According to the National Center for Health Statistics, preterm birth in this country has risen 36% since the 1980’s, resulting in roughly 540,000 preterm births in 2006. That number rose in 2007 and decreased slightly (0.1%) in 2008, despite the March of Dimes’ excellent program (began in 2003) highlighting the problem and funding research to combat it.
Certainly, the alarm bell should be sounding, nationwide! Why is this happening?
For years, it has been known that certain physiological events will trigger a preterm birth: trauma or injury to the mother is one, infection is another, incompetent cervix, a third, congenital anomalies, another (although in the past, those problems were often discovered at time of term delivery). We are only beginning to pull back the curtain on the complete range of possible answers.
For decades, statistics have shown preterm birth happens most frequently among those of African American descent, or women who’ve had a prior preterm delivery. Also, women of low socio-economic status, who lack prenatal care, overexert themselves physically or have stress induced low or high BMI, are more prone to premature delivery. Tobacco, alcohol, drug, or other substance abuse, prior induced abortion, prior cervical surgery, periodontal disease (!) , uterine overdistention (i.e., multiples, polyhydraminos), vaginal bleeding during pregnancy (placenta previa), uterine anomalies, anemia and reproductive tract infections also cause a woman to go into premature labor (Medscape, 2007).
Specifically, the newest studies show three main drivers of prematurity in the U.S.: increased maternal age, increased number of multiples, and increased number of cesarian sections (MOD, 2008). Looking at the list, it is obvious that the first begets the second, and hence the third. Behind the Big Three is the newest cause: Artificial Reproductive Technology (ART). Parents who delay childbearing are now able to conceive after age 35, which has been traditionally known as ‘too late to party.’ Some centers now guarantee a pregnancy by implanting multiple embryos. Some offer “Build a Baby” workshops where specific gender, hair and eyecolor selection is available. Indeed, it is a brave, new world in which we live. Now, don’t get me wrong. I’m not against ART (I’m an artist myself and enjoy the creative process), just cautious. The whole subject raises important questions we need to be asking, like : Have we taken liberty with our ability? Should tougher medical standards be in place? Where do we draw the line between what seems right for one, and what is right for society? Somewhere the call for bioethics sounds like the muffled drone of the town crier, overtaken by automatic technological invention.
The irony remains that despite our high rate of premature infants, we are a nation of incredible scientific prowess. We can send a man to walk on the moon, we can maintain the lives of infants born so small their skin is transparent and their eyes are fused. (Indeed, I have spent the past 20 years of my career dedicated to these young persons.) But yet, we cannot predict exactly when a baby will be born, or why. Priorities.
Podcasts | Candy July 6, 2009 | 
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