American mothers and babies are dying during childbirth far too often, a recent report from the National Institutes of Health confirms. Poor data practices could stand in the way of policy solutions to this major public health concern.
Stillbirth is a stubborn health problem in the United States.
While the United States has some of the most comprehensive health care on the planet, stillbirth remains a common problem. The risk of a fetus or baby dying in the womb is far more common in the U.S. than it should be.
Some studies suggest the U.S. may be witnessing the highest rate of stillbirths in several decades, partially attributable to inadequate access to obstetric care during pregnancy. Race is also a factor in the likelihood of stillbirth and the accurate diagnosis of a cause after death. Significant disparities exist in maternal and fetal outcomes based on geography, race and income.
More data and better funding could help.
The risk factors contributing to this national trend are not widely understood, perhaps because data on stillbirths are difficult to obtain.
Best practices in perinatal care — and in the worst cases, perinatal pathology — can help us understand these troubling trends. When babies are stillborn, for example, grief should be balanced against the urgent need for accurate medical data. Fetal autopsy, while it may be controversial for some, offers significant insight into causes of death, and therefore, prevention. Understanding the causes of stillbirth and other adverse outcomes can contribute to life-saving progress.
Federal agencies should also collaborate with state and local officials to reduce barriers to obstetric care for rural or low-income women. More funding is needed to expand research into stillbirth in communities most in need of support and also to provide active intervention in those communities.
Stillbirth rates should be falling, not rising. Best practices and more robust public health funding could help the U.S. understand — and ultimately prevent — stillbirths.