Why is the infant mortality rate in Cuba lower than in the United States?

Different Population!?

My understanding, however this isn’t authoritative so please correct me, is that in the US far more infants are attempted to be saved that would in other countries be considered stillborn.

Edited to add, this article: http://health.usnews.com/usnews/health/articles/060924/2healy.htm

Apparently if you look at the IMR + the PNM (deaths after 22 weeks), it can reveal interesting trends in the more industrialized countries.

Simple answer would most likely be the difference in Population and boils down to Numbers..

Sorry! It’s the infant mortality rate per 1000.

Seems though, developed countries have it less, while developing and other countries have it more. Reasons could be:
-availability of facilities, both technical and human, at the right place and on the right time.
-awareness amongst people.
-skill/expertise of doctors/surgeons.
-climate/weather.

But, again, I’m thinking of population and numbers. How did they reach per 1000? Averaging might distort the numbers.

We definitely attempt to save younger and smaller neonates in the US. We also are probably more liberal with our definition of “live birth” (ie. even an aborted fetus with a gasp or heartbeat are considered live births, as are neonates well under survivable gestations or birthweights with fleeting vital signs).

The difference between developed nations is in the definitions. The difference between developing and developed nations is access to care and technology.

Cuba has a very high incidence of abortion, although I believe China’s is even higher. They may be culling fetuses that show signs of, say, low birth weight, so only the healthier ones are being brought to term.

After the fall of the USSR, Cuba was immediately and vastly impoverished, having lost their Soviet subsidies.

At that time Castro and his government made the decision to institute widespread preventative medicine as a strategic measure, realizing that the cost would be far lower than the cost of treating developed illnesses.

So health care in Cuba is highly structured. Every neighborhood has a Doctor to which people can walk for treatment, and all treatment is paid for by the State (single payer insurance, our huge bugaboo.)

The result is that while not as technologically advanced (no MRI’s for instance) the Cuban system provides better access to routine healthcare for every resident.

@pdworkin said it best. The main focus of the Cuban health care system (which is extremely effective) is and has been prevention, mostly due to budgetary concerns. They have made great strides in public health and prevention across the board.

I think the mortality rate for Cuba is determined by the number of inhabitants, not the number of infants.

@grumpyfish – Interesting article. I wonder whether there that many babies weighing 500 grams or less in a group of 1000 to explain the difference.

It is quite intriguing to see a country under such a heavy economic embargo still manage to uphold such a level of health care.

My suspicion would be that since preventive care and mediation is free in Cuba, the average medical support for people is better in Cuba than in the US, for as far as it is relevant to the infant mortality rate.

@SpatzieLover the “Infant Mortality Rate” is determined by the number of infants… hence the name.

@all Here’s a great article to read on the how’s and why’s of Cuba’s infant mortality rate

@Dr_C I know how the numbers are taken and used. In some cases deaths are not recorded the same way

@SpatzieLover – Cuba has a death category for “ADD”?

Does that stand for something other than Attention Deficit Disorder?

@Cupcake I think ADD is caused by environmental issues (lead paint-etc) however, I haven’t a clue how it could be diagnosed in an infant. Maybe a brain autopsy?

Accidental Death or Dismemberment?

@mattbrowne I think it’s a combination of issues—and we’re talking about a difference of around 3 in 1000, which is miniscule.

It’s a large enough sample that we should be getting good statistical data.

@Cupcake No I don’t think there is another “ADD”.

good question

@grumpyfish – So do you think the US is doing enough when it comes to lowering the infant mortality rate? What about pregnant women without health insurance? Do they all get medical care or does this depend on donations? How does this relate to the current political discussion about health insurance for everyone?

I know these weren’t directed at me. But I thought I’d answer anyhow. Perhaps not the most brilliant answers but hey here is my two sense. This is a very important issue to me personally.

So do you think the US is doing enough when it comes to lowering the infant mortality rate?

Not at All! In fact I live in the county with the highest Infant Mortality rate in the United States. There are two support groups and just recently one research group. Nothing else in terms of support or prevention. It is a big deal but gets no media attention and little support from other resources.

What about pregnant women without health insurance?

From recent experience. Not all women can get health insurance or health care while pregnant.

