2.5%.

Although Montana’s cesarean rate is a few percentage points below the national average (estimated at 31.1% in 2006), it still greatly exceeds the recommended level of 10-15% established by the World Health Organization.  Cesarean rates above 15% reflect an abuse of the life-saving medical procedure.  Cesarean surgery is a major abdominal surgery with its own tangible list of risks.

* Data obtained from Montana’s Department of Health and Human Services

2006 Cesarean Statistics Released – it ain’t good

Today I was informed that the CDC released preliminary vital statistics for 2006 which includes state-by-state cesarean birth information.  Here in Montana the 2006 cesarean rate was 28%, earning us a rank of number 37 (of 51).  The national cesarean rate was 31.1%, an all-time high.  Although Montana was 3 percentage points below the national average, the rate still exceeded World Health Organization (WHO) recommendations by 13-18%!  The WHO determined that when cesarean rates exceed 10-15%, the risks of the surgery outweigh the benefits.  It is my understanding from a recent discussion with a hospital administrator that Community Hospital’s (Missoula) cesarean rate exceeded 30% in 2006.  Missoula’s cesarean rate is headed in the wrong direction. 

As a woman with one cesarean scar, these statistics are frightening.  Is cesarean birth becoming “normal” birth?  If one out of three babies is born through major abdominal surgery, then yes, I’d say the norm is swinging that direction.  You need to know that the percentage of birth by cesarean has risen 50% in the past decade.  This is straight from the horse’s mouth!  You also need to know that Montana’s VBAC (vaginal birth after cesarean) rate in 2005 was only 1%. 

For the second year in a row, ICAN has compiled a list of research from the past year that shows cesarean surgery should be used more judiciously and that VBACs should be routine/normal.  Currently, more than 300 hospitals across the U.S. ban women from having a VBAC, essentially coercing them into unnecessary surgery and feeding the growing rate of cesarean.  Very few Montana women have access to vaginal births after cesarean sections.  Only a handful of hospitals across the state allow VBACs – one of those hospitals is Community Hospital in Missoula

In August, the Centers for Disease Control released a report showing that, for the first time in decades, the number of women dying in childbirth has increased.  Experts note that the increase may be due to better reporting of deaths but that it coincides with dramatically increased use of cesarean.  The latest national data on infant mortality rates in the United States also show an increase in 2005 and no improvement since 2000.  “At a time when maternal and infant mortality rates are decreasing throughout the industrialized world, the United States is in the unique position of having both a rapidly increasing cesarean rate and no improvement in these basic measures of maternal and infant health.” says Eugene Declercq, Ph.D., Professor of Maternal and Child Health at Boston University School of Public Health.

Another report released in October by the World Health Organization, the United Nations Population Fund, the U.N. Children’s Fund, the U.N. Population Division and The World Bank, and published in the Lancet shows that the U.S. has a higher maternal death rate than 40 other countries.  “Women in the U.S. think they’re getting top notch care, but our death rate for mothers shows otherwise,” says ICAN’s President, Pamela Udy.  The U.S.’s maternal death rate tied with that of Belarus, and narrowly beat out Bosnia and Herzogovena.

Research from 2007 also shows that VBAC continues to be a reasonably safe birthing choice for mothers. “The research continues to reinforce that cesareans should only be used when there is a true threat to the mother or baby,” said Udy. “Casual use of surgery on otherwise healthy women and babies can mean short-term and long-term problems.” For women who encounter VBAC bans, ICAN has developed a guide to help them understand their rights as patients. The resource discusses the principles of informed consent and the right of every patient to refuse an unwanted medical procedure. Click here for a pdf copy of this important resource.

Women who are seeking information about how to avoid a cesarean, have a VBAC, or are recovering from a cesarean can visit www.ican-online.org for more information, to find a local chapter, and to receive support.

About Cesareans: ICAN recognizes that when a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death. http://www.ican-online.org/resources/white_papers/index.html Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. There are 94 ICAN Chapters across North America, which hold educational and support meetings for people interested in cesarean prevention and recovery.