By Ali Weatherford

(Trigger warning: some discussion of premature birth, stillbirth, and maternal/infant mortality)

Statistics was my most AND least favorite class in college. I had to take this class for my major, but I wanted nothing to do with anything related to math. Why would I need math as a Psychology major? It turned out to mean a lot of complicated math, but it was also the most eye opening class I’ve ever taken. Statistics can be used for good, but you have to know how to read them.

Why Statistics Are Important

Statistics can tell us a lot about our world. We can find out about how similar we are (or aren’t) to other people related to how we might expect to spend money, time, and effort. It can be interesting to read about those things, but for many pregnant people, the statistics they look for are about safety. You might hear the word “risk” tossed around a lot. People are categorized as either having a “high risk” or “low risk” pregnancy. What about medium risk? Can we get at least one more category?

When you are making choices for your maternity care, it can be helpful to know whether you’re considered high or low risk. For low risk women, ALL of the options are available. If you are considered high risk, you might have fewer options, but it depends on the type of issue you’re having.

For example, a home birth midwife might be perfectly well-equipped to manage certain kinds of “high risk” complications, but not all. If you have gestational diabetes, you might be pushed into the high risk category. A home birth midwife may decide that you still qualify for a home birth if your blood sugar levels are well-controlled by diet, and you don’t have any other risk factors. They may suggest some extra monitoring, and manage your prenatal care and birth very appropriately and safely. If you develop placenta previa on the other hand, that same midwife would understand that you need a different level of care and refer you to another provider. That limits your options, because you no longer qualify for an out-of-hospital birth, and you may even require the care of a Maternal Fetal Medicine specialist (MFM).

What does High Risk Mean?

If you have a condition or are labeled high risk because of your age or because of how you conceived, you might wonder what that means. What does “high risk” mean? Does that mean you and your baby are in mortal danger? Or does it mean that your risks are just highER than the next person’s?

In an article we recently published, I went over the differences between relative risk and absolute risk.

Relative risk is the likelihood of something happening (or not happening) compared to someone else. Relative risk would sound like, “Your risk of developing high blood pressure during pregnancy more than doubles after age 35”. So that means, compared to people under 35, your risks are higher. But what does this really tell you? Should you be very worried? Are you doomed to develop high blood pressure? The answer to this would be to ask another question.

What is My Absolute Risk?

8% of people under age 35 develop high blood pressure. For people over 35, the number is 18%. That number is more than double, but does it make you feel better to hear that actual number? When I see 18%, I don’t feel doomed. I recognize that it’s still unlikely. There is an 18% chance that I will develop high blood pressure, but there is a 72% chance that I won’t!

I might also ask about things that can lower my risks. There are probably some great options like getting more exercise, great nutrition, and lowering my stress levels.

Knowing your absolute risk can be very helpful, and I always encourage folks to ask that question when they’re confronted with scary-sounding statistics.

Some Stats for You

I’m writing this article in response to a reader’s request for more statistics. I wasn’t sure exactly which kind of statistics to include, so this is a list of some of the more common numbers that I see or hear about related to pregnancy, birth, and baby care.

For all of these and more, please remember to question statistics. A number might be correct, but not very applicable to YOU. The numbers I show below are averages. They include EVERYONE, and don’t always take into account your risk category or your ethnicity or race. It’s an unfortunate but true fact that black people especially, but also other people of color, immigrants, and people in the LGBTQIA+ community may expect different statistics. This is born of inequities and disparities in care caused by systemic racism and implicit bias. I think it’s wise to take this into consideration when you are facing those statistics, but also remember to determine your absolute risk. Increased risk is a serious problem, but knowing what your absolute risk is can be comforting.

  • Prematurity: About 10% of births are preterm. That means the baby is born before 37 weeks. This might sound like a scary number, but remember you can ask the question about lowering risks for anything. This number includes EVERYONE, including people having high risk pregnancies. The relative risk for folks experiencing a low risk pregnancy is about half. The absolute risk for a person experiencing a low risk pregnancy might only be 5%. With this statistics, also remember that a baby born at 35 or 36 weeks is very different from a baby born at 31 weeks. At 35 or 36 weeks, or even younger sometimes, a baby may be perfectly healthy and not need any special care.
  • Preeclampsia: About 5-8% of people develop preeclampsia.
  • Gestation Diabetes: About 5-9% of people develop gestational diabetes.
  • Cesarean Births: The most recent statistic is for 2023 and shows that nationwide, the cesarean rate was 32.3%. If you look at the March of Dimes map, you can see how this is divided by state. Let’s question it. It’s also important to zoom in even more for some statistics. For example, the overall cesarean rate for the U.S. is 32.3%, but for Texas, it’s over 33.2%. HOWEVER, you can look up your own hospital’s cesarean rate! You might see that around the Austin, TX area, the number hovers closer to 29%. I noticed one particular local hospital that is down to 22%. But zooming in even more, the hospital rates show an average of all the providers who attend births there. You might get even more comfort or insight by asking your own doctor about their cesarean rates. For some it will be lower than the hospital rate, and for others it will be higher.
  • Stillbirth: In statistics, mortality rates are usually not shown as a percentage. Instead of hearing the percent chance of this outcome, it’s shown as 1 in 175 births. I like to translate that into a percentage. For some reason, it helps me to hear it that way. If you ever want to do that for yourself, you take the Part (1), divide it by the Whole (175) and multiply that by 100.
    • 1÷175=.006
    • .006X100=.57%

