In the preface to Robert Woods’ Death Before Birth (2009), he notes that “the circumstances that affect infants and children after live births are closely associated with their experience in the womb and at delivery.” While he discussed this in a historial perspective, the topic is still very important. First, let’s take a look at Woods’ work:
Death Before Birth is the first to really tackle fetal health and mortality in a historical perspective, from the 17th to early 20th centuries. While examining an immense amount of statistics, Woods notes that interpreting records for fetal health and mortality is difficult due to the disparities in descriptions and record keeping between hospitals. Definitions become important as the lines between perinatal, neonatal, and stillbirth blur. Scandinavian nations had more thorough and accurate records in the 18th century, while Britain scantily kept records prior to 1927.
Woods notes that the turning point in maternal/fetal health and mortality is in the late 1930s and early 1940s when antibiotics became available, which reduced puerperal infection. As technology advanced, the dangers of childbirth were further reduced through the use of ultrasound, blood transfusion, prenatal care, induction for post-term pregnancies, c-section for abnormal presentation, and the professionalization of maternal staff.
Most importantly, Woods discusses the importance of considering factors that could affect fetal loss: the skills of the birth attendant (midwives or doctors), and the health of the pregnant woman, including her social, economic, demographics, nutrition, disease environment, or even biological and genetic factors. Today, we know more about genetic and biological factors that lead to fetal loss, as they are the most common.
On August 28, 2014, Dr. Susan Stone wrote “Focus On Preventive Care As The Long-Term Strategy To Improve Health” The Huffington Post, discussing the idea that “there has been a lot of press about the rising maternal mortality rates in the United States in spite of the fact that we spend nearly $30 billion dollars a year caring for mothers and their babies.” Why is that?
Stone notes that “a contributing factor associated with many of these poor outcomes is obesity. The rising rate of obesity in the United States is affecting our health, and this is reflected in our birth outcomes. In 1962, just 13 percent of Americans were classified as obese. Today, that number is closer to 60 percent.”
Despite being a technologically advanced nation, our maternal mortality rates are slowly climbing. Historian Robert Woods has it right when he suggests that prenatal conditions and delivery circumstances contribute to the conditions that affect an infant after a live birth. However, it can further be suggested that prenatal conditions directly correlate to the health and well being of children for their entire lives.
What do you think? Should more attention be given to getting mothers healthy and prepared for pregnancy and childbirth? Is this a global issue?
It is widely accepted that nutrition plays a vital role in the health of a growing baby….how long before a pregnancy should a woman be concerned with her own nutrition to support a growing human?
Something fun: What foods did you crave while pregnant!! (My husband is adamant I ate too many pickles. I, however, do not remember it the same way he does.)