Childbirth injuries fall sharply but more could be prevented
Research Activities, August 2009, No. 348
Injuries to mothers during childbirth decreased significantly between 2000 and 2006, according to data from the Agency for Healthcare Research and Quality (AHRQ). The number of mothers who experienced injuries while giving birth vaginally without the use of forceps or other instruments dropped by 30 percent. For mothers giving birth vaginally with the use of instruments and by cesarean section, injuries declined about 20 percent. Despite the declines, nearly 158,000 potentially preventable injuries occurred to mothers and infants during childbirth in U.S. hospitals in 2006. Specifically:
- Women covered by Medicaid were less likely to be injured while giving birth than privately insured mothers (127 vs. 185 injuries per 1,000 vaginal deliveries with instruments, respectively).
- Mothers ages 25 to 34 had the highest rate of injury during vaginal delivery with instruments (193 per 1,000 such deliveries) and mothers ages 15 to 17 had the highest rate of injury during vaginal delivery without instruments (48 per 1,000). Mothers ages 35 to 54 had the highest rate of injury during cesarean section (5.5 per 1,000).
- Mothers living in the highest income communities suffered 44 percent more obstetric injuries during vaginal delivery than those from the poorest communities. Black and Hispanic mothers experienced fewer childbirth-related injuries than whites (108, 130, and 162 per 1,000 vaginal deliveries with instruments, respectively). Asian-American mothers had the highest rate of childbirth-related injuries (203 per 1,000 vaginal deliveries with instruments).
AHRQ had more limited data on injuries to newborns during childbirth. The Agency found that:
- Injuries were highest to infants born in rural areas (2 per 1,000 deliveries for rural areas vs. 1.5 per 1,000 for large metropolitan areas) and the Northeast (2 injuries per 1,000) vs. the West (1.4 per 1,000).
- White infants had higher injury rates than other racial groups (1.9 per 1000 vs. 1.4-1.5 per 1,000).
- Injury rates were higher for infants with Medicaid coverage than those with private insurance (1.7 per 1,000 vs. 1.5. per 1,000).
For more information, go to Potentially Avoidable Injuries to Mothers and Newborns During Childbirth, 2006, Statistical Brief #74 (http://www.hcup-us.ahrq.gov/reports/statbriefs/sb74.jsp). The report uses statistics from the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured. The report also uses statistics from a special disparities analysis file created from the Healthcare Cost and Utilization Project 2006 State Inpatient Databases.