How does this relate to the current political discussion about health insurance for everyone?

I think it should be a bigger factor. Good point.

I question whether infant mortality should be part of the health care debate that is going on now. I think most women have access to basic health care while pregnant.

I would want to know if in the US we have statistically more drug addicted mothers than these other countries, if we are counting babies born in the 5th month when other countries don’t. I don’t have confidence the stats are apples to apples.

I think possibly infant mortality is more of a comment on society in general than our health care system.

Having said that I am all for preventative health care including maternity health care being more accessible and available to everyone.

Um…maybe because the government actually invests a considerable proportion of their meagre economic resources into health care, despite being financial hobbled by the American imposed trade embargo, that aggressively curtails Cuban commercial interests, even with non American countries. So despite all this a tiny country like Cuba has generated one of the best health care systems in the world, yet America for all it’s might can’t even get close to universal healthcare. Forget the Berlin wall, and the so called, triumph of capitalism, Bring down the Trade Embargo and really give us something to celabrate. Btw, when is obama closing the detention camps in Guantanamo, come to think of it when are the Americans leaving the Guantanamo period, in case they didn’t notice it’s a sovereign state and they aren’t invited.

There is also a problem with full term births. In the US our mortality rate is higer than most developed countries. It can be attributed to poor pre-natal care and # of births to early teen (physically and mentally immature) mothers.

@galileogirl are you saying that in some of these other countries the high risk groups are more likely to get abortions or use birth control hence making the pool of babies born more likely to be stronger?

Can data coming out of such a brutal communist dictatorship be considered reliable? It’s hard enough to compare data between democratic nations because each has its own standards and degree of transparency.

@Jack_Haas You are talking my language!

@JLeslie I am saying that in the US pre-natal care is not as available as other 1st world countries, especially in poorer communities, something that universal health care might alleviate. But we also have a problem with early teenage mothers whose bodies are less cabable of a trouble free delivery and the number of young girls who do not live the the healthy lives necessary to have a successful outcome and do not get care for a number of reasons. Since infant mortality extends to the first birthday we see higer death rates during the 1st year for those reasons also.

@Jack_Haas what you are mixing up is freedom of speech and free medical care. The brutal Communist regime does provide standard medical care to everyone. They may not be able to save the 22 week preemie or the acephalic newborn, but they offer free pre-natal care and have healthier mothers and thus healthier babies. Wouldn’t it be nice if we had as much free health care as we have free speech? Check out Masow’s principle.

@galileogirl thanks for explaining.

@Jack_Haas you are so dependable it cracks me up. We kidnap and torture people, and they’re brutal Communists whose birth data (monitored by the WHO) can’t be trusted. Well, at least you’re good for a laugh.

@SpatzieLover Nice! I thought I was stuck with frenglish, at least it’s a step in the right direction.

@pdworkin Based on a couple threadsI have this impression you and comrade galileogirl have me confused with a mirror.

I have no idea what that means, but then I seldom know what you mean.

@pdworkin And I suggest we all leave it at that.

@Jack_Haas U R Hilarious! ;D

@ all. I am part of a loss community. Not one of the mothers I know had a loss due to poor prenatal health care or due to drug use or having children while they were “too young”. Or any other factor attributable to mother. It happens (to them) because of health problems that are either not preventable, not treatable, or go unnoticed until it is too late. Having said that I still think that having better access to health care would help tremendously, especially prenatal health care, only to be certain that this isn’t a causal factor.

It seems like people are attributing a lot of factors to infant mortality (in the US) that are simply not the overwhelming case but rather what gets media attention. Everyone I know in the community has had a loss not attributable to any such factors. It just seems to me like some stereotypes are floating around that make sense, yes, but are not entirely accurate from what I have seen with personal experience.

Also the health care system needs to do a better job at finding out these medical causes and preventing them. There certainly is not enough research being done in this area. Just ask the March of Dimes.

@JLeslie . I think most women have access to basic health care while pregnant.

Sadly this is just simply not true.

