Examining Infant Mortality Rates

Measures of Success: A look at the true meaning of infant mortality rates in the United States. (My Tech Central Station column.)

One of my readers, an obstetrician, has been thinking along similar lines:

As an Ob/gyn doctor, you can imagine how fed up I am with all this brouhaha about infant mortality rates. The one thing most people don't understand is that not all countries calculate the rate the same. Some countries do not even include perinatal deaths- the baby has to be several days old until it "counts". And I doubt no country on the face of this earth expends more time and money getting very sick and premature babies to the point of viability so they can be delivered and have a (sometimes very long) shot at life. In addition, I'd like to know what the percent of triplets and higher-order gestations are in Cuba. We have IVF programs on every street corner, it seems, and the March of Dimes has recognized this as one of the driving forces behind our increasing rate of prematurity, which hovers around 11%.

I have a feeling that if we end our infertility programs and let sick babies die in utero or simply terminate those unfortunate pregnancies, we'd improve our stats considerably.

The other factor, which I didn't mention in the column is that our C-section rate is much higher than other countries. Outs hovers around 26%. Most countries with low infant mortality rates have a C-section rate of 10% or less. Whether our higher rate is due to higher rates of complicated pregnancies (multiple births, at risk preemies, etc.) or because of our fear of litigation, it's hard to say. Probably a little bit of both.