BIRMINGHAM, Ala. — According to a report released recently by the Center for Disease Control and Prevention, Alabama and its neighbor Georgia lead the nation in the rate of stillborn babies.
The fetal mortality rate in Alabama and Georgia is 8.88 per 1,000 live births for babies older than 20 weeks, compared to a 5.96 average for the nation. Alabama’s other deep-south neighbor, Mississippi, also had a high rate of stillbirth at 8.85.
A stillbirth occurs when a baby dies more than halfway through a pregnancy. Before 20 weeks, deaths are classified miscarriages, which are not counted in the same statistical category.
The numbers in the CDC’s study do not include abortions.
Medical experts note that the causes of stillbirths are varied, but there are several key factors that can make an individual more susceptible.
Dr. Karen Landers, a pediatrician and consultant to the Alabama Department of Public Health points out that the state’s highest-in-the-country rate correlates with Alabama’s higher-than-average rates of both smoking and drug use.
But drugs, alcohol, and cigarettes might not be the only cause. What women eat before and during pregnancy could also have a significant effect. “Consider that in Alabama, we have a higher rate of obesity than most of the rest of the nation,” Landers told AL.com.
Dr. Joseph Biggio, professor of obstetrics at UAB School of Medicine said, of stillbirth causes “Diabetes, hypertension, obesity and substance abuse are the things we saw over and over again.”
Even when all other factors are equal, not everyone’s chances of having a stillbirth are the same. The rate of stillbirth is highest among black women at 10.53, compared to 4.88 for white women. Mothers age 15 years or younger have the highest rate of stillbirth among different age groups, followed by mothers older than 35.
As reported by the U.S. Census Bureau, Alabama is sixth in the nation in African-American population percentage with 26.4 percent, behind its stillbirth rate companion Georgia, where African Americans make up 31.4 percent of the population.
Another explanation could also be Alabama’s high rate of teen births. With 34.4 per 1000 babies being born to mothers aged 15-19, the Yellowhammer State is fourteenth in the nation for teen parenthood.
Further questions come from Alabama’s legal prohibition on home-birth supervision by midwives. A 2013 study by the American Journal of Obstetrics and Gynecology suggests that the stillbirth rate for babies born at home is ten times that of babies born in hospitals.
However, the data has some gaps. Most of the referenced studies in the report used data from records submitted by trained midwives, but some of the data cited from previous studies was never adjusted for whether the birth was planned, low-risk, unassisted or attended. It was a review of home births, which assumed that a birth that occurred at home after 37 weeks must have been planned.
In state’s such as Alabama, where midwifery is banned for home births, the data on stillbirths in the home would be completely skewed as they were unsupervised by any legally licensed professional.
Regardless, Dr. Biggio believes that with the right care and circumstances, Stillbirths in Alabama can be prevented. “It’s a matter of making sure these patients have access to all the resources to manage these pregnancies successfully,” he said. “There are things we can do if we catch things before they happen.”
