Yet, stillbirths are not often recorded in infant mortality data, Goldenberg said. In addition, in the United States there remains a large disparity in the number of stillbirths between white and black women, he said, with black women at much higher risk. Similar disparities also exist between urban and rural women and between poor women and richer women.
"It is disadvantaged women that tend to have stillbirths much more often," Goldenberg said. "That's predominately because of access to care."
Dr. Cathy Spong, chief of the Pregnancy & Perinatology Branch at the U.S. National Institute of Child Health and Human Development, and author of an accompanying journal editorial, said that the disparities seen in stillbirths are the same ones seen in other adverse pregnancy outcomes.
These disparities "not only occur in stillbirth, it occurs in preterm birth and also in infant mortality," she said. "So, as you look at conditions in pregnancy, and the bad things that can happen you see consistent disparity."
The good news is that over the last 30 years there has been a substantial reduction in stillbirths in the United States, Goldenberg said. "Fifty years ago, the stillbirth rate was 50 per 1,000 births, to day it's between three to six per 1,000," he said.
"We have done very well, but there is still more to do." Goldenberg said. "It's mostly due to good obstetric care that most women in the United States get," he said. "But women who don't have access to timely care have as much a fourfold increased risk of stillbirth.".
According to Goldenberg, stillbirths typically occur die to major "catastrophes" during labor. These can include bleeding, seizures, prolonged labor or the baby not getting enough oxygen. "Most of those conditions are easily fixed in a good hospital," he said. "Women who don't have
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