In yesterday's LA Times:
Childbirth: Can the U.S. improve?
It is a big reason childbirth often is held up in healthcare reform debates as an example of how the intensive and expensive U.S. brand of medicine has failed to deliver better results and may, in fact, be doing more harm than good.
"We're going in the wrong direction," said Dr. Roger A. Rosenblatt, a University of Washington professor of family medicine who has written about what he calls the "perinatal paradox," in which more intervention, such as cesareans, is linked with declining outcomes, such as neonatal intensive care admissions. Maternity care, he said, "is a microcosm of the entire medical enterprise."
and in this week's Time Magazine:
Doctors Versus Midwives: The Birth Wars Rage On
It's this fact that has always been responsible for the fault line between obstetricians — who are trained to view birth as a medical procedure — and midwives, who see it as that but as something less clinical too. And if a new study conducted by two researchers at Oregon State University (OSU) is any indication, peace is not likely to be brokered between the two camps any time soon.
For a society as technologically far along as the U.S., we do a surprisingly poor job of looking after our tiniest members. About 99% of all births in the U.S. take place in hospitals, yet we rank 29th in the world in infant mortality — below Hungary and tied with Slovakia and Poland — with 6.71 deaths per 1,000 live births. That compares to a rate of about 3.5 deaths per 1,000 live births in Far Eastern and Scandinavian countries such as Singapore, Japan, Norway and Sweden.