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U.S. Ranks 47th in Infant Mortality. Why?

This is according to the CIA World Factbook.

Why does the U.S. rank so high?  Is it due to the health of the mothers?  More premature babies being born (thus meaning that the average birth in the U.S. is more complex)?  Or is it the standard of medical care?

A website on evidenced based maternity care argues that the reason is that mothers-to-be get too many medical interventions.  This website argues that interventions such as Cesareans or inductions are helpful and often life-saving for high-risk mothers.  For the average mother, however, these interventions increase the likelihood of complications and increase infant mortality.

For example, when a group of about 50 labor and delivery nurses from across the nation were asked how many had witnessed a natural or “physiologic” birth in their educational programs, about half raised their hands.  When  natural or “physiologic” birth was further defined as:“undisturbed, without continuous electronic fetal monitoring, without I.V. fluids, with food or drink at will, freedom to move about and not confined to a bed” the number of raised hands dropped to one or two. The opportunity is simply not present.

The problem is that although these interventions are helpful for the average high risk person, they are not beneficial for the average women. Since Cesareans not only are more lucrative than natural births, but also reduce the time the physician needs to attend to the laboring mother during birth, many physicians prefer Cesareans.

What is the solution? The website calls for fewer routine interventions unless they are medically indicated. For instance, the site recommends the end of routine fetal monitoring, as it increases the incidence of interventions and inhibits the mother’s ability to do what is necessary to give birth physiologically. This routine is not justified for everyone by reliable research and is often the gateway to other highly questionable routines.

Visit the Improving Birth webpage for more information.


  1. Overall life expectancy is repeatedly cited to claim that the expense of US healthcare is wasted, and that only governments deliver inexpensive, quality care. This is supported by an intentionally biased interpretation of the statistics.

    USA Healthcare is First – Infant Mortality is Low

    John Stossel reviews this well. “Why the U.S. Ranks Low on WHO’s Health-Care Study” (at the above link) analyzes that life expectancy is a bad measure of a country’s health-care system. The US has far more fatal transportation accidents than other countries. Our homicide rate is 10 times greater than in the U.K., eight times greater than in France, and five times greater than in Canada.

    When you adjust for these fatal injury rates, U.S. life expectancy is actually higher than in nearly every other industrialized nation. That doesn’t show a healthcare problem.

    The infant mortality statistics are also carefully biased. The US counts every live birth toward its statistics, however premature, even if the infant lives only a few hours. European countries may only count infants that live at least a day or which meet other health criteria. So, they claim fewer infant deaths, which dramatically changes the statistics for infant mortality and average life expectancy.

    Critics claim that the US is spending too much compared to the numbers reported by foreign national health systems. I don’t believe that those systems are including all of their costs. Government programs do not accurately report what they spend, and they leave out required expenses of other departments not usually considered as part of healthcare.

    How is this for bias? The WHO (the U.N. World Health Organization) ranks the U.S. first in specific quality of care (many factors of patient satisfaction), then lowers the U.S. rank to 37th for “overall quality” because that care is more expensive, and is not being provided as a government service (!). Then, critics cite the lower rank to claim that U.S. healthcare delivers less, despite spending more. This is ironic and fraudulent.

  2. You need to do a better job vetting your sources and actually reading for comprehension. You’ve linked the homebirth cranks, who are against any medical intervention because they don’t believe in medicine. They are not “evidence based”. This is a MANA propaganda site.

    Midwife delivery is consistently shown to be 3-7 times more likely to result in neonatal mortality, which is the appropriate statistic to look at, or at maternal mortality. Infant mortality is the wrong statistic as it includes the first year after birth.

    Now, why is the US infant mortality rate so high compared to other countries? A few reasons, one is you chose a very poor source for international statistics (21 per 1000 is not accurate). Two, the US counts live births differently from several other countries. And three because some US states suck at infant mortality, and others don’t. The rates for states like Massachusetts, New York, California, are superior or comparable to the top nations in your list with 4.9-5.5 per thousand live births. Whereas down south, Mississippi is at 10.2, Louisiana at 9.4, and Alabama 9.5, etc. Go take a look at the geographic distribution of infant mortality in the US, and ask yourself if you really think this is a problem of intervention, or have you been duped by the midwives?

  3. Mark can you give me a source on you point that “Midwife delivery is consistently shown to be 3-7 times more likely to result in neonatal mortality” ?

    Thank you.

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