Hacker News new | past | comments | ask | show | jobs | submit login
Welcome to the safest time to give birth in human history (theupwing.com)
39 points by jseliger 4 months ago | hide | past | favorite | 55 comments



Not according to the Guardian

Infant mortality is rising and births are plummeting. This is the legacy of 14 years of Tory cruelty

https://www.theguardian.com/commentisfree/article/2024/jun/0...


I was interested in that article’s claim as a 8% rise in a year seems high.

Looking at the data, the UK rate has been decreasing overtime but has plateaued in recent years and slight fluctuations could be noise. For most of the past 6 decades it has been decreasing steadily but at a decreasing rate.

It also appears different countries count infant mortality differently. Some have cut offs where they consider the live birth to be a still birth for reporting purposes. So it’s not a apples to apples comparison between countries.

https://data.worldbank.org/indicator/SP.DYN.IMRT.IN?end=2022...

On a side note, a friend of mine is a neonatal intensive care doctor. The majority of the infants they care for have issues due to heavy drug use during pregnancy. So at least in my country this has a large impact on infant mortality.


> I was interested in that article’s claim as a 8% rise in a year seems high.

It's all in the framing.

Between 2000 and 2017, the global maternal mortality rate fell by 38%. In low-income countries, the decline was more dramatic still, with a reduction of 46%.

They used the lagging gains that finally arrived in lower income countries to boost overall stats - and thereby avoided discussing trends in high income countries.

And lagging trends between poorer and richer countries is still a thing.

Having hit their possible peaks, poorer countries should continue to follow wealthy countries and plateau next.

If they follow (growing) western trends to unwind programs that bring healthcare to the poor, a reduction in healthy birthrates seems inevitable.


>The majority of the infants they care for have issues due to heavy drug use during pregnancy.

Is there any reason why that shouldn't be (or isn't?) prosecuted under child abuse and/or neglect?

I'm all for people doing whatever the fuck they want within the confines of the law they reside in, but that buck stops where the human rights of another begins.


It is. And children are taken away. The problem is, the state alternative to parenting is not working problem free either. My mother worked in that area(in germany), so I have some insight and can say, in many instances, the children had better circumstances with their junkie parents, than being dragged through foster homes. Siblings torn apart without warning etc.

What most junkie parents need is practical help, so they can have a rehab, not prosecution.


How are the children affected by drugs during pregnancy over the long term? Do they suffer mental or physical disabilities as they grow up?


It is definitely a bad influence. Crystal meth is the favourite around here and especially in combination with alcohol it is pure poison.

But it is hard to tell in hindsight, how a children would have grown up different. I know some, who turned out quite well, despite all this. You couldn't tell by the looks and behavior that their mother was drugged at birth (and before and after).

Much more important are stable social conditions. A junkie mother who loves her children and is there for them at least some of the time is way better than no mother and just distant social case workers to whom the children are just a job. (Some are doing a great job with love, but they ain't the majority around here)

But there definitely also are cases of disabilites, that are very likely drug induced.


Here's a good review with nuances:

https://www.britishjournalofmidwifery.com/content/legal/shou...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5151516/

I like this take:

> Viewing these cases as potential criminal offences will do nothing for the health of women and their babies. There is a strong public interest in promoting the good health of pregnant women and babies, but, as longstanding government policy recognises, this interest is best served by treating addiction and substance abuse in pregnancy as a public health, not criminal issue.

Another aspect I'm almost sure affects babies is alcohol / drug use by either parent prior to conception. In the months prior if the father or mother consume drugs, you will have a negative impact on your child, and nobody gets prosecuted, because nobody can tell you're 10% dumber or 15% more anxious for your whole life due to it.


There are probably a decent number that also continue well into a pregnancy, without realizing they are.


The figures about safety are likely little comfort to expectant mothers when they go into an NHS hospital and see the sheer prevalence of avoidable mistakes, large and small. This isn't just a maternity ward issue, although the effects of poor attention and mistakes are particularly dangerous there, it's a risk across all NHS hospitals.

It's sad as the hospitals do so much to a high standard but they surround their core processes with a low quality support that quickly undermines the good work.

From my many experiences over the last few years visiting friends/relatives in hospital, a huge number of tasks are messed up by overstretched low level staff.

Just one recent example, a lady in the bed next to a relative had been admitted with a serious infection, purely for an IV drip for antibiotics as she couldn't keep the tablet form down - she was sent by her GP and this should have been routine but due to hospital communication mix-ups they wouldn't give it and she deteriorated over five days whilst they did nothing but a few basic tests, all the time in discomfort for something that could've been resolved easily.

Underfunding is the cause but the cure will need not just money but a return to rigour, attention to detail and a focus on communication.


Opinion column, and the paper's bias aligns with their claim. More internet literacy needed!


> Not according to the Guardian

To be fair that's an opinion piece.


