Opinion

These two studies should be a wake-up call to natural-childbirth extremists

You can't lay America's infant mortality rate at the feet of doctors

There is a lot of guilt surrounding childbirth these days.

Many women, including actress Kate Winslet, are ashamed about having a C-section. Women who have opted for pain medication have reported feeling guilty about it. Medicalized births can even be a source of PTSD.

At the center of this guilt is a belief that doctors and hospitals can't be trusted. By doing what medical experts recommend, many think, a woman has somehow failed herself and her child. Indeed, alternative-birth advocates have long cited the high rate of infant mortality and C-sections as reasons to steer clear of a typical, medicated hospital birth at all cost. But as two new papers show, that just doesn't align with the data.

First off, the infant mortality rate in the U.S. isn't nearly as high as we think. The Centers for Disease Control and Prevention ranks us at an embarrassing 56th in the world, with 6.1 deaths per 1,000 births. According to a draft paper from health economists at the University of Chicago, USC, and MIT, comparing the U.S.'s rate with that of Finland and Austria, this isn't entirely true.

What's hiking up the U.S. rate is the fact that we define extremely preterm births as live births, while other countries consider them miscarriages or stillbirths. So if a baby is born before 23 weeks and doesn't make it — which is highly likely — his or her death will be included in our national infant-mortality rate. This difference accounts for 40 percent of the U.S.'s infant-mortality rate compared with that of countries like Austria and Finland, which has the lowest rate in the world.

Even more interesting is the fact that neonatal deaths are actually less frequent in the U.S. than they are in Austria and Finland, once the researchers accounted for the babies who die months after they leave the hospital and go home. So for a good many children who don't make it to their first birthdays, doctors and hospitals aren't the problem; what happens after the babies leave is.

It should come as no surprise that the babies who are more likely to die at home are those born into poor families. In fact, there is no difference in infant mortality between wealthy women in the U.S. and those in Finland or Austria. There is, however, a big difference between wealthy states like California and poor ones like Mississippi.

The other new paper that guilty mothers should pay attention to is in the Journal of the American Medical Association. It shows that there is actually no connection between C-section rates and increased maternal or neonatal complications or morbidity.

This isn't to say that we shouldn't be working to reduce the unnecessarily high C-section rate in our country, something doctors agree should be changed but warn us can't happen overnight. But we need to put to rest the idea that if a woman does get a C-section, the chances of something going wrong are higher.

One way women can relieve themselves of the guilt surrounding childbirth is by trusting experts. That's not to say that women shouldn't educate themselves or feel empowered in the delivery room, just that it is OK to let go and rely on to the experience and instincts of our doctors. As these studies suggest, we are in pretty good hands.

More From...

Picture of Elissa StraussElissa Strauss
Read All
In defense of family dinner
If your family dinner looks nothing like this, you're not alone.
Feature

In defense of family dinner

Why being miserable in high school is good for you
The Breakfast Club
Feature

Why being miserable in high school is good for you

The end of the gushing celebrity profile
The Vogue September issue
Opinion

The end of the gushing celebrity profile

The problem with 'boyfriend' jeans
Really?
Opinion

The problem with 'boyfriend' jeans

Recommended

US births did not return to pre-pandemic levels in 2022
Pregnant woman holding ultrasound photo.
bye, bye, baby

US births did not return to pre-pandemic levels in 2022

WHO chief warns of pathogens that could be 'even deadlier' than Covid-19
Dr. Tedros Adhanom Ghebreyesus
stern warning

WHO chief warns of pathogens that could be 'even deadlier' than Covid-19

Cannabis abuse disorder, explained
Marijuana leaves in the hands of a doctor
Briefing

Cannabis abuse disorder, explained

The casino on the couch
A man holding a cell phone while winning an online bet on a football game.
Briefing

The casino on the couch

Most Popular

Is Trump's wall working?
International Border Wall Between Tecate California and Tecate Mexico.
Briefing

Is Trump's wall working?

Can Chris Christie make a comeback?
A black and white photo of Chris Christie waving
Profile

Can Chris Christie make a comeback?

YouTube to stop deleting false claims about 2020 election
The YouTube logo seen in London in 2019.
Reversing Course

YouTube to stop deleting false claims about 2020 election