01.07.11: Reading the fine print
Now that the holidays are out of the way, I’m finally taking a close look at the Centers for Disease Control’s preliminary 2009 birth statistics and 2008’s final birth statistics. What I find fascinating is the fine print – the statistics within the statistics.
For example, it’s no big surprise that the C-section rate is continuing to rise. We’re at 32.9% now; up 2% from 2008 and continuing the trend that has increased c-sections by 60% since 1996. Check out last year’s blog on our ever-rising C-section rates to find out why. Women in all age brackets and races were affected. Most c-sections were performed on women between ages 25-34, but here are two stats I think are particularly intriguing:
1) African American women saw the largest increase (3%) and have the highest percentage of c-sections.
2) Half of all deliveries of women 40 and older were c-sections.
While it makes sense that women in higher risk groups would have more c-sections, I wonder why these two groups are having so many? Prior to 1996, presumably, African American women and older mothers were capable of having safe vaginal births. Maternal and newborn health statistics haven’t improved due to all these c-sections, so what’s going on? Many of these c-sections are repeat procedures resulting from VBAC bans. This leads me to think we need to take better care of our African American and 40-something mothers to help them have the healthiest birth outcomes, but maybe without doing so many surgeries on them.
Birth rates are down among women of all ages and races, (meaning fewer women are having babies), except in the 40-something crowd. They seem to be having more fertility success than in previous years. That may be a testament to advancements in infertility treatments. It may also be due to increasing confidence and social acceptance that women over 40 can be mothers. Maybe women today can do it all, as long as they’re willing to do some things a little later in life.
Fewer teenagers are having babies. In fact, teen births have reached a record low. Thank God for that. Not many (if any) 15-19 year-old girls are ready to become mothers. They need to spend a few more years being kids and at least a few being women, before they’re expected to hand their lives over to raising children.
While studying age statistics for births in 2008, I was struck by the real numbers at the high and low ends of the spectrum. Out of the 4.2 million babies born in 2008:
• 5764 of them were born to girls between the ages of 10 and 15.
• 541 of them were born to women between 50 and 54.
Writing from the perspective of a woman at the higher end of that spectrum, I’m not so worried about how those 50-something women will handle the stress of having a newborn. I worry more how they’ll deal with a teenager when they’re in their mid-60s and early-70s. I worry for their children when they become responsible for the care of an aging parent while they’re supposed to be focused on college.
I worry a lot more, however about those little girls; the 10- 14-year-olds who are not only sexually active (or were raped), but who became mothers. While here in the US, childhood pregnancy is unusual, in other parts of the world, it’s extremely common. No matter what the cultural differences, little girls have no business having babies when they’re still babies themselves.
My work with CARE has taught me that girls under age 15 are five times more likely to die in childbirth than adult women. They’re also at much greater risk for developing fistulas (tears) between their vagina, rectum and/or bladder and then having lifetime disabilities and social isolation. If their birth doesn’t severely damage their bodies, it will certainly damage their lives. Finishing even a basic education will be unlikely and college will be almost out of the question. Employment prospects will be slim and these girls and their babies will be destined to repeat poverty cycles.
2009 saw fewer preterm deliveries, especially among babies older than 36 weeks. That’s partly because fewer women and doctors are scheduling inductions and c-sections before 39 weeks. We previously thought most babies older than 36 or 37 weeks gestation was “term enough.” Now we know that babies need a full 39-40 weeks to do the developmental finishing work that will insure their best health.
What do all these statistics tell us? We’re making head room in some areas, but need work in others. Doctors are getting savvy about how to use science and medicine thoughtfully and carefully to deliver healthy babies to healthy mothers. Mothers are getting savvy about how to be their healthiest while still being smart healthcare consumers. Healthy pregnancy is more than just a numbers game. It’s about smart choices, a measure of good fortune and making the most of what you’ve got.
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.