By Kate Bluett
Correct me if I'm wrong, but isn't this the United States of America? In the twenty-first century? Aren't we first in the first world? So why is our rate of women dying in childbirth rising again?
It's not a huge increase, but it is cause for concern. We also have one of the worst infant mortality rates in the developed world. And surprisingly, no one blames these rates on a corrupt health care system turning patients away. Rather, the rising maternal mortality rate is blamed on higher rates of obesity and C-sections; one-third of the infant deaths are the result of prematurity.
Obesity contributes to the rise in C-sections: an overweight mother is more likely to have a bigger baby. The difference between birthing a 7-pound baby and a 10-pound one is significant; it can cause serious complications. These complications may require a C-section birth. High-risk pregnancies are also more likely to require C-sections; they're also the ones more like to end prematurely, especially if the high-risk qualification is due to the presence of multiple babies in the womb. And our rates of multiple births have been skyrocketing for decades, ever since in vitro fertilization was introduced, in fact.
In vitro fertilization, as practiced in the US, often results in multiple-baby pregnancies. That's because American doctors usually implant four or more embryos into the womb, a procedure that's illegal in other developed countries. But embryos tend to implant in batches or not at all, and parents want the most children they can get out of one second-mortgage-inducing round of treatment. So in go the embryos and out, if they're lucky, come the babies.
Many do not survive—the female body is built to bear only one baby at a time. Doctors know this, well in advance of performing any assisted reproductive procedures, but they do them anyway. In vitro fertilization, egg donation, and fertility drugs all carry the risk of this outcome, but they're all getting more common by the day. And even if only one embryo "takes," the results are not good: even singleton babies manually implanted in the womb are more prone to prematurity, low birth weight, and birth defects. But doctors implant them day after day after day.
We the people are raising our infant and maternal mortality rates deliberately. People want babies, of course, but they are now demanding them on their own terms in greater and greater numbers. They think their terms do not include deformity and early death—why else would they screen embryos for genetic abnormalities and hereditary diseases before implantation? Their terms include timing, gender, number, and health; IVF parents are not so unreasonable as to demand certain eye colors (unless they're using donor gametes, in which cases donor appearance can be a factor). But the terms of the deal are the terms of the deal. The cost of IVF doesn't begin to cover the external costs to children's health and well-being. But in a consumerist culture, the costs to a future generation don't matter. What matters is the consumers of today being able to demand—and get—whatever they can pay for. No matter who foots the real bill.