1/21 Women Experience Birthing Trauma
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|Tue, 08-14-2007 - 4:33pm|
One in 141 babies experience birth trauma each year; one in 21 women: report
TORONTO (CP) - One in every 141 newborns suffers injuries during the birthing process, and one in 21 mothers giving birth vaginally experiences trauma, a new study on patient safety suggests.
The report by the Canadian Institute for Health Information, which excluded Quebec in its analysis of hospital data from 2003 to 2006, said birth trauma includes injuries to a baby's scalp and nervous system or skull fractures.
"There is a range in terms of impact," Dr. Jennifer Zelmer, CIHI's vice-president of research and analysis, said in an interview Tuesday.
"We do know that babies who have birth trauma tend to stay in hospital on average a day longer than ones who don't. So they may require additional care and monitoring during their stay. And for some babies they would recover relatively quickly; for others, it would have more serious consequences downstream."
Babies are at higher risk if the mother has diabetes or is obese, or if she has a small pelvis or has had a prolonged pregnancy, Zelmer said.
Problems can also arise if the baby is in an abnormal position or if labour is induced, she added.
It's the first time these numbers have been collected from Canadian hospitals in this way, she noted.
"Now we know it's about one in 141, we can start looking as people are introducing programs to try and reduce the risk, where have we been most successful? Are there things that we can learn from that, and then potentially spread them more broadly?" Zelmer said.
In terms of mothers, the trauma experienced could include third-or fourth-degree tears, or injury to the bladder or urethra.
Again, these could lead to longer stays in hospital, or long-term consequences like incontinence or a prolapsed uterus, Zelmer said.
Dr. Ken Milne, past president of the Society of Obstetricians and Gynaecologists of Canada, said it's difficult to interpret the numbers without knowing the clinical circumstances of individual events, and whether they were expected in a high-risk situation, or unexpected in a low-risk pregnancy.
For instance, he said certain problems might be anticipated if there is a very large baby and labour is obstructed.
"Some of the most difficult deliveries that I was ever involved in were deliveries where that baby's head was really jammed down tightly into the mother's pelvis, and even trying to deliver a baby through the abdominal wall was a very difficult process," he said from London, Ont.
Milne said it would be useful to have more information so that doctors could learn from unexpected events, and try to mitigate them.
"It is helpful to simply have the report because it brings about an awareness and it makes us focus, I think, where we should focus," he said.
At the same time, he said it's important to remind everyone that Canada is a very safe place to deliver a baby, and statistics support that.
CIHI, which produced the report, is a not-for-profit organization that collects and analyzes information on health and health care in Canada. The report also said:
-One in 279 patients (excluding Quebec and parts of Manitoba) experience a pulmonary embolism, which occurs when a blood clot or globule of fat or tissue travels through the veins and into the lung.
-Foreign objects, including sponges or surgical instruments, are left in a patient after surgery about once in every 3,000 surgeries (excluding hospitals in Quebec and parts of Manitoba).
-A Commonwealth Fund International Health Policy Survey, released previously, showed that in 2005, 10 per cent of adults with health problems reported receiving the wrong medication or a wrong dose.