I think it depends on the country, no?


"Safest time to GIVE birth"


It seems like the Guardian is spreading misinformation for election reasons anyway, judging from the comments - the increase in infant mortality it claims is well within the range of normal year-to-year variation, which is presumably also why an article that claims it's the "legacy of 14 tears of Tory cruelty" uses a claimed increase over just one year.


How would you describe the effects on the NHS of 14 years of Tory rule?

‘Cruelty’ is a very emotive word obviously.


Honestly, I don't care one way or another whether it's safer to give birth now than before (that said, it probably is in 99% of cases).

No, I care more and am thoroughly disgusted about the fact a fundamental thing as childbirth is used for political points.


> No, I care more and am thoroughly disgusted about the fact a fundamental thing as childbirth is used for political points.

To be honest, safety of childbirth in the public health system is as political as it gets.

If the current government (either on purpose or by incompetence) made the public health system worse for childbirth, they should absolutely be held accountable by entities such as newspapers. Hell, it's one of the main reasons newspapers exist, to held governments accountable.

Your points make no sense.


The guardian is spreading loony-leftist misinformation on a permanent basis, never mind the election. It’s like standing on shifting sands that one really does have to be a seriously critical thinker to see through. Reading it is a recipe for becoming mind-addled, probably more mind-addled than reading the Daily Mail which at least is obvious in its simple right-wing messaging. Plus, there’s a reason why The Guardian is free… (said as someone who reads it daily).


Plus I’m already getting downvoted but case in point from even the two articles posted in this thread, in terms of shifting sands of Hegelian contradiction which it peddles.

“Economists across the west are alarmed by falling birthrates, which makes the two-child benefits limit peculiarly vindictive.”

BUT

The best thing to do for the planet is have one less child.


It's not as clear cut as you are making out and I would suggest that you are spreading your own misinformation.

There have only been 3 year on year rises between 1980 and 2014 (increases of 0.1, 0.1 and 0.2 infant deaths per 1000 live births) [1].

Since then, there have been 2 sustained rises over several years, totalling 0.3 in each case. The second of which is ongoing and could continue to rise - we lack data from 2023.

These are anomalous given the decades long downward trend in this type of mortality.

(There are other very significant issues in maternal healthcare from the same period. A corresponding upward trend in maternal mortality in recent years [2]. And black women in the UK are nearly four times more likely than white women to die within six weeks of giving birth, based on figures from 2018-2020.)

Call it what you want, but outcomes surrounding a basic biological function getting worse after 14 years of control by a single party in one of the richest countries in the world is worth covering.

This isn't partisan politics either. Compare these non-opinion headlines from the famously left-leaning (sic) Telegraph:

- 2011 - Infant mortality falls by 60 per cent in a generation [3] - 2024 - British infants more likely to die before first birthday than those in other developed countries [4] > The UK’s global ranking has gradually fallen from 23rd in 2015 when the infant mortality rate was 3.9 deaths per 1,000 births. While other countries improved, Britain’s rate stagnated before it fell during the pandemic back to figures not seen since 2012.

Even though they ultimately will tend to point the blame in different directions, they are reporting the same underlying story.

[1] https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...

[2] https://www.bmj.com/content/384/bmj.q62

[3] https://www.telegraph.co.uk/news/health/news/8388584/Infant-...

[4] https://www.telegraph.co.uk/news/2024/02/05/british-infants-...


Also according to the Guardian: Want to fight climate change? Have fewer children

https://amp.theguardian.com/environment/2017/jul/12/want-to-...


And if you want to get rid of house fires, get rid of houses!


The article also does it. Near the bottom it suggests family planning. Not a bad thing per se if not for family overplanning.


They’re not wrong.


sure. and in the next breath, they'll tell you the the western countries need millions of immigrants to make up for your nonexistent birth rates. anti-natalism and pro-immigration always go hand in hand.


Pretty sure you want to include location as a variable in this kind of statistic.


Why?

Do you think there is anywhere on earth where it's more dangerous to give birth now than a hundred years ago?


The US states that decided the mother and child dying during labour was preferable to abortion seem to qualify as more dangerous than they were in 1920.


You might be underestimating the prevalence of laws prohibiting abortion in the 1920s.


So your claim is that if a US doctor thinks carrying to term is dangerous, no abortion is allowed?

I'm all for choice, but I'm also for absolute clarity in such statements, and absolutely against any phrasing, for any issue, that is crafted to cause misunderstanding, and an even worse interpretation of the facts.


In a lot of states, yes, a doctor is putting their license, financial future and even their freedom at risk if they believe that a pregnancy needs to be terminated for the life or health of the person carrying it, but some activist DA or judge disagrees.


I would want to see sources before taking a comment like this seriously. I used to live in one of the most regressive Islamic countries in the world (where abortion was absolutely not allowed), and my wife had zero issues aborting a pregnancy when it was found to be threatening her health. It was done within hours and without a single moment of controversy.

