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Childbirth Death Rate Rises in U.S.

By MIKE STOBBE,
AP
Posted: 2007-08-24 23:20:01
Filed Under: Health News, Nation News
(Aug. 24) -- U.S. women are dying from childbirth at the highest rate in decades, new government figures show. Though the risk of death is very small, experts believe increasing maternal obesity and a jump in Caesarean sections are partly to blame.

Some numbers crunchers note that a change in how such deaths are reported also may be a factor.

"Those of us who look at this a lot say it's probably a little bit of both," said Dr. Jeffrey King, an obstetrician who led a recent New York state review of maternal deaths.

The U.S. maternal mortality rate rose to 13 deaths per 100,000 live births in 2004, according to statistics released this week by the National Center for Health Statistics.

The rate was 12 per 100,000 live births in 2003 - the first time the maternal death rate rose above 10 since 1977.

To be sure, death from childbirth remains fairly rare in the United States. The death of infants is much more common - the nation's infant mortality rate was 679 per 100,000 live births in 2004.

Maternal deaths were a much more common tragedy long ago. Nearly one in every 100 live births resulted in a mother's death as recently as 90 years ago.

But the fact that maternal deaths are rising at all these days is shocking, said Tim Davis, a Virginia man whose wife Elizabeth died after childbirth in 2000.

"The hardest thing to understand is how in this day and age, in a modern hospital with doctors and nurses, that somebody can just die like that," he said.

Some health statisticians note the total number of maternal deaths - still fewer than 600 each year - is small. It's so small that 50 to 100 extra deaths could raise the rate, said Donna Hoyert, a health scientist with the National Center for Health Statistics. The rate is the number of deaths per 100,000 live births.

In 2003, there was a change in death certificate questions in the nation's most populous state, California, as well as Montana and Idaho. That may have resulted in more deaths being linked to childbirth - enough push up the 2003 rate, Hoyert said.

Some researchers point to the rising C-section rate, now 29 percent of all births - far higher than what public health experts say is appropriate. Like other surgeries, Caesareans come with risks related to anesthesia, infections and blood clots.

"There's an inherent risk to C-sections," said Dr. Elliott Main, who co-chairs a panel reviewing obstetrics care in California. "As you do thousands and thousands of them, there's going to be a price."

Excessive bleeding is one of the leading causes of pregnancy-related death, and women with several previous C-sections are at especially high risk, according to a review of maternal deaths in New York. Blood vessel blockages and infections are among the other leading causes.

Experts also say obesity may be a factor. Heavier women are more prone to diabetes and other complications, and they may have excess tissue and larger babies that make a vaginal delivery more problematic. That can lead to more C-sections. "It becomes this sort of snowball effect," said King, who is now medical director of maternal-fetal medicine at Riverside Methodist Hospital in Columbus, Ohio.

The age of mothers could be a factor, too. More women are giving birth in their late 30s and 40s, when complications risks are greater.

Other characteristics of the maternal mortality rate include:

-- Race: Studies have found that the maternal death rate in black women is at least three times greater than is it is for whites. Black women are more susceptible to complications like high blood pressure and are more likely to get inadequate prenatal care.

-- Quality of care: Three different studies indicate at least 40 percent of maternal deaths could have been prevented.

Sometimes, there is no clear explanation for a woman's death.

Valerie Scythes, a 35-year-old elementary schoolteacher, died in March at a hospital in New Jersey - the state with the highest Caesarean section rate. She had had a C-section, as did another teacher at the same school who died after giving birth at the same hospital two weeks later.

However, Scythes died of a blocked blood vessel and the other woman died from bleeding, said John Baldante, a Philadelphia attorney investigating the death for Scythes' family.

"I'm not sure there was any connection between the two deaths," Baldante said.

Also mysterious was the death of Tim Davis' 37-year-old wife, Elizabeth, who died a day after a vaginal delivery at a Danville, Va., hospital in September 2000.

She had a heart attack after a massive blood loss, Davis said. It's not clearly known what caused the heavy bleeding. There was no autopsy, he said, a decision he now regrets.

Two previous births had gone well.

"Nothing led us to believe anything was wrong with this pregnancy. She was like a picture of health," he continued, noting she had been a YMCA fitness instructor.

A lawsuit against the hospital ended in a settlement. Davis also sued the obstetrician, but a jury ruled in the doctor's favor.

The child born that day, Ethan, starts second grade next week. "He's a happy kid," Davis said. "He's just never had a mom."

Copyright 2008 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.
2007-08-24 19:24:34
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Recent Comments

1 - 10 of 2294
2294 comments

danielheyes 07:41:55 PM Sep 06 2007

Ymmarta Unless you want me to turn into a raving witch I suggest you think twice about forced birth control. how about forced vesectomies? i didn't think so. the hormones in birth control make me evil and gain weight. the female reproductive system is not to be messed with. Deannalouise84 congrats my children were both over 10 pounds at birth. the babies to big excuse is just that an excuse. along with almost all the other so called 'complications' I was born c section dec. 24th go figure my mom was inlabor 12 hours the day before a holiday. um can we say "i'm a doctor instead of being patient I'm gonna hurry up and go home to my family" all this while risking an unsuspecting womens life
I LOVE MY MIDWIFE TRUST BIRTH!

Deannalouise84 08:04:12 PM Sep 05 2007

I delivered my first child vaginally. He weighed 9 lbs. 3 oz. I was fifteen at the time. Since then, my husband and I have welcomed 2 more children into the world without any complications or C-Sections. If a fiteen year-old can deliver a 9 pound babie, why can't an adult woman?

Ymmarta 01:23:34 AM Sep 05 2007

We need to increase abortions at all stages of pregnancy, not just in the US but worldwide. Forced birth control would also prevent these tragedies. Financial incentives would be provided to those that had voluntary abortions.
Implementation of these ideas will reduce deaths related to childbirth. It would also reduce the population explosion that threatens the human race with extinction. -Mike

Danercdee 07:55:32 PM Sep 04 2007

I need to send this to my malpractice attorney because I am currently in litigation regarding me almost dying due to somebody not reading my plastic braclet that said I was allergic to morphine. I was in a coma, on life support and yes, it was a planned C-section just like my other three. Once you have a C-section it seems like you do not have a choice to try natural childbirth. I never did. This article could not have come at a better time.....at this time I need a miracle it seems to get compensated for someone elses mistake......

suturelady98 11:59:22 AM Sep 04 2007

I agree that too many C-Sections seem to be done, these days. While both of mine were necessary the numbers - statistically - seem to be so high. It does appear to be a convenience, for some doctors, and shouldn't be when we are talking about major surgery. I am not sure as to why some of you sort of make this into an argument over whether one should go to a doctor and hospital - for care - or a midwife. I think that there are highly qualified doctors and midwives out there. It just depends on your health needs, personal preferences, etc. There are always going to be the cases, sadly enough, where the midwife should have taken the mother and baby to the hospital as there are also cases of doctor errors at the hospital. I do agree with the poor man who lost his wife, that it doesn't seem like that many women should be losing their lives - in childbirth - these days with all of the modern advances. I also agree that there is A LOT OF GREED among some of the doctors and a lot of t

Chantenuit 07:05:26 AM Sep 04 2007

I went to college with a woman who was a midwife. She had both the mother and the child in one of her deliveries. The baby was too big but instead of getting her to a hospital for a C-section she talked the mother into "toughing out". As the baby was died, trapped inside he kicked and hit one of the mother's major veins and it burst. She bled to death.

There are legitimate needs for C-sections. Had the woman I just told you about been in a hospital both she and her son might still be alive. I would never have a homebirth. If some kind of problem occurs during labor, to either me or my baby, I'd want to be in a facility with people who can intervene as quickly as possible. Women with perfectly normal, low risk pregnancies do have complications at times.

Chantenuit 06:41:45 AM Sep 04 2007

rbadman46.... I fail to understand why the maternal mortality rate will increase if Hillary is elected president. Many doctors call for C-sections earlier in the labor are trying to hedge their bets and not get hit with a massive malpractice suit when a child is born with complications because a c-section wasn't performed soon enough.

harbordoula 10:06:10 PM Sep 03 2007

And for the record, yes, if I wanted a SURGEON, I would go to an OB and expect him to be well rested. But that's why I don't go to an OB in the first place for normal, low-risk care. It's not their job.

harbordoula 10:05:12 PM Sep 03 2007

DRM, I'm sorry that you've bought into the idea that per birth repayment is the only way that doctors make money. Doing more cesareans allows doctors to take on more clients, bill more office hours, bill more specialty hours, than they would be able to do if they were doing mostly vaginal births. Add in inductions and the number goes higher. Any person who goes into obstetrics should be expecting to be doing births around the clock and they do, which is why they have partners or backups. Unfortunately, this isn't enough and they have now started to force patients to birth when they aren't ready through induction or through surgery, whichever comes up. If you are going to talk about your spouse being an OB, then what is his cesarean rate? Because anything over 15% is endangering moms and babies so he can "feel more rested" rather than being on call. OB is not a 9-5 profession. It's simply not. And 7am-6pm is normal working hours. A good OB should have reliable backup if they want more

THUMSTONE 10:27:33 PM Aug 30 2007

Universal Healthcare. All the efficiency of the Post Office with the compassion of the IRS. Good luck.

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