There are treatment inequities all across the United States, largely defined by income. People who do not qualify for SSID generally have very poor health care. If you impose a map of the incidence of high infant mortality over a map of the United States, you will find that it is the neighborhoods with the lowest socio-economic status that correspond with the high mortality and morbidity. In brutal Communist Cuba, health care is available to all at no cost.

@pdworkin I don’t think there is any arguing with that point. People with low socio-economic status have the highest rates of all sorts of medical (and other) issues.

Is this response in reference (or rather in argument) to something I said? If so I’m failing to see the connection and I apologize.

…infant mortality rate in Cuba lower…

Fidel personally hands out the cigars…..

It was intended to support what you said about health care inequalities. I was agreeing with you, in my cumbersome way. Well, I was both agreeing with you and taking yet another gratuitous shot at @Jack_Haas.

@pdworkin I guess I’ll put on a big smile then. :) again apologies for being dense

I was the one who was being dense.

I can’t find it now, of course, but a couple of years ago I found a chart that listed breastfeeding rates by country. When compared to a chart listing infant mortality rate by country, many of the countries where babies are routinely breastfed exclusively for the first few months (and continue to breastfeed well beyond that) had the lower mortality rates. There could be many factors involved, but I found it interesting that places where mothers tend to breastfeed more often and for longer periods of time had lower infant mortality rates.

These graphs puts the US in an even worse light. We’re nowhere near the top of the list. The most recent breastfeeding info by country I could find is in a different format than the mortality rate chart so not easy to compare. However, some of the countries that have a lower mortality rate than the US also have higher breastfeeding rates. Sweden has a 97% initial breastfeeding rate. Norway’s is 99%, Czech Republic is 92%, Spain is 91%, Denmark is 98%. The US has an initial breastfeeding rate of 70%. That means 70% of moms here start out breastfeeding compared to 98% in Norway. Norway has about half the infant mortality rate as the US.

I’m sure there are many, many contributing factors, but I wouldn’t dismiss breastfeeding as one of them.

@MissAusten that is an interesting consideration

@MissAusten Many of the countries you mention have 6 months to a year maternity leave.

@RedPowerLady I think @galileogirl point is important. A lot of this thread was about women getting proper pre-natal care, but maybe infant care is what is more important in these particular statistics. Have we clarified the ages of death? I might have missed something.

It would also be interesting to know the causes of death at least divided into sudden illness (like pneumonia or meningitis), genetic causes (some of the countries mentioned by @MissAusten have very homogenous populations), premie/low birth weight.

Maybe age and marital status of the mother matters for pre-natal care because single and/or young women probably have a higher incidence of being late to admit to themselves they are pregnant. I could be wrong. I do personally know a woman who waited until her 4th month to see a doctor and she was married and middle class with plenty of access, just did not want to be pregnant. We, some of the women at work, actually told her she was pregnant a few times until she finally went to the doctor.

Generally, infant mortality measures perinatal mortality, which is to say during or just after birth, which suggests that the breastfeeding statistic may be an artifact or may actually be measuring something else, like an attitude, perhaps, that affects infant mortality.

The definition of infant mortality rate is “the number of infant deaths (one year of age or younger) per 1000 live births.”

The infant mortality rate isn’t just the number of babies that die during or shortly after birth, but during the first year of life. Various diseases (as well as SIDS) are the most common causes of death during the first year of life. Since breastfeeding passes a certain level of immunity to the baby from the mother and also decreases the risk of SIDS, I don’t think maternity leave or parental attitude has too much to do with it.

It is perfectly possible to breastfeed while working. It’s just easier not to, harder to find good advice/help if you try it, and very difficult to spend time and energy explaining yourself to people, working with a boss who doesn’t care that you need to pump, and many other reasons. My first experience trying to work a full time job while breastfeeding an infant did not go well, so I know first-hand how how hard it can be. The second time went much better, so I also know first-hand how easy it can be. It all depends on your resources and what information you arm yourself with.

Like I said before, I’m sure there are many factors that contribute to a country’s infant mortality rate. Prenatal care, level of education, breastfeeding, access to good nutrition and clean water, and many other things. I am probably not expressing it well, but I have a four year old sitting here begging to play Webkinz and it’s very distracting!