So, on average, the chance of having a stillbirth is .57%. And always remember that low risk pregnancies can mean a lower number, and that you may ALWAYS ask how you can lower your risks. Also remember that stillbirths are defined as a fetal death that occurs in utero after 20 weeks of pregnancy.

  • Maternal Mortality: This rate is shown as 18.6 deaths per 100,000 live births. That percentage is .0186%. That’s the average in the U.S. The highest rate is for black women, at .05%. The high resource country with the next highest rate is Chile with a rate of .0143%. The lowest rate that same year was for Norway at 0%.
  • Infant Mortality: The rate in the U.S. is about 5.342 deaths per 1,000 live births. That rate is .53%. This rate does not include stillbirths, only deaths that occur after birth. It’s also important to recognize that includes infant deaths that occur in the first year of life. Most people think it includes deaths that occur immediately following birth and as a result of birth.
  • Birth defects: About 1 in 33 babies is born with a birth defect. That’s a 3% chance. That sounds high, but if you look more carefully, you’ll see that birth defect is a very broad category and includes conditions that are more severe and debilitating, but also those that can be completely resolved with a simple surgery or managed well with medications.
  • Sudden Infant Death Syndrome (SIDS): This is a very scary thing to think about for most parents. We have an article discussing SIDS, how it’s different from Sudden Unexpected Infant Death (SUID), and some prevention strategies. The SIDS rate is about 1 in 1000 babies or .1%. The SUID rate is about 100.9 per 100,000 or .1%. This is confusing, right? That’s because SIDS is a SUID, but not all SUID cases are SIDS and they get lumped together. You really have to dig for this one. SIDS rates are actually lower than .1%. More than half of the SUID cases have a known cause. It’s usually an accident that could have been prevented with better education or circumstances. In true SIDS cases, the baby was apparently healthy, and there was nothing in the environment that could have caused the death. This makes me feel better. There is a less than .1% chance that my baby will die from SIDS which is something that parents really have no control over. I can also see from these statistics that I can do something to reduce my risk.
  • Breastfeeding rates: In last week’s article, I referenced the American Academy of Pediatrics (AAP) statement that recommends “exclusive breastfeeding for approximately 6 months followed by continued breastfeeding with complementary foods for at least 2 years and beyond as mutually desired.” The CDC issues a health ‘report card’ with a section about breastfeeding. Here are some things to notice:
    • About 84% of babies are breastfed some.
    • About 46% are exclusively breastfed for 3 months
    • About 27% are exclusively breastfed for 6 month
    • About 39% are breastfed at 12 months

This isn’t great. We’re not meeting the recommendation set by the AAP. But that 84% number looks great! Unfortunately, that includes people who go on to breastfeed for 2 years, but also those who breastfeed twice. Also, the 39% at 12 months might seem OK, but remember that the recommendation is that breastfeeding continue for 2 years! Many people drop off at one year, and it’s down to 11.5% at 2 years. It is absolutely true that any amount of breast milk is beneficial. It’s also true that more is better! Our goal is to help families achieve these goals if they desire it. Always contact a lactation consultant for help if you’re struggling. You will likely have insurance benefits to cover it! Once you figure it out, it gets much easier over time.

Breastfeeding rates are a great one to look at, because you can probably do something about it.

Breastfeeding also happens to be an excellent way to reduce some other risks. By getting some prenatal breastfeeding education, and learning about some best birth practices, most people increase the likelihood that they’ll be successful. And then if things don’t go smoothly, you can get help and will likely have great results.

Resources

About the Author

Ali Weatherford, ICCE is the manager of Parent Education at Breastfeeding Success and a childbirth educator certified by the ICEA. She has also trained with Birthing From Within™, DONA International, Spinning Babies™, and regularly attends annual conferences and training related to childbirth education, perinatal mental health, and more because she will never be done learning! She has a BA in Psychology with a background in research and writing. When she’s not teaching and learning about birth, she’s probably cooking and hanging out with her two wonderful kids and many pets at home in Austin, TX.