Some
Statistics for Pregnancy, Labor, and Birth
As
you are preparing to teach a class, do you ever wonder about the incidence of
certain interventions? Knowing what percentage of women experience something may
help you decide how much time to spend on it in class. Do you get questions
from students in class about how likely they are to have something happen to
them? This document is to gather as many of those numbers into one place as
possible.
Please
note: some of these statistics are based on governmental records of data, for
example, how many babies are born each year in the
It is important to clarify with students that all statistics show you is the relative chance of something happening to “the average pregnant woman.” To find out how likely it is to happen to them, they should consult with a caregiver familiar with their history and condition.
Demographics
·
Babies
born each year in the U.S:) 4,140,419 in 2005 (CDC)
·
In
·
Age
of mothers… percentage of all mothers who were in this age group: 10-14 years
old: .2% of mothers. 15-19: 11%. 20-24: 25%. 25-29: 26%. 30-34: 23%. 35-39:
11%. 40-44: 2%. 45-54: .13% (CDC – 2001)
·
Age
of mothers… amongst 1000 women in this age group, how many had babies in 2005:
10 – 14 year olds: .7 per 1000. 15 – 17: 21.4; 18-19: 69.9; 20 – 24: 102.2; 25
– 29: 115.6; 30 – 34: 95.9; 35 – 39: 46.3; 40 – 44: 9.1. 45 – 49: .6 http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimbirths05/prelimbirths05.htm
·
Unwed
mothers: 36.8% of mothers in 2005, (CDC)
·
Average
number of children born to a woman over a lifetime, in
·
Twins
are 2.9% of live births. Higher order multiples: .18% (CDC)
·
Most
women who gave birth had wanted to become pregnant either prior to (15%) or at
the time (42%) they became pregnant. However, over 4 out of 10 pregnancies
resulting in births were unplanned, that is, the women did not want to become
pregnant at the time they conceived this pregnancy; this includes 34% who had
hoped to become pregnant at some point in the future, and 8% who had never
wanted to become pregnant. (LM2)
·
Infant
mortality. 6.63 infant deaths per 1,000 live births in 2004. There are 39 other
countries with lower infant mortality rates. (CIA).
Nearly 1 in 10 infant deaths were from sudden infant death syndrome (SIDS).
There were a total of 2,648 deaths from SIDS in 1999. (CDC)
·
Histories
that expectant moms bring into the room with them:
1. Pregnancy
history: Approximately 35% of women will have had an abortion before the age of
45. Approximately 25 – 30% of pregnancies end in miscarriage, so many of the
women will have experienced a past miscarriage. 25% of couples experience
infertility at some point in their lives. In 2001, 40,000 babies were born in
the
2. Abuse
history: Approximately 1 in 3 women have been sexually abused at some point in
their lives. 31% of American women report having been physically or sexually
abused by a husband or boyfriend at some point in their lives. (Commonwealth Fund survey,
1998). Of the women who experience abuse at some point in
their lives, 30% report it began during their pregnancy. It is estimated that 6
– 20% of pregnant women will be physically abused during pregnancy.
Pregnancy
Prenatal care (includes info on low
birthweight and preterm babies
·
About
3 in 10 women have a visit to a health care provider to plan their pregnancy
before they conceive. (LM)
·
83%
of mothers learned about their pregnancy from a home pregnancy test (LM2)
·
Women
who received prenatal care in their first trimester: 84.1% (CDC 2003). 83.2%
(WA) 17% of women reported that they could not get their first prenatal
appointment as early as they wanted to. (LM2)
·
Women
receiving late or no prenatal care: 3% (WA 2001)
·
Prenatal
Caregivers: 77% OB/Gyn. 7% Family Physician. 13% Midwife. 4% Nurse or PA
·
Preterm
birth (before 37 weeks gestation): 12.1% nationwide in 2003 (CDC) In
Washington, 12% in 2001 (WA)
·
Low
birthweight: 7.9% nationwide in 2003 (CDC).
·
Proportion
of infants who did not survive first year amongst very low birth weight (1500
grams or less) 51%. Amongst moderately
low weight (1500-2499 grams) 14%. (MO)
·
Value
of prenatal care. Rates of complications among high-risk patients in a prenatal
care program (including education, more frequent visits, and more provider
attention) compared to non-participants.
Preterm birthrate: 7.4 vs. 9.1%
Rate of low birthweight babies: 5.8 vs. 6.4% (MO) Preterm labor episodes successfully stopped:
11.4 vs. 6.6%
·
Cost
of prenatal care for one mother: $702. Cost savings available in the first year
of care for an infant of normal birthweight rather than low birthweight:
$59,700.
·
Smoking
in pregnancy: 11% in 2003 (CDC)
·
Before
pregnancy, 25% of women were obese according to body-mass-index, and 26%
overweight. At the time of study, 3 – 12 months ater
birth, 32% were obese, and 29% overweight. (LM2)
·
Median
weight gain in pregnancy: 30 pounds (LM2)
Childbirth Education / Sources of
Information
·
36%
of women report taking classes: 70% of new moms, 19% of experienced moms (LM)
In LM2: 56% of new moms, 9% of experienced.