@Jack_Haas – This is a good point. I despise all totalitarian regimes as well and Cuba is certainly bad, only slightly better than North Korea. But keep in mind the data comes from the CIA and I assume they have very reliable sources. And there’s a second number coming from the UN which would certainly question Cuba if they are trying to fake the numbers.

My point really was about how can critical Republicans be motivated to abstain from overly harsh criticism when it comes to health care reforms. The United States is a great country and it managed to send people to the moon so I would expect many people being eager to do better than Cuba when it comes to infant mortality. Competition can be a good thing for making progress. However, if we are comparing apples with oranges, things look different. Therefore I asked this Fluther question. To find explanations for this curious fact why the US is ranked lower on this CIA list than Cuba.

@all In the US Infant Mortality is after birth deaths only. I find that interesting. But since we were asking about it I thought I’d look it up. Now I see others have stated that as well. It would be interesting to also include pre-birth losses, they may relate moreso to lack of access to health care but still not at the fault of the parent..

Having said that I still want to emphasize that infant mortality is most often not the fault of the parent. And I still see some hints of beliefs in that direction. So I just want to make it clear. Apologies if that is not the case but it is a good point nonetheless.

This graph isn’t necessarily clear on that point but it may be of interest in the discussion. It graphs out leading causes:
Causes of Infant Mortality

This article is a bit more clear. It does emphasize my point that it is not parent’s fault.
Leading Causes of Infant Death

I’m not sure this adds anything to the debate about why the US has higher rates. But it is a point I wanted to make anyhow.

thanks @MissAusten I am always learning things on Fluther

@mattbrowne A democratic country like france has a “secret” police whose agents are tasked with monitoring any suspicious activity among the public. They have complete cooperation from hoteliers, restaurateurs, etc… as a foreigner working in france you must have been “studied” by one of these agents. They innocently sit in cafes, hotel bars, observe and listen to people inconspicuously. They follow suspicious looking tourists around etc… I don’t think CIA agents would risk the kind of humiliation their country would suffer if Castro’s far more powerful and omnipresent secret police caught them gathering health care related data the regime doesn’t want to be made public. I simply can’t imagine that anything the Castro regime doesn’t want released could be.
As for the UN proofing data from an evil regime, it was a funny joke, thanks!

Even between the US and Europe we’re comparing apples and oranges because even democracies cook the books to look better. The Paris-based WHO has been suspected of applying EU-centric standards for a long time now. The UN? As long as the results don’t show the US and Israel in a good light they’ll validate just about anything.

When it comes to infant mortality rate I remember reading about an objection from US news and World Report in a Wikipedia entry: in the US, the loss of a day old fetus is considered infant loss while European countries only include fetuses 16 weeks and older. It’s only one example, maybe there’s a lot more so I wonder about the WHO rankings’ validity.

@Jack_Haas >>>maybe there’s a lot more so I wonder about the WHO rankings’ validity.

I can tell you from how WHO is handling the swine flu here in the states, I do not trust their figures. It is now up to each state to report cases. So on the surface it looks like Wisconsin is inundated with H1N1, but in reality, our Health Depts, hospitals and universities are just more on top of testing patients when they have flu-like symptoms.

This is why I question how the numbers coming out of a communistic country can be trusted to be obtained in a reliable fashion.

@SpatzieLover I completely agree. As a medical data analyst (whose job is to collect and analyze data regarding neonates) I assure you that numbers and statistics are easy to manipulate (even with good intentions!) and difficult to compare. All countries (and counties and cities) have different data collection and reporting standards.

Localities with well thought out, inclusive and rigorous data collection and reporting can be viewed as having poor quality care.

Localities with multiple data exclusions (ie. < 500 gram births, within 1 day of birth, with APGAR score < 3, etc.) can be viewed as having high quality care.

It’s all in the data definitions.

@Cupcake Thanks for the insight. I’ve read a few books on statistics and scientific error. I now question most figures I read because of it.

I’m more likely to question any stats from a communistic country. A dictator would certainly want to portray his country as “better”.

@SpatzieLover Great example! There are already so many functional disparities between US states. Imagine with countries that have cultural and customary disparities on top of that. It’s not apples and oranges but the whole produce alley.

