Interesting Article on Infant Mortality in US

[KatieMac]

From <a href="http://www.time.com/time/health/article/0,8599,1736042,00.html" target="_blank" class="SmlLinks">Time Magazine.</a>


This jumped out at me:

"Basically the longer that baby can stay in utero, the better it's going to do."

I believe this to be true, based on my own experience. All of my children were late, one of them was overdue by 16 days! Neither I nor my children suffered any ill effects. Why do we treat all overdue pregnancies as an emergency, when more often than not the opposite is true? Are these interventions such as inducement and c-section, sometimes pre-term, causing stress to the infants and possibly leading to death?

I have a friend who I hadn't seen in a while and she told me they had a scare when their third baby was born. I listened with interest, and as I listened to her story I couldn't believe my ears. Her doctor opted to induce her SIX WEEKS EARLY. Why? The baby was not in distress. Fluid was not low. She didn't have any health complications whatsoever. The reason he opted to induce her was because she was already 5 cm dilated. Now, this is not uncommon. Women, especially women who have had several children, frequently dilate prior to their due dates. Sometimes weeks before. It serves to make the "true" labor shorter. It's a positive function.

The risk that doctor took with this woman's baby astounds me. They were quite concerned that his lungs were not developed enough. I think he had to be in NICU for a while. Where is the justification for this? I was so unsettled when I heard the story, and this article confirms that my concerns are not unfounded.

[momyshaver]

Wow.. that is INSANE....and disturbing. Sadly, not suprising. Just curious.. is your friend local?

[KatieMac]

No she isn't...but she goes to a VERY prominent OB-GYN in her area. OB-GYN to the stars...has famous clients.

[momyshaver]

Ugh; that just disgusts me that a "professional" would do that simply based on dilation!! This is coming from a mom of 5 who walks around from 3-5 cm. for weeks to months before birth..and still has bags of water that practically need an ice pick to break! <img align="absmiddle" src="http://www.knoxmoms.com/forums/Skins/Classic/Images/EmotIcons/Tongue.gif" border="0" title="Tongue"> Seriously though, what horrid implications for maternal-child health if professionals are practicing such non evidence based care..(and believe me, they are,..this is NOT an isolated incident!)

[jenmomto3]

I would like to think that the doctor did this to insure that he was on hand with the delivery.&nbsp; Some women do walk around for months dilated up to five but some do not.&nbsp; I personally start dilating when I'm around 30 weeks.&nbsp; However, I've started as early as 27 weeks dilating to 4 at the time and being stopped by sulfate magnesium.&nbsp; What I'm getting at is this.....&nbsp; was she efaced a lot had the baby already engaged the canal?&nbsp; that makes a big difference since most of us that have had a lot of kids dilate quick but may still have a thick cervix and not be in immediate danger of giving birth early.&nbsp; My son was six weeks early, the doctors broke my water --- for the record -- I was "dilated to a very loose 4" since week 27 with him and at 33 weeks I was 5 and heavily medicated to keep him in.&nbsp; By, breaking my water there they were able to have NICU on hand the entire birth was less than 45 minutes and he was already having problems from being in the canal for 6 weeks that did not show on ultrasounds.&nbsp; If I gave birth that quickly at home it could have been fatal since he could not regulate temp, kept choking on fluids that came up from his lungs and was having difficult breathing (I had already had 2 steroid shots and his lungs were developed) I would not have wanted to experience that in&nbsp;a setting that wasn't controlled.&nbsp; &nbsp;I would hope that there was more to your friends case than lets just get the baby out.

[KatieMac]

I hope so too. It's possible she didn't describe it to me very clearly.

When I read the article it just made me think of her and it was a bit chilling, to say the least. It just worries me that babies might be induced in cases where it can actually harm them. Nearly all the inducements that I have heard of usually end in c-section due to the Pitocin causing the babies blood pressure to drop and it turns into an emergency situation when, hands off, things might have worked out. And of course, breaking the water is much less invasive than using a drug to start labor.

Of course I am not a proponent of being completely hands off and I am so grateful for doctors being there to make those tough calls. Everything in balance!

[momyshaver]

