Infant mortality rising

[Believeitornot]

I saw that there’s an increase in infant mortality rates. What a worry, how can this be? Is it the nhs bring run into the ground?

Story here www.theguardian.com/society/2018/mar/15/concern-at-rising-infant-mortality-rate-in-england-and-wales

I also saw the same story posted in the daily mail which blamed immigration in the headline I refuse to link but the bias is appalling.

Poverty was mentioned

i was thinking about the cuts in nhs, closure of birthing units but that wasnt mentioned in the report linked but smoking , obesity, and poverty was

When I was pregnant, I was given vouchers for vitamins etc, but couldn't find anywhere that would actually accept them!

We could just set means tested gap payments but that would be too obvious and we all know that the NHS must be free at the point of access to absolutely everyone no matter how many times over they could afford to pay for their care

Why?

(I assume you meant 'GP' rather than 'gap')

poverty and cuts to social care generally meaning more vulnerable women arent getting the same level of care they used to be. Not just during pregnancy but in general. So with things like addiction and mental health the outreach for that has been cut back so I could see that effecting births in terms of women being generally less healthy when they get pregnant. Ditto with poverty. Issues with nutrition either from lack of decent food or obesity caused by poverty or lack of health education.

And then of course advances in medicine which lead babies to survive where they wouldnt have in the past but not advanced enough to keep the babies alive long term yet.

roadtorivendell because if its means tested you run the risk of everyone who can pay just going completely private and having essentially a better healthcare system for people with money. I mean it has not worked very well in America. We want a good healthcare system for everyone not just a shitty basic one for poor people that barely keeps them alive then a super expensive good one for wealthier people.

roadtorivendell because if its means tested you run the risk of everyone who can pay just going completely private and having essentially a better healthcare system for people with money.

Well, it depends on if you're talking about a nominal charge for a doctor visit (e.g. Germany) or a privatised system (US). I see no strong case against the former.

The infant mortality rate in the three months after birth in the U.K. is higher than the US. The rate here in the Us, after the first six months starts to increase and gets high in the 9-12 month period.

Healthcare here during pregnancy for everyone no matter their income is amazing. You get exactly the same treatment and under medicare it's at no cost to the parent(s). Going for scans, you all go to the same places. If you are high risk you are seeing the same doctors.

It wasn't always this way and Hilary Clinton was the one who pushed very hard for this change. It has been extremely effective at lowering the infant mortality in the first six months after birth. Sadly it looks like it's other factors causing the rate to climb post six months.

It is of no surprise that the mortality rate is rising in the Uk. Maternity care is shockingly awful. I had three babies in 6 years. All three pregnancies were managed by the same doctor who also delivered all three babies.

None of my friends in England have had much of any continuity of care. I've had a good friend lose a baby shortly after birth and from our skype calls the baby never looked right to me. Turned out forceps were used at birth and caused significant damage to their sons brain. My friend was in labour for 5 days. Her waters had been broken for over 48 hours. Here in the US they will move onto a CS after 24hrs of waters being broken. 5 days of labour is cruel and really shouldn't be happening.

Huh? I'm in Germany and we don't pay to see the doctor. I have only ever paid for prescriptions and occasionally €20 for a specialist, but even most of those have been covered entirely.

The German system works well but Germans pay far more for their healthcare per head than Brits do. The nationalised service makes the most sense in terms of efficiency and cost-effectiveness but it does need to be properly funded.

I don't think the US system of having a guaranteed doctor deliver your baby is very good. This is a lot of strain on one doctor and encourages speeding up of labour which doesn't always have good outcomes. It also means each doctor is limited in how many patients they can take on in a given period - although I was surprised to learn that this is many more than e.g. an independent midwife in the UK would take on at once, which I feel is unsafe. (this continuity is a nice option, but not really practical). I was in labour for over 48 hours and I did not think this was cruel. I would have found it more distressing to be whisked off for a c-section or given drugs to speed up my labour when it was deemed that it was "taking too long". It's different if somebody is becoming exhausted - I found this was handled sensitively in my case.

bertie of course there are other doctors. In the group I was a patient of they had three doctors closely following each pregnancy in the last trimester so they could step in and be aware of medical history. Notes are all electronic and easily shared between hospitals.

