Birth-day choices

Article Abstract:

In 1980, between one and four percent of the women in the United States gave birth to their children in places other than a hospital. There are various opinions about alternate birth sites, with those opposed to them claiming a concern for the safety of the mother and child, while supporters stress the positive psychological advantage and the absence of unnecessary medical intervention. In a study of nearly 12,000 women by Rooks and others, published in the Dec 4, 1989, issue of the New England Journal of Medicine, it was concluded that women who gave birth in birth centers had low rates of complications. The number of cesarean sections performed and use of analgesia and anesthesia were low compared with hospital procedures. Since the study analyzed only approximately half of the birth centers in the nation, safety is still a concern with the use of birth centers. There may be great differences in quality between centers. Centers that did not participate in the study may have higher rates of complications. The mortality rate for mothers and children in birth centers was 1.3 deaths for every 1,000 deliveries, which is the same as in the hospital. However, the mortality rate in the birth centers may be skewed, as only women with low risks of complications give birth in birth centers. It is thought that the best arrangement is for birth centers to be located in hospitals. The birth centers can offer the homelike atmosphere without medical intervention unless an emergency occurs, at which point proper facilities will be readily available.

editorial

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Outcomes of care in birth centers

Article Abstract:

Birth centers are facilities outside of the hospital where women give birth to their children. There are more than 240 birth centers in the United States. The labor, delivery and follow-up care of 11,814 mothers and their infants from 84 birth centers were analyzed in the National Birth Center Study. Twenty percent of the women had no complications during delivery. Minor complications that pose no inherent risk of death or permanent damage, such as temporary fetal distress, failure to progress further in the labor, increase in maternal temperature, tearing of the perineum or the portion of the body which surrounds the distal portion of the urogenital and gastrointestinal tract of the mother, occurred in 50.8 percent of the women. Twenty percent had somewhat more serious complications, such as higher temperatures, retained placentas or high blood pressure. Eight percent had serious complications such as thick meconium, which is the baby's first stool, or sustained fetal distress. Sixteen percent of the women were transferred to a hospital, with 2 percent being emergencies. The rate of cesarean sections was 4.4 percent. The infant mortality rate was 1.3 deaths per 1,000 births, which is the same rate as in the hospital. Safety is a major issue in the use of birth centers, which are only recommended for mothers who are of low-risk for obstetrical complications, especially those who have had children before. From the study, it was concluded that birth centers are a safe and acceptable alternative to hospitals.

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Making motherhood safe in developing countries

Article Abstract:

The year 2007 marks the 20th anniversary of the Safe Motherhood Conference in Nairobi, an event that initiated a global program to reduce maternal mortality in developing countries. A review of the conference's efforts toward improving maternal health, since 1987, reveals that although every country has its own unique challenges, accelerating progress is possible with government support.

Forecasts, trends, outlooks, Kenya, Developing Countries, Health aspects, Forecasts and trends, Market trend/market analysis, Motherhood, Mothers, Maternal mortality

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