Obviously, you can imagine the additional incentives to report the right statistics in a country where doctors and scientists can either disappear without a trace or be sent to psychiatric facilities for slight “readjustments”!

@RedPowerLady I can’t imagine blaming a parent for their child’s death under normal circumstances. Obviously breastfeeding has nothing to do with congenital defects or premature births. The vast majority of infants in the US who aren’t breastfed grow up just fine, and babies who are breastfed do get sick and die, or do die from SIDS. I just thought the possible link between breastfeeding and infant mortality was interesting. I’m sure it’s clear by now that I am a big fan of breastfeeding, but I don’t think it’s the defining factor of parenting.

Also, the main causes of infant deaths worldwide are not the same main causes of infant death in the US. I should have been careful about what I was looking at when I said above that various diseases and SIDS are the leading cause of death. From the information you provided, that apparently isn’t the case in the US. It just goes to show that what’s true for one part of the world isn’t necessarily true for another part of the world.

@MissAusten Yes I was certainly talking about main causes in the US. And I was not referring to your statements on breastfeeding. I really do find the information interesting. I don’t think breastfeeding is causally linked to infant death but perhaps it is correlated somehow. Or if not it could just be an interesting piece of information. I am also a huge fan of breastfeeding :)

I was referring to statements about parents using drugs, purposefully not getting health care, having children when they are too young, etc.. Statements which have been made in some way within this thread. I just don’t like the slight references that parents are somehow at fault whether that is what is intended in such statements or not. It is horrible to blame parents in any way for their child’s loss when most often they have played absolutely no part in it. I just want to break down that stereotype, If in fact it does exist.

They have decent health care for all instead of massively fantastic health care for the rich and no care for the poor.

And despite the immature fantasies of some, a totalitarian society may suppress political
opposition without denying basic needs. So says “comrade” galileogirl.

In communist fluther… answer lurves you!

So of course the question is what are the stats in other countries for why their infants die? The information @RedPowerLady provided does shed light on why in the US.

And, I think still there is the question of “pre-birth losses.” Each country might define that differently I think. Except it has been said here that WHO and other seemingly impartial organizations do the reporting. What do you think? I mean if a women goes into labor in rural China at 5 months do you think that is a pre-birth loss, even if it is delivered and lives for a few minutes? In the US I think that would be counted as a post birth loss. Just guessing.

@JLeslie You are correct about the US. If baby takes one breath outside of womb then it is post birth loss. Pre-birth losses would be stillbirths and miscarriages.

@RedPowerLady do you think it is defined differently in other countries? I have a problem with how we define it, but that is another subject altogether.

@JLeslie I’m kinda scared to ask but i’m so curious: What is your problem?

I know it is similar in other developed countries. But I really have no idea in “under developed countries”. Actually I just looked it up and “do not report all live births of babies under 500 g and/or 22 weeks of gestation” Also other countries don’t count premature births. Also some countries that have gender preferences misrepresent live deaths as stillbirths.

@RedPowerLady I really would have to think this through, which I haven’t. Off the top of my head I am bothered by the extreme pro-life movement to put out propaganda about how we let babies die in garbage cans. I completely respect people who are pro-life, but I personaly know two pro-life people who had late term abortions (well, one was second trimester). They are still pro-life. There abortions were because the fetus was doomed to fail. I do not mean that the baby would be handicapped or retarded, I mean one had basically no brain, and the other I honestly don’t remember the problem. These women planned their pregnancies. When they found out the bad prognosis they did not want to have a dying fetus inside of them, they did not want to have to deliver a larger fetus, and they wanted to be able to get pregnant as soon as possible. So, when I think of what is counted as pre-term and post-term death, it causes me to think about my frustration with all of the attacks on late-term abortions. Maybe I am confusing two things, but I think they are intertwined.

Having said all of that, I don’t know that I have a better way to define infant mortality, when to start counting it as pre-term or not. I would have to think about it more and probably discuss it to get some opinions from others. Obviously not for this thread.

