Our UC Stats

[Serenyd]

From the roll call and birth stories sticky

485 births

4 infant deaths, 0 maternal (causes: cord wrapped too many times around neck, uterine ruputure, shoulder dystocia w/ cord compression, fetal demise - they believe baby passed away before labor began)

43 transfers (not all emergent, some were for pain relief/prolonged labor)
10 cesareans

0.8% infant death rate
8.9% transfer rate
2% cesarean rate

[weliveintheforest]

Interesting!

[Devaskyla]

Very interesting. How long did it take to calculate that?

[truejoy]

wow, thats good to know.

[Serenyd]

It's hard to compare our statistic to U.S. statistics because of many factors.
Perinatal, neonatal, intrapartum, and fetal mortality rates all have different meanings. Perinatal is late term intrauterine death and early neonatal death (1st 7 days), neonatal period is 1-29 days of life, intrapartum is death during labor, and fetal is synonymous with stillbirth. All four infants were "stillbirths" but one was dead before labor began, one died d/t uterine rupture during a UBAC (higher risk), and two died of fetal asphyxia.

These were the best statistics I could find:

U.S. 2003 - 6.74 deaths per 1,000 fetal deaths and live births. This includes
Infant deaths of less than 7 days and fetal deaths with stated or presumed period of gestation of 28 weeks or more. This is the perinatal death rate.

This is a death rate of about 0.7%

We really need more numbers to draw any significant conclusions but I think our numbers look pretty good! I'd also encourage any lurkers who UC and don't ask to be added to the birth rolls to do so, to help those considering UC to make an informed decision. Post your birth stories so others can learn from them. We have to help each other.

Source for US perinatal mortality stats: http://www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_06.pdf

I know, I know, I'm such a nerd.

[TzippityDoulah]

wow you are on the ball with math! that made my head spin haha

that is really neat to see "on paper" like that!! thanks for sharing!

[ErinBird]

Remember tht the UC roll call contains self-reported results- one of the least accurate methods of data collection. I know my UC is on the list, but if I had transferred I might not have returned to this space to announce the birth, or to have the statistics added to the roll call.

[amberskyfire]

That's very interesting! I was hoping at least that the infant mortality rate would be better than the national average, but then it's hardly a scientific study, plus we need a lot more births to get a more accurate picture, and one of the stillbirths was because the baby passed away before labor, not because of unassisted birth.

The results were not disheartening, however. I think they are awesome and show that not only in unassisted birth AT LEAST as safe as hospital birth, but that we mamas are intelligent and know to transfer if we need to. Too many people believe that we are trying to be martyrs and kill our babies just to have a crunchy experience. Now I can show husband's family that we are at LEAST as good as doctors. Yay!

Go mamas!

[delicate_sunshine]

Thanks so much for this. It really helps put things into perspective with numbers and statistics attached.

[phatchristy]

Originally Posted by ErinBird

Remember tht the UC roll call contains self-reported results- one of the least accurate methods of data collection. I know my UC is on the list, but if I had transferred I might not have returned to this space to announce the birth, or to have the statistics added to the roll call.

:

I know some here IRL who post on MDC, one with a sad outcome and they're not on the stats page.

We could only get an accurate picture if we were to have two similar groups with women from similar backgrounds one with birth attendants and one without. There are also big variances with UC too...some have no outside prenatal care, some have shadow care with some sort of health practitioner. There would have to be a way to account for those differences. We'd likely have issues with sample size I'll bet as well.

[Serenyd]

Originally Posted by phatchristy

:

I know some here IRL who post on MDC, one with a sad outcome and they're not on the stats page.

We could only get an accurate picture if we were to have two similar groups with women from similar backgrounds one with birth attendants and one without. There are also big variances with UC too...some have no outside prenatal care, some have shadow care with some sort of health practitioner. There would have to be a way to account for those differences. We'd likely have issues with sample size I'll bet as well.

You're never going to get two perfectly balanced groups. It's impossible. This is a problem with any study. That is why they have limitations. Also, I know there are some people who lurk and UC with sucessful outcomes and never post. Some UCers are kind of shy about their private lives, YKWIM? Some don't care about being on the birth rolls. So I just used the information we already had. Maybe it is not perfect, but it is more information than we had before.

[jenneology]

Thanks for doing this! I'm excited to show my husband.

One thing that I find interesting, of the fetal deaths (oh I hate sounding this clinical knowing that there are mamas on here who lost their sweet little ones) is I think that most could not have been prevented by being in the hospital. Although that raises questions, were those 4 births hospital transfers, or did the deaths occur at home? I think that further investigation into the causes of death for those children would be a good thing to do. The UK has the maternal death reporting system and describe how mothers die in childbirth, giving a final conclusion for what happened, if it could have been prevented and if someone was responsible. I think that doing that for these births would be beneficial information for women seeking to make the UC decision.

[jenneology]

Originally Posted by amberskyfire

That's very interesting! I was hoping at least that the infant mortality rate would be better than the national average,

I actually think that its a good thing to see that the UC rate here is about the same as the national average. No matter how hard we as mothers and they as doctors, specialists, experts, policymakers, etc try to prevent all fetal deaths, its not ever going to happen. There will always be a portion of risk to childbirth, its inherent to life and the process. Those 4 deaths could likely be unpreventable and were going to happen regard of the birth location, and attendants.

