Are We Causing Our Incredibly High Preterm Rate?

The San Francisco Chronicle on the national trend towards C-section:

The Centers for Disease Control and Prevention have tracked an increase in preterm births for decades, with the percentage of births delivered before 37 weeks of gestation rising 21 percent between 1990 and 2006. That increase is the main reason the nation's infant mortality rate has stubbornly refused to decline, remaining higher than most other developed nations.

Some preterm births were linked to mothers' smoking, and others to the mothers' lacking insurance. But more than 90 percent of the increase in preterm, nonmultiple births is attributable to an increase in babies being delivered by C-section at 34 to 36 weeks gestation, according to the March of Dimes.

"It comes from a general change in obstetric practice in our society," said Dr. Alan Fleischman, medical director of the March of Dimes Foundation. "The doctors and the women are intervening in a much more aggressive style toward the end of pregnancy."

Fleischman and other medical experts say there are a number of reasons doctors and mothers are choosing C-section delivery - and not all of them stem from medical necessity, the health of the mother or infant.

Read the rest of the article here.

New York City Midwifery Care - 1931-1961

The Maternity Center Association, New York City ~ 1931-1961

From 1931 the Lobenstine Midwifery Clinic of New York City, in affiliation with the Maternity Center Association (MCA), offered home birth services to help meet the needs of the most economically deprived and needy families of the upper Manhattan tenements. Between 1931 and 1961, 5,766 mothers registered with the clinic, of which 87% gave birth at home, attended by midwives. Their maternal mortalities were less than one third the national rates of the time. Their average neonatal death rates were only 16 per 1,000, while that of New York City as a whole ranged from 28.9 in 1931 to 18.4 in 1961. These results by the MCA midwives are even more remarkable in light of the fact that poor nutrition was prevalent among their clients. 36.4% of them suffered from secondary anemia, 6.3% tested positively for syphilis and 6% were in their tenth pregnancy. The MCA discontinued its home birth services years ago, but retains its legacy of superior outcomes.

~ From Law, M., Report on the Maternity Center Association Clink, NY, 1931-1951, American Journal of Obstetrics and Gynecology, 69:178-184, 195S.

~ Faison, J., The Maternity Center Association Clinic, NY, 1952-1958, American Journal of Obstetrics and Gynecology, 81:395-402, 1961.

These data and additional studies which I will be posting and crediting to Dr. David Stewart's work have been excerpted from his book, The Five Standards for Safe Childbearing, by Dr. David Stewart, Ph.D. Dr. Stewart is a medical statistician with special education in obstetrics and is one of the leading world authorities in the area of midwifery and home birth statistics. He has been an invited lecturer at meetings of the American College of Obstetrics and Gynecologists (ACOG) and the National Perinatal Association (NPA) and numerous other childbirth-related functions throughout North America. He has served on committees of the American Public Health Association (APHA) and the American College of Nurse Midwives (ACNM). Dr. Stewart is the author or co-author of more than 200 publications, including 13 books. He serves as the Executive Director and co-founder of the International Association of Parents and Professionals for Safe Alternatives in Childbirth - NAPSAC International.

For more information, or to purchase The Five Standards for Safe Childbearing, contact:

NAPSAC International

Rt. 4, Box 646

Marble Hill, MO 63764

Phone/Fax: (573) 238-2010 or

(800) 758 - 8629