Overall the US is ranked 37th in health care behind all other developed countries, and quite a few developing countries. This despite the fact that we spend nearly twice as much per capita as the next highest spender. So let’s not go by brutal dictatorships and ambiguous baby statistics alone. Let’s ask why, when are are matched by the exact same metrics (Life Expectancy, Infant Mortality, Mortality and Morbidity Index, Excess Deaths, etc. etc.) we rank number 37 in the world, and let’s ask further, why, when we have an opportunity to correct this we water it down and make a nearly useless bill that may not pass anyway. (Hint: Follow The Money.)

@pdworkin Good Point. I think there are many indicators to describe our overall health and healthcare system, not sure why they dwell on infant mortality.

@JLeslie So what are your thoughts on how those losses should be classified? I only ask out of curiosity of your opinion not out of judgment or anything like that. I suppose I’m confused if you think more births should be classified as “infant mortality” or post birth or less should be. Or something different altogether. I guess I will say I do have an opinion on this topic as well so as not to seem like I’m hiding it. But I don’t want to cloud your opinion with mine so was waiting to say something.

@pdworkin and let’s ask further, why, when we have an opportunity to correct this we water it down and make a nearly useless bill that may not pass anyway

I am all for correcting it. And I think that the useless bill is at least one step in the right direction. What would your suggestion be?

For Obama to grow a pair of balls, but he doesn’t seem to be following my suggestion.

@pdworkin As much as I support Obama I really wish he would stick to his guns on the issue and put forth something that will work despite the criticism.

And on Don’t Ask Don’t Tell, and on the Defense of Marriage Act, and on getting the fuck out of Afghanistan and Iraq, and on standing up to the Joint Chiefs of Staff, and on Wall Street. He is a major disappointment.

@pdworkin Okay okay I see your point. LOL.
But i am one of those people that say ‘just give him time, a little more time, it’s only been a year’.

He could have dispensed with Don’t Ask Don’t Tell with a stroke of his pen. It would have taken 47 seconds. He’s had a year. I think you are waiting for a bus that doesn’t run on that route.

@pdworkin don’t kill my hope…...

Interesting to see so many people wondering about the validity of the Cuban figures. I feel these may very well be very reliable. After all: 6.26 for the US is an astonishingly high number, quite in line with what may be expected from a country such as… Cuba.

In The Netherlands, for example, we are at 4.7 for infant mortality and at 5.9 for under first years. The latter number says a lot as well: for every 10,000 children in The Netherlands, twelve die between their first through fifth birthday. In the US these numbers are respectively 6.3 and 7.8. That means fifteen children per ten thousand born. The US and The Netherlands are pretty similar in being modern countries. I would worry being an American. In The Netherlands we do about our figures (which are unfavorable, compared to many of our peers in Europe.)

The problem may likely be though, that in the US, the statistics for those groups that are in control (politically and economically) are a lot more favorable. And asking those who are economically better of to support those that aren’t, must by a communist conspiracy.
Or worse even… socialism. brrr… shiver

@RedPowerLady Thoughts. Well, I think of a very close girlfriend of mine who is pro-life. She would not abort for any reason. I think even if she were dying during pregnancy she might opt to save the baby. If she found out her fetus had some sort of serious brain problem that would certainly lead to death eitehr in-utero or shortly after birth, she would continue with her pregnancy, have the baby and let it die naturally. I would abort the fetus, or at least I am inclined to think I would. So, in her case the statistic goes up for infant mortality, and in my case I do not affect the number, even if our situations are exactly the same. So, I wonder if the US stat is higher than some countries, especially those like Sweden or Denmark where there is less reliance on religion and from what I understand more atheism and higher education than the US.

Here’s the thing, if I think about it I cannot say, well you should not count my girlfriends baby in the statistic, because it seems awful to ignore the life of her child.

And, if I remember your link correctly there was a large category of “other” for cause of death, which probably does not have to do with what I am talking about. So, I recognize that even if we altered the statistics considering what I have mentioned it might only move the numbers less than one point per one thousand?

I think the numbers regarding death for 5 years and younger might have more significance than the infant mortality.

@whitenoise I understood the 5 year and younger to include the infant mortality rate, you are saying that it is age 1–5? Did you read that somewhere for how it is defined, or is that your interpretation of the statistic? I had assumed to get deaths between the ages of 1–5 you would have to take the number of deaths before age 5 and subtract out the infant mortality number.