To me, those deaths all sound to be "organic" in nature meaning that they likely could have happened in a hospital as well as at home--no one, not even the demi-god OB could have prevented it (I'm going off of really limited information to make that speculation).

I think there's also an interesting point to be made about iatrogenic causes of death. Iatrogenic means that it was doctor caused. Is those deaths were unpreventable, then the additional variable of doctor negligence would be taken out of the equation. Or it would be transferred from doctors to families who are the ones embracing the responsibility of that birth and we could speculate that parents could be just as likely to make "mistakes" as highly educated, paid and skilled professionals are. Maybe that's where OBs are the most afraid, they realize that the stats could support the conclusion that they all their effort really is uneeded in most cases.

Another thing about making this analysis of stats comparable, is that we'd need a whole lot more UC stories. The infant mortablity rates and maternal mortality rates are measured by porportions of 100,000 to minimize variablity due to chance. Our sample is only 450. However, I still think that its very informative. Really, is anyone interested in writing up a research study on this and getting it published after asking permission for the UCers here to be included?

[jenneology]

Also did you count this one?

http://www.mothering.com/discussions...2&postcount=24

Not sure if you would because its reported by a friend and not by a member.

[knitted_in_the_wom]

Originally Posted by Serenyd

It's hard to compare our statistic to U.S. statistics because of many factors.

...

These were the best statistics I could find:

U.S. 2003 - 6.74 deaths per 1,000 fetal deaths and live births. This includes
Infant deaths of less than 7 days and fetal deaths with stated or presumed period of gestation of 28 weeks or more. This is the perinatal death rate.

This is a death rate of about 0.7%

I will note that a certain blogger is comparing the UC data presented here with the CNM hospital neonatal death rate and coming out saying that the UC death rate is 20 times higher...

I take issue with comparing the UC numbers with CNM numbers on the CDC wonder data set. My biggest reason for taking issue is that in the case of the CNM data, I'd bet my house that there are a good number of neonatal deaths not being attributed to CNMs in that data set that started out as intended CNM births, but at some point transferred to OB care, and are thus reflected in the OB numbers.

How many of the 4 deaths reported here as UC deaths had actually already transferred to OB care prior to the death?

Then there is the issue of that blogger only cherry picking what she considers to be "low risk" CNM births--after 37 weeks, white non-Hispanic, blah, blah, blah.

Is this REALLY reflective of the UC population birthing here? How many of the UCer's here are doing VBACs which many CNMs are not "allowed" to attend? How many are less than 37 weeks? How many have undiagnosed GD, are "too old" for CNMs...or whatever else risk factor you want to throw in there?

As others have pointed out...you are working with a "self selected" data set...so the true results could be skewed a LOT in either the direction of a higher or a lower death rate.

And finally...statistical significance. If there had been only ONE death in the UC group, that blogger would be crowing that the UC death rate is 5 times the CNM death rate...but obviously there is an issue of statistical significance going on.

Jenn

[jenneology]

Ok, I'm just demonstrating my obsessive birth/researcher tendency now...

I'm also interested in how many women who UC'd here would say after the fact that the experience was traumatic.

I'm considering a PhD program where I would do a dissertation on traumatic birth (PTSD, anxiety and depression after births that were scary/disappointing/abusive). It would be interesting to compare the incidence of trauma in UC and homebirths to trauma in hospitals. I have the theory that trauma in hospitals is much more likely to occur and that it should be added as a indication of morbidity (after the fact health conditions, illness, disease and wounds that are left over and do not include death).

[amberskyfire]

Originally Posted by jenneology

One thing that I find interesting, of the fetal deaths (oh I hate sounding this clinical knowing that there are mamas on here who lost their sweet little ones) is I think that most could not have been prevented by being in the hospital. Although that raises questions, were those 4 births hospital transfers, or did the deaths occur at home? I think that further investigation into the causes of death for those children would be a good thing to do.

If you go look at the list, the mothers actually have stories posted that explained what happened. For most of them yes, I think they would have happened the same in a hospital. One happened unexpectedly AFTER the hospital transfer while the baby had been doing pretty much okay until the emergency happened, but that was after the transfer. One had died before labor began. A third died at home because the cord was wrapped too many times around the neck causing the baby to suffocate because it was stuck for I think 20 minutes while crowning. While it's possible that that one could have been helped by being in hospital, I don't think it would have been as they probably would not have continued monitoring as the baby was coming out. Baby would have had to be pushed back in for a cesarean. It was just one of those freak occurrences, you know?

It's important to know, of course, that sometimes these things just happen and whether in a hospital or at home, there really isn't anything that can be done in some cases. My heart goes out to those mamas who have lost their little ones. They are living my nightmare and to be so strong and brave after the death of your baby is a strength I don't know if I could ever aspire to.

[Romana]

Originally Posted by jenneology

I'm also interested in how many women who UC'd here would say after the fact that the experience was traumatic.

At least one.

The hospital part of the birth was not traumatic. The PTSD I experienced was due to the UC, at-home part.

[hollycat]

with my stillbirth a birth story was the last thing i wanted to write. tho i think some women need to do it, i think its pretty common not to.

[mamabaig]

I was reading the unnamed blogger's post and found out about your UC stats. I have left a reply to the other uc stat post adding my 4 UC's. HTH!

And yes, I think it is important when comparing that many uc's are *not* low-risk. My last baby was my 7th, born at age 38, without *prenatal care.*

Spirit-Led Birth
Emergency Childbirth