·
They
took classes because they wanted to learn about labor and birth (82%), wanted
to prepare for a natural childbirth (37%), because their caregiver recommended
it (26%), and because it was viewed a routine thing one does in pregnancy (11%)
LM2
·
Women
reported that their childbirth classes had these effects: 88% had a better
understanding of childbirth options, 78% more confident in ability to give
birth, 70% better able to communicate with health care providers, 60% increased
trust in hospital, 585z decreased fear of medical interventions, 54% increased
trust in health care provider. 14% said the class made them more afraid. (LM2)
·
Of
those who took classes, 88% at hospital or caregivers’ office, 4% at home, 7%
at a community site. (LM)
·
Most
important sources of information about pain relief ]:
25% relied most on doctor or midwife, 15% on classes, 9% on friends or
relatives, 3% Internet. (And own experience for multiparous
women.) (LM)
Ultrasound
99% of women had one. 59% had 3 or
more. 15% had six or more. (LM2)
Variations in Pregnancy:
·
Gestational
Diabetes: 3.5% (WA)
·
Pregnancy
Induced Hypertension: 5% Eclampsia: .4% (WA)
·
Prolapsed
cord: 1 per 1000. CDC 2004
·
Abruptio placenta: 4
per 1000 CDC: 2004
·
Breech presentation: 4% CDC 2004
Group B Strep
·
Before
prevention methods were widely used, approximately 8,000 babies in the
·
30
– 40% of pregnant women normally carry the bacteria (in the throat, intestines,
or vagina) without having any illness. Newborn babies can be infected before
birth if vaginal bacteria infect the amniotic fluid, during birth, or after
birth by close physical contact with mother
·
Most
GBS infections occur in babies less than 3 months of age, with an incidence of
about 1 case per 1000 births
·
If
a mother is a carrier of GBS, there’s a 50% chance her baby will be infected. Less
than 1% of full-term babies who become carriers of GBS develop GBS meningitis
of other severe GBS infection.
·
If
baby is born prematurely, especially before 32 weeks, then the mother’s
antibodies to GBS are not transferred across the placenta and the baby is at
much greater risk of GBS disease.
Source for last four items: http://www.meningitis.ca/groupbstrepdisease.html
Due Dates:
·
Preterm
(before 37 weeks): 12.8% (WA)
·
Term
(37-41 weeks): 79% (WA)
·
Post-term
babies (after 42 weeks): .07% (WA)
Induction / Augmentation
·
CDC
2004: 21% induction / 13% augmentation
·
Self-induction:
22% of women tried to start their own labors, using methods such as
walking/exercise, sexual intercourse, or nipple stimulation. About 21% of these
women succeeded in starting their own labors. 58% of the women who tried to
induce labor were just ready for pregnancy to be over with. 33% were trying to
avoid medical induction. (LM2)
·
41%
of surveyed women say their doctors tried to induce their labors. 84% of medical
inductions started labor. (LM2)
·
In
·
Reasons
for induction: 59% of induced moms report that induction was for medical
reasons only, 18% for non-medical reasons only, and 16% for medical and
non-medical reasons in combination. (LM)
·
Of
those who were induced: 19% say induction was because “I wanted to be done with
my pregnancy and have my baby.” 11% said “this helped ensure my chosen
caregiver would attend my birth.” 6% said “I wanted to control the timing of my
birth to make work or personal plans” and 11% provided other non-medical
reasons. (LM)
·
Means
of induction: of moms who were induced, they report 80% oxytocin, 49% amniotomy, 33% sweeping membranes,
24% prostaglandin gel, pouch, or tablet. Most women had a combination of
multiple methods. (LM2)
·
Of
19
·
Augmentation:
Moms report: 54% had membranes broken, 53% artificial oxytocin. (LM)
·
Of
mothers who had ultrasounds to check baby’s weight, 16% were told baby would be
over 8 pounds, 14 oz. Only 12% were that big.
Care During Labor and Medical Interventions
Cost of Care
Prenatal care and postpartum
follow-up by a doctor or midwife: I have had a hard time finding an estimate. May be around $1500. http://199.106.73.174/resources/low/1800030/
Hospital
charges. (All Washington state CHARS data, 2005)
For normal labor and vaginal delivery
w/o complications, costs range from $2400 – 11,000 in
For cesarean birth without
complications, costs range $4400 – 19,000 in
For normal newborn care: $477 – 4300
in
Electronic Fetal Monitoring
·
Used
in 84% of all live births. (CDC)
·
By
moms’ report: 93% of moms had EFM: 73% had EFM alone, 20% had EFM combined with
a handheld device such as a Doppler. Among those using EFM, 66% were monitored
continuously, 23% were monitored most of the time. Only 4% were monitored
intermittently, and only 7% had only a baseline measure. Only 6% were never
attached to a fetal monitor. (LM)
·
Of
women who had electronic monitoring, 70% were monitored externally. 22% had
both external and internal EFM, and 4% were monitored only by internal EFM.