@pdworkin I remember seeing Pres. Clinton after he was out of office and a journalist asked him about Don’t Ask Don’t Tell. He said that he fully intended to make gays in the military a non-issue, they he fully supported gays in the military. What he did not expect as a young politician newly in the white house was the HATE and anger of the opposing side. He admitted in the interview that he was unprepared for what he would come up against. I think it looks like it is a just a signature to get this done, but it is more complex unfortunately in politics. Drives me crazy also, believe me.

I’m aware that many Americans are anti-UN, anti-WHO, anti-whatever-international-organization. I have to live with that.

@mattbrowne I would think on Fluther our collective is less likely to be anti those organizations. Just an assumption.

@JLeslie Agreed.

@JLeslie You know I was in that exact same position with my son. It has nothing to do with abortion beliefs. It has everything to do with a hundred other factors. I think you would be surprised at what your decision would be if you had carried your child and come to love him/her so deeply and towards the end of pregnancy find out that he/she has a congenital defect that will lead to their passing. I would think the exact opposite of you. I think more lives should be counted as infant mortality. Just because some people choose abortion does not mean that those mothers who choose to have a child that will pass should have their babies short lives not “count”. I agree that is a horrible thing to say. When you make the choice then the repercussions, in either direction, are yours. It seems almost like you are inclined to demonize those who wish to spend an hour and half with their child vs. abort them. I cherish that time I spent with my son and would never have made the choice to do away with it. It wouldn’t have helped him or me. And I am very happy that his short life is recognized officially. I suppose this is just way too close to home. Also these deaths do not count in the other category. They count in the congenital defects category. The largest one. If you have never been in the position of carrying a child to nearly full term (and I have no idea if you have) then you wouldn’t understand just how much you could love your child, before birth, in sickness, in the short time they are alive. That is why mothers choose to have their babies. And that choice is beautiful and should not be condemned as messing up the statistics because they choose life over an abortion. Although I do not have any negative feelings towards women who choose to abort just so you know. Just explaining the other side. In fact when I said above I’d count more lives as infant mortality I truly mean that. I’ve had friends who have had stillbirths. I am a huge fan of birth certificates for stillborn babies. They were alive inside their mothers and unfortunately passed just before birth. Thankfully most states have come to a compromise and included what is called a “stillbirth certificate” that at least acknowledges the existence of that child. Anyhow you may be surprised to know that I am pro-choice I just do not agree with some arguments pro-choice advocates use in favor of the cause. Choosing to have your child is not about the abortion cause, it is about the love between parent and child, it has absolutely nothing to do with any “cause”. Okay I’m off my soapbox.

@RedPowerLady I think I am not conveying well what I feel. I realize this is a subject that hits very close to home for you. As you see above I said what I think I would be inclined to do if in the position, I would never assume I know what I would do or impose any value on what another woman chose. I can understand why women would choose either way of dealing with this situation. My miscarriages were very early in my pregnancies, I do not think it is the same as finding out late in a pregnancy that something is wrong, and I did not have to choose anything really, it just happened. Except with one of my ectopics, I had to take medicine to end the pregnancy.

I can understand wanting to “legitamize” the birth of a child no matter how short the life was. I agree with this practice. I recently searched for my fathers twin siblings who died shortly after birth. It seems we have found the record, but I still do not have details. I WANT to know, even though my father seems fine not knowing. I am glad there is a record. I never thought of it in regards to still births. I am not sure I know technically what a still birth is? Does that mean the baby is alive all the way up until delivery and then it never breaths once born?

I was not saying we should or should not count or how we should count in the end, I was saying how each country counts might vary, and/or certain countries might have women more likely to abort than others in bad circumstances, swaying the stats.

I don’t feel like you are on a soap box :).

In the link you provided http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5642a8.htm other is the largest category, unless I am misunderstanding?

@JLeslie I was referring to the second link which was a bit more clear to me personally than the graph. They seem to be a bit contradictory but not too much so.

Still birth only means that a baby is born silent (i.e. deceased). It also means a late-term loss. This means a woman carried her child for the majority of pregnancy and at some point the baby passes (for whatever reason, there are many) and then she must go into labor to birth her child who is already passed. Also sometimes a baby passes in the process of being born. I probably shouldn’t type out all these things. I think the less women know about the possible complications the better. When it comes to pregnancy ignorance really is bliss.