Certainly, everything in balance..I think that things need to be considered on an individual situation.&nbsp; However, with the staggering financial costs for each day a baby is in NICU, in addition to the physical risks like infection, not to mention other health risks preemies face..I wonder if it would not often&nbsp;be safer and&nbsp;cheaper for a high risk mom to have an extended&nbsp;stay in the hospital if they have an antepartum unit like some hospitals do, (I don't know if they do in&nbsp;Evansville),&nbsp;(where&nbsp;the pregnant mom&nbsp;and baby can be monitored closely) rather than&nbsp;induce. Something just doesn't make sense to me for inducing so early..when the problem is mom dilating early..if baby is not coming imminantly, why rush? It seems to me that the answers given is so that the Drs. can control the situation, (like you mentioned with inducing so NICU could be on stand by). I question if that is always the&nbsp;best decision based on current&nbsp;science.&nbsp;I am glad that there is health care available when it is needed for our smallest members of the community, great advances have been made, but I want evidence based care from womb to tomb--I think we all do. The U.S. does not rank very favorably&nbsp;in terms of maternal or fetal mortality, even when accounting for various factors with other nations. Something is wrong with this picture. The analysis of many obstetical interventions in A&nbsp;Guide to Effective Care in Pregnancy and Childbirth showed that many interventions had no benefit and some were even harmful--yet they are still used routinely in many hospitals. Don't believe me? Check out the&nbsp;analysis yourself at <A href="http://www.childbirthconnection.org/">http://www.childbirthconnection.org/</A>&nbsp;and you can view the PDF's for free along with some other research. I am so frustrated with the state of maternity care locally--not just Evansville,..locally as in ..the United States! Many studies have shown that the countries with the best outcomes have midwives for normal, low risk pregnancies, and the OBs handle the high risk ones. Like KatieMac said..balance is needed. The scales are very unbalanced here and we need to ask ourselves who is benefiting..because it is not mothers and babies.

[KatieMac]

It's good to hear about when inductions go well. My friend I mentioned before has very easy inductions and I'm so glad it works out for her!

I just tend to prefer to be very hands-off unless necessary, and my practitioner is the same way. I did grow a biggun last time...my little girl took after her 6'5 daddy and weighed 9 lbs 15 oz at birth! I still can't believe I gave birth to a baby that size, and I can't believe how fast I recovered! I am small boned as well, and very short! I could not believe my eyes or ears when she was born! But I wouldn't have it any other way...my body just takes a long time to gear up for labor and delivery. I'm not sure an inducement would help in my case.

It is EXTREMELY frustrating waiting for the kiddos to arrive. I'm no super woman. When my second son was 16 days overdue I cried so hard I threw up! It's very hard on my emotions, no question. But ultimately I just tend to be leery of anything disrupting the natural process. It's just the way I am programmed I guess! I'm like that about most things <img align="absmiddle" src="http://www.knoxmoms.com/forums/Skins/Classic/Images/EmotIcons/Smile.gif" border="0" title="Smile">

[KatieMac]

5'2!

For the record, I was in ALOT of pain. My daughter laid on my left side FOREVER. I had sciatica and the only relief was the pool. Someday I am going to have a lot to hold over that little girl's head <img align="absmiddle" src="http://www.knoxmoms.com/forums/Skins/Classic/Images/EmotIcons/Tongue.gif" border="0" title="Tongue"> I went through all kinds of stuff to bring that little sweetie pie into the world!! Whenever I feel like a wuss I just remember my little (big?) Alice, 32 hours of labor and no drugs!

[KatieMac]

Just for funsies...<a href="http://viewmorepics.myspace.com/index.cfm?fuseaction=viewImage&friendID=20532427&albumID=802384&imageID=8992590" target="_blank" class="SmlLinks">this</a> is what I looked like when I was overdue with that 10 lb baby!

[momyshaver]

<div class="Quote"><b>KatieMac (5/16/2008)</b><hr noshade size="1" class="hr">Just for funsies...<a href="http://viewmorepics.myspace.com/index.cfm?fuseaction=viewImage&amp;friendID=20532427&amp;a lbumID=802384&amp;imageID=8992590" target="_blank" class="SmlLinks">this</a> is what I looked like when I was overdue with that 10 lb baby!</div></P><P>I remember that<img align="absmiddle" src="http://www.knoxmoms.com/forums/Skins/Classic/Images/EmotIcons/BigGrin.gif" border="0" title="BigGrin"> You did good KatieMac..you did good<img align="absmiddle" src="http://www.knoxmoms.com/forums/Skins/Classic/Images/EmotIcons/Cool.gif" border="0" title="Cool">

[KatieMac]

Yes...yes I do! After she came out I said NEVER again! Two weeks later I said, well, maybe again!! What is it about those cute little boogers that makes you forget all the pain and sickness and general misery?

[MommyMcQuay]

It is funny this was brought up today (or I read it today) I attended the Perinatal meeting and the research is pointing more and more to the issues that people are having later in life to being born premature...</P><P>It is obvious to most that a pre-term baby has breathing and eating issues...and we have all these babies who have breathing issues and turn into asthma, or have reflux and poor weight gain. </P><P>With Andrew, my OB was willing to induce at 39 weeks IF I was dialated to a certain point. Andrew had other plans and came at 38 weeks (my first one was&nbsp; a week early too on his own.)</P><P>I know where MommyShave stands on all of this, Katie Mac, are you in the biz too?

[KatieMac]

No, not in the "biz", just a big supporter of child-birth being as natural as possible!