(LM)
·
Increase
in risk of c-section associated with the use of EFM: 41% (MO)
·
Significant
differences observed in one-minute Apgar scores below 4 among infants who
received continuous EFM: None (MO)
·
False
positive rate for multiple late decelerations in fetal heartbeat…: 99.8% (MO)
·
World
Health Organization: In conclusion, the method of choice for the monitoring of
the fetus during normal labour is intermittent
auscultation…. Individualized care of the labouring
woman is essential, and this may be achieved more smoothly by the personal
contact required by regular auscultation. Only in women with increased risk,
such as labours which are induced or augmented,
complicated by meconium-stained amniotic fluid or by any other risk factor,
does electronic monitoring seem to be advantageous. In the majority of labours without increased risk, electronic monitoring
increases the number of interventions with no clear benefit for the fetus and
with a degree of additional discomfort for the women. (WHO)
Food in Labor
·
56%
of moms say they were interested in
drinking something, and 27% in eating something between when their labor began
and when they gave birth. At birthplace, 34% were permitted to eat or drink, only 13% were allowed to eat in labor.
Looking only at vaginal births, 35% actually
did drink something, 14% ate something.
·
In
the
I.V. / Heplock
·
86%
of moms receive an IV (LM)
·
Of
19 hospitals in the
Urination
·
52%
of moms had a catheter to remove urine (LM)
Group B Strep
Incidence: 10 – 30% of all adults are
colonized with group B streptococcus. 12 – 35% of pregnant women. Chance of
transmission to fetus / infant: 40 – 75%. Disease in infants (presumably this
means symptomatic infectious disease) 1 – 2% (1 – 3: 1000 live births) (MB)
Length of Labor
·
By
moms’ reports: average length 10.3; 43% say 1-6 hours, 7% more than 24 hours
(LM)
·
Friedman
curve (obstetrical definition): From 4-10 cm dilation, a good rate is 3.0 cm /
hr. Minimum is 1.2 cm / hr.
·
Leah
Albers study of ‘normal’ birth without intervention: 4-10 cm: nulliparas 7.7
hours on average (19.4 hours still within range of normal), with normal
progress defined as half a centimeter per hour; second stage 53 minutes average
(up to 147 normal.) For multips: 5.7 hours / 13.7
hours and 17 minutes/57 minutes.
· Precipitous labor: Precipitous <3 hr: 2% overall. (From first time moms who have a .7% chance to 8th-time moms who have a 5% chance) CDC 2004
· Prolonged >20 hr: .5% overall (first time moms 1%, second timers .2%) CDC 2004
·
Comfort Techniques
·
Labor
support/who provides: 96% had someone providing emotional support and/or
assistance with physical comfort: 82% partner or husband, 56% nurse, 38% family
member or friend, 34% doctor*, 8% midwife*, 3% doula. (LM2)
·
Labor
support from primary caregiver. Of those attended by obstetricians, 37%
received supportive care in labor; of those attended by family physicians, 44%.
Of those attended by midwives, 66%. (LM2)
·
Labor
support / how effective: 90% of moms described the supportive care they
received as good or excellent. Most likely to be given an “excellent” rating:
doula – 88%; family or friend – 73%; partner or husband – 72%; doctor – 71%,
midwives and nursing staff – 68%. (LM2)
·
71%
did not walk around once they were admitted to the hospital. Primary reason:
connected to things (67%), pain medications (32%), caregiver telling them not
to walk (28%), choosing to stay in one place (21%) (LM)
·
Non-drug
methods of pain relief: 61% used breathing techniques, 60% used movement or position
changes. 32% used hands-on techniques such as massage and touch; 30% used
mental strategies such as relaxation or visualization. 15% used hot or cold
objects, 12% used environmental changes such as music or aromatherapy, 8% used
showers, 6% used tubs, 5% used birth balls, 1% used
sterile water injections. (LM)
·
Moms’
report of effectiveness of pain relief: 89% said tub or Jacuzzi was somewhat
helpful (49% said very helpful). Other positive ratings: Hot or cold objects:
82%. Hands-on: 81%, position changes 79%, environment changes 76%, birth balls
very helpful to 32% of those who used them. (LM)
·
Breathing
techniques were rated as at least somewhat helpful by 69% (22% said very
helpful), but 30% rated them as not very helpful or not helpful at all. (LM)
Pain Medication
·
By
mothers’ report: 80% used some pain medication: 63% had epidurals, 30% had
narcotics. 5% had general anesthesia, 2% were given nitrous oxide, 2% were given pudendal or other
local blocks. (LM)
·
Moms’
report of effectiveness of pain relief: 78% said epidural was very helpful;
Narcotics rated 66%, pudendal or other local blocks
57%, nitrous 52%. (LM)
·
Common
narcotics at
·
Epidural
Rates at
Epidural Side Effects
For all the details on research results, see separate article.
What parents know about epidural side
effects (from LM survey taken after birth):
|
|
Agree
strongly % |
Agree
somewhat |
Disagree Somewhat |
Disagree
Strongly |
Not
Sure |
|
Epidurals
provide more effective pain relief than any other method |
54 |
23 |
5 |
6 |
12 |
|
E.
require certain interventions such as EFM and IV |
34 |
29 |
6 |
4 |
28 |