The analysis reveals that the typical length of US pregnancies decreased by 0.6 weeks from 1990 to 2020 (from 39.1 to 38.5 weeks) and is shorter than England and the Netherlands. In 2020, just 23% of US births happened at 40+ weeks, compared to 44% in the Netherlands and 40% in England.
A recent multi-country analysis of the typical pregnancy length and timing of birth in the US, England, and the Netherlands recommends that the United States might improve maternity care outcomes by decreasing medical interventions throughout childbirth.
The maternal and infant mortality rates in the United States are alarmingly high compared to other european countries and rich nations, and maternal health outcomes continue to degrade. A brand-new research study from researchers at Boston University School of Public Health and Harvard-affiliated Beth Israel Deaconess Medical Center is clarifying the possible impact of healthcare facility organizational structures and staffing in United States maternity care on the birth process and negative birth results.
The study, published in PLOS ONE, compared gestational age patterns and timing of home and hospital births in three high-income countries with varying maternity care designs: the US, which greatly depends on obstetricians and scientific interventions, and England and the Netherlands, which primarily use midwives for low-intervention care.
In 2020, only 23 percent of US births occurred at 40 or more weeks, compared with 44 percent of births in the Netherlands and 40 percent of births in England. In England and the Netherlands, births at house and at the healthcare facility took place at similar times of the day, peaking in the early morning hours between 1 a.m.-6 a.m
. In the US, there was an obvious distinction in birth timing between the two settings: births at home peaked in the very same early morning hours as house births in other nations. The paper is the very first worldwide study utilizing big datasets to compare gestational age and birth timing in three high-income countries; most prior research has focused on data from individual hospitals or countries.
The findings show that the average length of United States pregnancies gradually declined by over half a week in between 1990 and 2020, from 39.1 weeks to 38.5 weeks, and that United States pregnancies, typically, are much shorter than pregnancies in England and the Netherlands. In 2020, only 23 percent of United States births happened at 40 or more weeks, compared to 44 percent of births in the Netherlands and 40 percent of births in England. The gestational age pattern for house births was the same in all three countries.
In all three nations, the scientists also took a look at birth timing by hour of the day for house and vaginal births at the health center, and then repeated this analysis, limiting the comparison to hospital-based vaginal births without interventions such as induction or labor augmentation that could potentially change the timing.
In England and the Netherlands, births at home and at the health center took place at similar times of the day, peaking in the early morning hours between 1 a.m.-6 a.m
. In the US, there was an obvious distinction in birth timing in between the 2 settings: births at house peaked in the very same early morning hours as house births in other nations.
” Our multi-country analysis reveals that the US is an outlier in gestational age distribution and timing of low-intervention healthcare facility births,” states study lead and corresponding author Dr. Eugene Declercq, teacher of neighborhood health sciences at BUSPH. “Theres a lesson to be gained from nations with more positive maternity results than the United States in having health center staffing and functional plans adhere more closely to the natural patterns of birth timing and gestational age rather than attempt to have birth timing fit organizational needs.”
The research study included nationally representative and publicly readily available population-based birth information from all three nations, consisting of data on more than 3.8 million births in the United States and 156,000 births in the Netherlands in 2014, and more than 56,000 births in England from 2008-2010. The scientists examined home and healthcare facility birth timing for births that took place in between 37 and 42 weeks.
” Every system is perfectly designed to get the results that it gets,” says research study senior author Dr. Neel Shah, chief medical officer of Maven Clinic and a going to scientist at BIDMC. “The amazingly poor outcomes of the United States maternal health system demand greater attention to its style. Our study shows that in contrast with other high-income nations, American hospitals may be designed to focus the benefit of clinicians more than the needs of individuals delivering.”
Referral: “The natural pattern of birth timing and gestational age in the U.S. compared to England, and the Netherlands” by Eugene Declercq, Anneke Wolterink, Rachel Rowe, Ank de Jonge, Raymond De Vries, Marianne Nieuwenhuijze, Corine Verhoeven and Neel Shah, 18 January 2023, PLOS ONE.DOI: 10.1371/ journal.pone.0278856.