Do you have any case law to support this being a valid concern?


All the US states with abortion bans do have exceptions to save the life of the mother.

The particular issue is that currently it's an actual legal minefield for doctors in a number of those states due to vague definitions, over zealous prosecutors, and relatively tight time limits.

This article:

https://www.kff.org/womens-health-policy/issue-brief/a-revie...

appears to give a good overview of the state of affairs.

For now at least the real danger is doctors being unwilling to risk their licence and making borderline calls in many situations with a ticking clock.


The permissible exceptions seem pretty clear to me. The claim that this is a “legal minefield” is one that should be substantiated. If that were true you should at least be able to provide a reference to a controversial prosecution.


The claim is made in the brief linked.

> at least be able to provide a reference to a controversial prosecution.

Why? This is all relatively recent changes, there are doctors on record saying they've been unwilling to perform abortions for a variety of reasons and at risk of the mothers health.

That doesn't at all imply the necessity for the existence of a prosecution - but it does woman's health is suffering due to fear of prosecution.


An equally likely explanation is that these doctors are simply grandstanding and using the opportunity to stoke some moral panic. This is one of the most divisive political issues in the country, and the link you posted would support the claim that “some doctors are passionately unhappy about the change”. But if you want to claim that it’s a “legal minefield” then you should be able to offer some proof.

As far as I know there have been zero controversial prosecutions resulting from this change, so all you’ve managed to provide is somebody’s speculation that it might turn into a legal hazard at some time in the future. Given how massively politicised this issue is, I think it would be pretty stupid to just accept people’s baseless speculations as fact.


> But if you want to claim that it’s a “legal minefield” then you should be able to offer some proof.

The claim is made in the brief linked. I am not one of the authors of the brief linked.

> As far as I know there have been zero controversial prosecutions resulting from this change

Which proves nothing with respect to the matter of Doctors stating they've been unwilling to risk prosecution.


Going to have to jump in here, defrost. You did indeed claim it is a "legal minefield", only later to say "Well, actually, I meant this single, one paper claims that."

Hyperbole is what this paper likely is engaging in. It's certainly presenting a "worst case scenario" examination. And even if not, it's only presenting possible issues.

Issues which may or may not come up, and all of these states have differing legislation.


I did indeed accurately paraphrase the part of the brief that discussed the current legal status of medical abortion issues in some US states.

> only later to say "Well, actually, I meant this single, one paper claims that."

I certainly referred to that paper. I did not make the claim that you're asserting via paraphrasing my comment.

> Hyperbole is what this paper likely is engaging in.

In your opinion. An opinion you seem uncertain about. By my reading it presents as measured and as quoting the actual concerns of actual people.

> Issues which may or may not come up,

All the issues raised do indeed come up in real life - medical cases can get messy and mother | child health issues are not always as neat, well packaged, and clear cut as some seem to think.

There are always edge cases in any given state in any given month.

Don't take my word for it, go and ask several practicsing OBGYN's.

Do try and avoid the likes of Dr. Christina Francis & Co. who appear comfortable dodging and outright misleading the US Senate: https://youtu.be/T-5Gym8Mq1Y?t=104 & t=168

Further: https://www.murray.senate.gov/senator-murrays-opening-remark...


Sample size of 1. Did you do it legally? Could your wife do it alone without her male guardian forcing the issue? How do you know doctor's chances to get in trouble did not dramatically increase after?


> Yes, at one of the largest hospitals in the country.

> She discovered the issue and had the procedure scheduled before I even arrived at the hospital.

> Because this is a routine medical procedure in every country that has any sort of healthcare system.


OK, that's a data point.


Some location currently undergoing civil war, for instance.


In USA it's arguably more dangerous than a few years back, especially if you're black https://jamanetwork.com/journals/jama/article-abstract/28066...


Why pick a hundred year horizon? All of human history gives quite a bit more leeway, no?


A hundred years was being generous (in the 1920s modern medicine was fairly recognisably taking shape). If you want to make it five hundred years or a millennium ago then be my guest.


And what would be the answer then? Where would it be safer somewhere in history than it is now?


Maternal mortality in the US has generally been considered to either be flat or rise over the last few decades.


The drop in healthcare standards in the NHS is more than offset by the longterm trend to safer childbirth in emerging and developing economies.

Things like zika aside, there's never been a better time to give birth at planet scale.

(Also ignoring post birth risk of war, famine and global warming)


Safest time in history, lowest fertility rate in history. Massive political polarization over it as well.


Infant mortality rates are historically moving down, but so are fertility rates.

21st century demographics will be a tough cookie to crack.


If you are not in US.


Yeah it’s pretty amazing what they can do, the earliest surviving premature baby was born after just 21 weeks of pregnancy.


And yet we don't. Curious!




Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: