Instruct: Given a question, retrieve passages that can help answer the question.
Query: What percentage of women in the U.S. die from complications during birth?
Every year, an estimated 342,900 women die from complications of pregnancy and childbirth, 99% of these deaths occur in developing countries. Worldwide, for every 100,000 live births, about 251 women die. In some industrialized countries such as the U.S, this is 13 deaths for every 100,000 live babies born with American women having a lifetime risk of 1 in 2,100 of dying from childbirth related complications. However, in some countries, such as Afghanistan up to 1,600 women die for every 100,000 live births and women have a 1 in 11 lifetime risk of maternal death.
The World Health Organization (WHO) defines maternal health as the health of women during pregnancy, childbirth and the postpartum period. According to estimates from UNICEF, Uganda’s maternal mortality ratio, the annual number of deaths of women from pregnancy-related causes per 100,000 live births, stands at 435 after allowing for adjustments. Women die as a result of complications during and following pregnancy and childbirth and the major complications include severe bleeding, infections, unsafe abortion and obstructed labor.
In response to the high maternal mortality ratio, in 2013 the Department of State to created the Maternal Mortality and Morbidity Task Force. According to Amnesty International's 2010 report, five medical conditions collectively account for 74% of maternal deaths in the US.Postpartum depression is widely untreated and unrecognized, leading to suicide. Suicide is one of the most significant causes of maternal mortality, and reported to be the number one cause by many studies.
A report released in April 2008 by the Foundation for Child Development, which studied the period from 1994 through 2006, found mixed results for the health of children in the U.S. Mortality rates for children ages 1 through 4 dropped by a third, and the percentage of children with elevated blood lead levels dropped by 84%. The percentage of mothers who smoked during pregnancy also declined. On the other hand, both obesity and the percentage of low-birth weight babies increased. The authors note that the increase in babies born with low birth weights can be attributed to women delaying childbearing and the increased use of fertility drugs.
During the third stage of labor, while the infant is being born, the vagina undergoes significant changes. A gush of blood from the vagina may be seen right before the baby is born. Lacerations to the vagina that can occur during birth vary in depth, severity and the amount of adjacent tissue involvement. The laceration can be so extensive as to involve the rectum and anus. This event can be especially distressing to a new mother. When this occurs, fecal incontinence develops and stool can leave through the vagina. Close to 85% of spontaneous vaginal births develop some form of tearing. Out of these, 60–70% require suturing. Lacerations from labor do not always occur.
Perineal pain after childbirth has immediate and long-term negative effects for women and their babies. These effects can interfere with breastfeeding and the care of the infant. The pain from injection sites and possible episiotomy is managed by the frequent assessment of the report of pain from the mother. Pain can come from possible lacerations, incisions, uterine contractions and sore nipples. Appropriate medications are usually administered. Routine episiotomies have not been found to reduce the level of pain after the birth.
Due in large part to the dramatic reduction in the risk of unwanted pregnancy engendered by the introduction of the Pill in 1960, not to mention the legalization of contraception nationwide by the Supreme Court decision in "Griswold v. Connecticut" in 1965, along with the steadily increasing acceptance of abortion and delayed marriages for career-minded young women influenced by second-wave feminism, or the chic rejection of the responsibilities of marriage altogether in favor of living together without raising a family, U.S. birthrates fell below replacement level starting in 1965 and remained depressed for almost 20 years; thus, children born during this period became known, at least in the popular press, as "baby busters" (as opposed to the "baby boomers" of the postwar years). Birthrates hit an all-time low during the post-OPEC recession in the mid-1970s.
Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks' gestational age. These babies are known as preemies or premies. Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes or the leaking of fluid from the vagina. Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems and sight problems. These risks are greater the earlier a baby is born.
The cause of preterm birth is often not known. Risk factors include diabetes, high blood pressure, being pregnant with more than one baby, being either obese or underweight, a number of vaginal infections, tobacco smoking and psychological stress, among others. It is recommended that labor not be medically induced before 39 weeks unless required for other medical reasons. The same recommendation applies to cesarean section. Medical reasons for early delivery include preeclampsia.
In those at risk, the hormone progesterone, if taken during pregnancy, may prevent preterm birth. Evidence does not support the usefulness of bed rest. It is estimated that at least 75% of preterm infants would survive with appropriate treatment, and the survival rate is highest among the infants born the latest. In women who might deliver between 24 and 37 weeks, corticosteroids improve outcomes. A number of medications, including nifedipine, may delay delivery so that a mother can be moved to where more medical care is available and the corticosteroids have a greater chance to work. Once the baby is born, care includes keeping the baby warm through skin to skin contact, supporting breastfeeding, treating infections and supporting breathing.
