close to home: potentially fatal placental abnormality due in large part to previous cesareans

A still-rare (3/1000 births) but once incredibly rare (0.8/1000 before the rise in cesareans) and very serious placental complication, placenta accreta, is linked to having had previous cesarean(s). Because NJ, my home state, has the highest cesarean rate in the nation (for the 13th year in a row), one can extrapolate that we likely have the highest accreta rate as well. Here's a sobering story about a family in my town...

"We were making preparations for death," DeLeon-George, of South Orange, says now. "We grappled with a lot. There were a lot of what-ifs."

DeLeon-George had a rare condition. The placenta growing inside her was attached to scar tissue on the wall of her uterus from four previous Caesarean sections, forming its own extensive network of blood vessels, likely leading to massive bleeding — two units per minute — just as her youngest daughter Hannah was coming into the world. Essentially, the placenta, a life-giving organ for the unborn child, had become like a dangerous growth and had to be carefully extracted.

DeLeon-George’s problem is still a rare one for mothers-to-be, but doctors say as the rate of C-sections continues to increase, it’s apt to become more common. Called placenta accreta, it’s a disorder by which a placenta attaches to a previous C-section scar, and grows at an uncontrolled rate into vital organs such as the bladder, endangering the life of the mother.

meet the new Bill - more like the old Bill

a rousing speech in which Bill mentions infant mortality rates sucking in comparison to how much we spend on health care (about minute 7:01 on the counter)

drop in infant mortality

Yesterday the New York Times reported a 2% decrease (in 2006 numbers, the most recent available) in infant mortality, but...

Infant deaths in the United States declined 2 percent in 2006, government researchers reported Wednesday, but the rate still remains well above that of most other industrialized countries and is one of many indicators suggesting that Americans pay more but get less from their health care system.

and here's an important part, directly linked to birth practices:

Preterm birth is a significant risk factor for infant death. From 2000 to 2005, the percentage of preterm births in the United States jumped 9 percent, to 12.7 percent of all births. The most rapid increase has been among late preterm births, or babies born at 34 to 36 weeks of gestation. Some 92 percent of these increased premature births are by Caesarean section, according to a recent study.

Dr. Alan Fleischman, medical director of the March of Dimes Foundation, said that a growing number of these late preterm births might be induced for reasons of convenience. “Women have always been concerned about the last few weeks of pregnancy as being onerous,” Dr. Fleischman said, “but what we hadn’t realized before is that the risks to the babies of early induction are quite substantial.”

I wish we humans would realize our hubris & understand that just becasue we can does not always mean we should.

I also hope that people consider these factors when evaluating our healthcare system in this country - the numbers are the numbers and they clearly indicate that spending the most (twice as much, in fact) is not getting us to where we need to be.