I think the research supports your idea that in different countries women make different choices and thus the statistics are different. It also suggests that hospitals make different choices, like trying to save a life vs. not trying to which affects the statistics.

I don’t know what really set me off above, I suppose I read something into what you were saying that you weren’t. Some sort of miscommunication. I suppose my point was that women don’t make their choice based on abortion beliefs. It has to do with other factors. I would think that is true for most countries but I may just be projecting my own feelings onto the situation.

@RedPowerLady Well, I brought up late-term abortion, and understanding your situation, I can see why you might get emotional about the topic at hand. I can understand why you want to be sure that people don’t mush the various topics together, or make assumptions about you or others who have been in such a difficult and sad circumstance. The topics seem intertwined, but I understand how they are also very separate. Like I said I know people who are pro-life who chose to abort, I am sure there are many who are pro-choice who choose not, like you. What makes it different is wanting the baby or not I think. When a woman wants the baby and something has gone wrong, it is not an abortion discussion really, it is deciding what to do in the specific circumstance. More accurately it might be a euthanasia issue?

About the still births. So if a woman delivers, even if the baby was already dead in utero-it is considered still born if I understand correctly. I have to say I am torn. The subject is really so complicated and as you point out there are so many different things that can go wrong in pregnancy, so many different situations and variables. Although I am pro-choice for the reason specifically that I do not think the government should be able to demand an individual support another life with their own life systems, either male of female, I am in agreement with the supreme court that at the point of viability (I think they moved it to 5 months when I was a teen, used to be 6 months) there must be extreme circumstance on the basis of the life of the mother or significant health problems for the fetus to have an abortion. So, admittedly, my thinking is somewhat inconsistent. I tell you all of this, because if I am willing to agree that the child is viable, even while still in utero, then I guess logically a birth certificate would make sense even if the child died before it’s birth. So, I guess for now I have no final opinion on the matter, just simply that I can see validity in your argument and your desire to count the baby.

On a side note: I do wish people talked more about the perils of pregnancy, not in this discussion, but in the media in general, because I think the ignorance hurts us in the end actually, especially hurts women.

When a woman wants the baby and something has gone wrong, it is not an abortion discussion really, it is deciding what to do in the specific circumstance.

Agreed.

Also I appreciate your understanding very much. Your first paragraph was simply fantastic.

I also agree with your last statement in truth and logic. In fact I am a very huge advocate of making pregnancy and infant loss something that is more appropriate to discuss in society. It should be normalized.

I suppose the issue of controversy here is how to define viability and if viability should even be a determining factor in this issue.

@JLeslie
No you and I are agreeing on the numbers.

The mortality rates for my country ae 5.9 under five years, of which 4.7 die within the first four years, which means an average of 1.2 children die per 1,000 births.

I just don’t feel 1.2 children can die. It feels somewhat numbing the impact when one talks about .2 children dying.

1.2 per 1,000 equals 12 per 10,000. That felt a little more respectful than the statistical 1.2. Sorry for the confusion.

@whitenoise Yes of course, I should have thought through the math better. I agree that 12 per 10,000 gives more meaning to the number of children.

@JLeslie – Yes, that’s my perception too. On average Flutherites seem more open about the role of international organizations.

Does anyone know of a site that can validate what the definition of an infant is for each country? Yes, statistics show we have a larger mortality rate than Cuba. Could this be because what we identify as an infant may be different than what Cuba’s identification may be? I would hope that the WHO is not out to make America look bad since as of March of 2006 they have received $100 million dollars from the U.S.; instead, they could be seeing this information without going into detail about how the information was gathered. If one were to log onto Fidel Castro always tells the truth dot com (Fictional), you would probably be given statistics about his country that make it seem wonderful. I am not writing this to down Communism or debate which form of government is best. I just believe that since many countries do not even agree on a set way of measuring distance, we cannot be sure that countries agree on what defines an infant. But once again, if anyone does know of website that states what each of these countries defines as an infant I would be interested in seeing the information.