Preterm birth is the most common cause of death among infants worldwide. About 15 million babies are preterm each year (5% to 18% of all deliveries). Approximately 0.5% of births are extremely early periviable births, and these account for most of the deaths. In many countries, rates of premature births have increased between the 1990s and 2010s. Complications from preterm births resulted in 0.81 million deaths in 2015 down from 1.57 million in 1990. The chance of survival at 22 weeks is about 6%, while at 23 weeks it is 26%, 24 weeks 55% and 25 weeks about 72%. The chances of survival without any long-term difficulties are lower.
The record for the smallest premature baby to survive was held for a considerable amount of time by Madeline Mann, who was born in 1989 at 26 weeks, weighing and measuring long. This record was broken in September 2004 by Rumaisa Rahman, who was born in the same hospital at 25 weeks' gestation. At birth, she was long and weighed . Her twin sister was also a small baby, weighing at birth. During pregnancy their mother had suffered from pre-eclampsia, which causes dangerously high blood pressure putting the baby into distress and requiring birth by caesarean section. The larger twin left the hospital at the end of December, while the smaller remained there until 10 February 2005 by which time her weight had increased to . Generally healthy, the twins had to undergo laser eye surgery to correct vision problems, a common occurrence among premature babies.
In humans, the usual definition of preterm birth is birth before a gestational age of 37 complete weeks. In the normal human fetus, several organ systems mature between 34 and 37 weeks, and the fetus reaches adequate maturity by the end of this period. One of the main organs greatly affected by premature birth is the lungs. The lungs are one of the last organs to mature in the womb; because of this, many premature babies spend the first days and weeks of their lives on ventilators. Therefore, a significant overlap exists between preterm birth and prematurity. Generally, preterm babies are premature and term babies are mature. Preterm babies born near 37 weeks often have no problems relating to prematurity if their lungs have developed adequate surfactant, which allows the lungs to remain expanded between breaths. Sequelae of prematurity can be reduced to a small extent by using drugs to accelerate maturation of the fetus, and to a greater extent by preventing preterm birth.
During the subacute postpartum period, psychological disorders may emerge. Among these are postpartum depression, posttraumatic stress disorder, and in rare cases, puerperal psychosis. Postpartum mental illness can affect both mothers and fathers, and is not uncommon. Early detection and adequate treatment is required. Approximately 25% – 85% of postpartum women will experience the "blues" for a few days. Between 7% and 17% may experience clinical depression, with a higher risk among those women with a history of clinical depression. Prevalence of PTSD following normal childbirth (excluding stillbirth or major complications) is estimated to be between 2.8 and 5.6% at 6 weeks postpartum.
The U.S. teenage pregnancy rate is 26.5 per 1,000 women. The rate has declined by 57% since 1991. In 2013, the highest teenage birth rate was in Alabama, and the lowest in Wyoming. Abortion is legal throughout the U.S., owing to "Roe v. Wade", a 1973 landmark decision by the Supreme Court of the United States. While the abortion rate is falling, the abortion ratio of 241 per 1,000 live births and abortion rate of 15 per 1,000 women aged 15–44 remain higher than those of most Western nations. In 2013, the average age at first birth was 26 and 40.6% of births were to unmarried women.
Having children later was not exceptional in the past, when families were larger and women often continued bearing children until the end of their reproductive age. What is so radical about this recent transformation is that it is the age at which women give birth to their first child which is becoming comparatively high, leaving an ever more constricted window of biological opportunity for second and subsequent children, should they be desired. Unsurprisingly, high first-birth ages and high rates of birth postponement are associated with the arrival of low, and lowest-low fertility.
Maternity blues, also known as baby blues and postpartum blues, is a transient condition that 75-80% of mothers could experience shortly after childbirth with a wide variety of symptoms which generally involve mood lability, tearfulness, and some mild anxiety and depressive symptoms. Baby blues is not postpartum depression, unless it is abnormally severe.After the placenta is delivered, the placental "hormone factory" shuts down causing radical changes in hormone levels, and the woman can suffer symptoms due to withdrawal from the high pregnancy levels of estrogen, progesterone and endorphins. Combined with this shift in hormone levels is the physical, mental and emotional exhaustion - as well as sleep deprivation typical of parenting a newborn. All of these factors contribute to the condition.
In the United States, 82.5 million women are mothers of all ages, while the national average age of first child births is 25.1 years. In 2008, 10% of births were to teenage girls, and 14% were to women ages 35 and older. In the United States, a study found that the average woman spends 5 years working and building a career before having children, and mothers working non-salary jobs began having children at age 27, compared to mothers with salary positions, who became pregnant at age 31. The study shows that the difference in age of child birth is related to education, since the longer a woman has been in school, the older she will be when she enters the workforce.
The U.S. birthrate exploded after World War II. From 1944 to 1961, more than 65 million children were born in the United States. At the height of this baby boom, a child was born every seven seconds. Factors that contributed to the baby boom consisted of young couples who started families after putting off marriage during the War, government encouragement of growth of families through the aid of GI benefits, and popular culture that celebrated pregnancy, parenthood, and large families.
