by
Olga Deshchenko, DOTmed News Reporter | May 24, 2011
From the May 2011 issue of HealthCare Business News magazine
Many experts also draw links between America’s vast socioeconomic disparities and infant death. While both preterm birth and SIDS can happen to any family, these conditions are more prevalent among poorer Americans. (According to Gregory, half of U.S. births are funded by Medicaid.)
There are also significant differences in IMRs by race and ethnicity. A 2008 NCHS report found that the infant mortality rate for black women was 2.4 times the rate for white women in 2005.
The report’s authors reasoned that high risk factors such as socioeconomic status and access to medical care in part play a role in explaining the variance in the rates but “many of the racial and ethnic differences in infant mortality remain unexplained.”
Elective delivery
Additional factors that distinguish the delivery of American infants from those in other developed nations are caesarean sections and drug inductions for early deliveries.
The American College of Obstetricians and Gynecologists maintains that unless there is a medical reason for doing so, babies should not be delivered before 39 weeks. And yet, the U.S. rate of early deliveries is higher than in other countries, and “medical justification for a significant proportion of early deliveries is questionable,” according to a 2010 March of Dimes report.
According to the report, 10 to 15 percent of births in the U.S. are elective deliveries that are carried out without medical indications and before 39 weeks. Elective delivery before 39 weeks is “associated at a minimum with significant short-term morbidity,” the report says.
Babies who are delivered early are also more likely to end up in intensive care units. And studies show that infants born before 39 completed weeks have higher rates of respiratory distress syndrome and infant death.
“The bottom line is babies should be born at the right time, for the right reason,” says Berns. “It shouldn’t be done for the convenience of moms, the family or a provider because it works out with his or her schedule.”
“The womb is the best place for the baby,” he adds.
What can be done?
Although the societal factors that may influence infant death rates are many, it doesn’t mean America can’t take steps to improve newborn survival rates.
For one, a simple strategy that should be ongoing is patient education and awareness. For example, many women will show up to the hospital with preterm contractions, only to be sent home and reassured that it’s not time yet. When a woman experiences the contractions again, she may be too embarrassed to come back. But women should be mindful of preterm contractions and “seek medical attention sooner and repetitively,” says Gregory.