After you have seen how childbirth works elsewhere I really started wonder how the mortality rate is so low in the UK.

Yes I must admit I'm happier with the childbirth care in Germany than in the UK, particularly postnatal. But I don't think it's the dark ages in the UK either. I do agree the NHS is underfunded. And I wouldn't particularly want to give birth in the US but I realise my view is skewed because I haven't been through it.

Honestly it wasn't as medical having babies here. I had complications, namely preeclampsia and gestational diabetes. First time there was no question that the aim was moving away from a vaginal delivery. Second time DS had a huge head and it came out of my pelvis. It was extremely painful and I was thankful to have a CS. Third time around I went for a CS because I gave up trying to have a vaginal and they were worried about my scar after 30 weeks.

Having an obn monitoring me was better because they were monitoring my overall health throughout the pregnancy and after. I got mastitis with my second and at my last appointment my obn noticed a small lump and knew from my notes that's where the mastitis was. While waiting for the scan (same day) I wasn't freaking out. Meanwhile in England they are proud they get women at risk of breast cancer through testing in two weeks. Here it's 24hrs for testing and waiting for 2-3 days for results.

digg.com/2017/uk-birth-us-safety-comparison

Makes interesting reading.

That's funny how that article bears no relation to the experience of the majority here in the US. Standard first appointment is at 8 weeks unless you have awful nausea or bleeding. If you want an abortion they will take you in for your first appointment and counseling session if you are pre 8 weeks.

If you have no insurance Medicaid kicks in very quickly here in NJ. Friend was left by her 'D'H when she was 15 weeks pregnant and her care transferred over insurance wise but she stayed with the same medical team.

The article fails to recognize the poorest in America are far poorer than the poorest in the UK. The doctors here do follow the same practices nationwide too. Best practices are set out by the specialty group. Hospitals then follow these guidelines. I would hope in the UK it's the royal college of obns setting out best practices rather than the NHS itself. The NHS should follow what the royal college sets as best practices based on research.

Also, a CS wasn't an option unless medically necessary. I also really liked having my own room while in labour and during my stay as well as having a nursery to send my baby to so I could sleep in peace. I was extremely tired and the rest was very much needed. I went home having had enough sleep to properly look after my baby.

I don't know which group is the majority but certainly yes we mustn't ignore that inequality in the US is massive and the very poor (who don't tend to have internet access, may not be literate, certainly aren't spending time on forums discussing these issues) are really living in conditions which are nowhere near what you'd expect for a developed country. That contributes to and massively skews things like mortality rates. Interestingly though practice seems to vary even among middle class/rich Americans - everyone on my birth group from the US was surprised when I mentioned that both in the UK and Germany I'd been given paper notes to carry around with me so that if I needed to see any doctor, emergency, specialist, anything, they all have access to the same information. Everyone I've seen has written in the booklet as well. Nobody (online, US dominated site) mentioned an electronic version of the same thing.

NICE sets the guidelines which the NHS follow in theory. Probably informed by the RCoG though I don't know offhand. Part of the problem in the UK is that the NICE guidelines are sometimes not followed due to poor staff training, understaffing or simply overwork. That's really alarming and needs to be addressed. There was a poster only last night here on MN who was fobbed off about reduced movements at 37 weeks, she kept pushing to be seen by a consultant and has now been induced, to the relief of everyone following the thread. That's against NICE guidelines as women are supposed to be seen, not advised to wait.

bertie That's right about no notes to carry around. My notes for all three pregnancies were kept online as well as full paper back up. In an emergency they just email them to the hospital that needs them. Any of the three local hospitals could access them though. When I had a problem of violent vomiting at 37 weeks my obn called ahead to let them know we were coming. There was a wheelchair and nurse waiting for me outside. They had already seen my notes and knew my history. Triage happened before I got there. It was absolutely amazing to see such joined up care.

Yes but my point was that in this group, which may not be representative, who knows, nobody had heard of any shared notes at all, electronic or not.

I think there are positives and negatives in both UK and US. Personally with the UK system I benefited from the quality of care when I’d left hospital and when I needed it most the care was amazing.

bertie I asked and was fascinated with the organization between the different groups I was being seen by. I had never experienced anything like it before. It's normal here and American friends are all shocked that you walk around with your notes in a bag in the UK.