Harrison's Principles of Internal Medicine, recommends that pregnant women with active genital herpes lesions at the time of labor be delivered by caesarean section. Women whose herpes is not active can be managed with acyclovir. The current practice is to deliver women with primary or first episode non primary infection via caesarean section, and those with recurrent infection vaginally, even in the presence of lesions because of the low risk (1-3%) of vertical transmission associated with recurrent herpes.
Faculty provides care for thousands suffering from mild to traumatic brain injuries. The concussion clinic at Medstar NRH focuses primarily on this form of brain injury and is regarded as one of the best in the country according to U.S. News & World Report. 75 percent of all traumatic brain injuries that occur are concussions. Traumatic brain injuries contribute to a third of all deaths in the United States with over 1.5 million brain injuries occurring each year. During their stay, patients are also educated on precautions they can take to prevent a future incidence.
In the United States, the birth rate is 105 sons to 100 daughters which has been the natural birth rate since the 18th century. About 80 percent of prospective adoptive parents from the US will choose a girl over a boy. In fertility clinics that enable sex preferences, daughters are usually preferred over sons. In the traditions of various Abrahamic religions, Luluwa is regarded as the first daughter to have ever existed.
Depression often starts at young age and affects women more commonly than men. One or two mothers out of 10 have depression after childbirth. Depression also limits a mother’s capacity to care for her child, and can seriously affect the child’s growth and development. A study showed that exposure to maternal mental distress is associated with undernutrition in 9‐month infants in urban Pakistan.
The U.S. National Center for Health Statistics creates standard forms that are recommended for use by the individual states to document births. However, states are free to create their own forms. As a result, neither the appearance nor the information content of birth certificate forms is uniform across states. These forms are completed by the attendant at birth or a hospital administrator, which are then forwarded to a local or state registrar, who stores the record and issues certified copies upon request.
Since 2016, ProPublica and NPR investigated factors that led to the increase in maternal mortality in the United States. They reported that the "rate of life-threatening complications for new mothers in the U.S. has more than doubled in two decades due to pre-existing conditions, medical errors and unequal access to care." According to the Centers for Disease Control and Prevention, c. 4 million women who give birth in the US annually, over 50,000 a year, experience "dangerous and even life-threatening complications." Of those 700 to 900 die every year "related to pregnancy and childbirth." A "pervasive problem" is the rapidly increasing rate of "severe maternal morbidity" (SMM), which does not yet have a "single, comprehensive definition".
According to a 2004 WHO publication, sociodemographic factors such as age, access to resources and income level are significant indicators of maternal outcomes. Young mothers face higher risks of complications and death during pregnancy than older mothers, especially adolescents aged 15 years or younger. Adolescents have higher risks for postpartum hemorrhage, puerperal endometritis, operative vaginal delivery, episiotomy, low birth weight, preterm delivery, and small-for-gestational-age infants, all of which can lead to maternal death. The leading cause of death for girls at the age of 15 in developing countries is complication through pregnancy and childbirth. They have more pregnancies, on average, than women in developed countries and it has been shown that 1 in 180 fifteen year old girls in developing countries who become pregnant will die due to complications during pregnancy or childbirth. This is compared to women in developed countries, where the likelihood is 1 in 4900 live births. However, in the United States, as many women of older age continue to have children, trends have seen the maternal mortality rate to rise in some states, especially among women over 40 years old.
Controversy over the practice of UC has largely centered over whether it is, as claimed by proponents, a safe method of childbirth. Critics of UC, such as the Society of Obstetricians and Gynaecologists of Canada (SOGC), claim that unassisted childbirth is quite unsafe, and that those who engage in it are "courting danger". A spokesperson for the American College of Obstetricians and Gynecologists issued a one-word assessment of freebirth: "dangerous". The SOGC notes that more than 500,000 women worldwide die annually from complications during childbirth, and that even in developed countries, in which expectant mothers generally receive complete prenatal care, as many as 15% of all births involve potentially fatal complications. In poor countries in which there are conditions of malnutrition and taboos surrounding childbirth or there is a lack of qualified birth attendants, rates of maternal and infant mortality and complications such as fistula are much higher, with disparities in death rates from childbirth between developed and developing countries approaching two orders of magnitude. Critics also point out the high rates of complication and death arising from childbirth that existed before the development of modern medicine: between 10 and 15 deaths per 1000 births.
The rising maternal death rate in the U.S. is of concern. In 1990 the U.S. ranked 12th of the 14 developed countries that were analyzed. However, since that time the rates of every country have steadily continued to improve while the U.S. rate has spiked dramatically. While every other developed nation of the 14 analyzed in 1990 shows a 2017 death rate of less than 10 deaths per every 100,000 live births, the U.S. rate has risen to 26.4. By comparison, the United Kingdom ranks second highest at 9.2 and Finland is the safest at 3.8. Furthermore, for every one of the 700 to 900 U.S. woman who die each year during pregnancy or childbirth, 70 experience significant complications such as hemorrhage and organ failure, totaling more than 1 percent of all births.