Last month on The PediaBlog, we applauded declining teen birth rates reported by the American Academy of Pediatrics while also considering the reasons why the solution to this problem remains elusive:
Poverty and lack of education have long been the key problems influencing teen birth rates, but the study suggests that other factors, like the availability of reliable sex education and access to the health care system, may also come into play in creating the clusters of high teen birth rates. Clustering is more likely to occur in southern states; northern states generally have lower teen birth rates. What is clear is that preventing teen pregnancies from happening in the first place should be the essential goal of any policy put forth. Alleviating poverty, improving our public education system (and providing effective sex and science education), and expanding access to health care, including contraception strategies, are essential targets for a satisfactory solution to a problem that affects all of us.
Overall, according to a new study, 3,941,109 babies were born in the United States in 2016 — a decline of 1% from the year before. Birth rates fell for teenagers (down 9% for 15-19 year-olds in 2016) but also decreased among all maternal age groups. The cesarian section rate has fallen each of the last four years, however, almost one-third (32%) of babies are delivered in this fashion. Unfortunately, two pregnancy outcomes — prematurity (born before 37 weeks gestation) and low birth weight (2,500 grams or 5 pounds 8 ounces) — have seen increases, all in a nation that already leads the way compared to other developed countries, says Maggie Fox:
Already the United States has much worse rates of infant mortality, preterm birth and low birth weight babies than other industrialized countries. The new data from the CDC’s National Center for Health Statistics (NCHS) shows no improvement.
“The increase in the preterm birth rate is an alarming indication that the health of pregnant women and babies in our country is heading in the wrong direction,” said Stacey Stewart, president of the March of Dimes, a charity focused on ending birth defects.
“Preterm birth is the number one cause of death among babies and a leading cause of lifelong disabilities,” she added.
The usual suspects — obesity, tobacco use, exposure to pollution and toxic chemicals, socioeconomic status, geographic location, lack of prenatal care — help explain why 130 countries have lower rates of preterm births. For example, the risk of low birth weight is doubled for African-American babies compared to white babies. Southern states seem to have more problems than northern and coastal states do in producing healthy birth outcomes. These same states, many of which are rural ones which rely so much on rural health clinics and hospitals, also struggle with providing health care for their citizens. In the U.S. in 2016, only 77% of pregnant women began their prenatal care at the ideal time — during the first trimester — and 6.2% didn’t receive care until the third trimester or received no prenatal care at all. Exposure to chemicals, pollution, and emissions of industrial toxicants is also associated with adverse birth outcomes. Exposure to particulate matter (PM2.5) and other air pollutants have been linked with prematurity, low birth weight, miscarriage, and birth defects. A 2015 University of Pittsburgh study found an association between proximity to shale gas (unconventional natural gas) wells in Southwestern Pennsylvania and low birth weight; a 2014 study by researchers in the Colorado gas patch found an association between living in proximity to unconventional natural gas wells (fracking) and the development congenital heart disease, which can be a serious birth defect in newborns.
Not every infant in this country comes into the world with the same genetic profile, prenatal exposure pattern, economic opportunity, zip code, or access to future health care. And while the problems we are discussing today can affect anyone, their solutions — lower obesity rates, avoid tobacco, tackle pollution in all its forms, ensure health care for every American citizen — improve the lives of everyone. That’s something we could all applaud.