Title:	Preterm Birth in the United States
Authors:	Janet M. Bronstein
Keywords:	Preterm Birth
Issue Date:	2016
Publisher:	Springer
Description:	The United States is an advanced technological society. It has the largest gross domestic product (GDP, the total dollar value of all goods and services produced) of all of the world’s nations. It also has the largest portion of GDP that is devoted to health care, 16.4 %.1 Yet the U.S. infant mortality rate ranks 33rd of the 36 nations included in the Organization for Cooperation and Development (OECD—European Union, EU applicants and selected other developed countries). This low ranking is not a recent phenomenon—it has been observed for decades, ever since comparative infant mortality rates have been available. The reason for this low ranking is also clear, and has been stable for decades: the United States has a much higher rate of preterm births—infants delivered before their mothers’ pregnancies reach term (at least 37 weeks gestation) than other developed countries. The U.S. actually has a lower mortality rate per preterm birth age than other countries, but this high survival rate is not sufficient to compensate for the larger number of infants born before they reach term. The persistence of high preterm birth rates in the U.S. population has been labeled an enigma by biomedical researchers, an issue of concern by clinicians, an indicator of the need for political and health sector reform by social advocates, the trigger for ethical dilemmas in health care and social policy, and a human tragedy for the families involved. It is a complex phenomenon that involves many participants, each of whom has a different view and set of experiences: the mothers who experience an early end to their pregnancies and the fathers of infants born early; their physicians, nurses and hospitals; those who finance the care of these mothers and infants and those who worry about maintaining resources for such expenditures; scientists responding to the challenge of explaining preterm birth; politicians who feel pressured to respond to preterm birth when it is framed as a social problem; and advocates who believe that their agendas offer solutions to the problem, to name just a few. Each group is able to describe the phenomenon from its own perspective, and each often believes that its perspective represents the issue of preterm birth overall. The situation is reminiscent of the ancient Indian story of the six blind men encountering the elephant: the one touching its side believes it is a wall, the one touching its tusk believes it is a spear, the one touching its trunk believes it is a snake, the one touching its leg believes it is a tree, the one touching its ear believes it is a fan, and the one touching its tail believes it is a rope. The blind men argue vehemently about who has the most accurate view of the elephant, when in fact none of them has complete knowledge of what the elephant is like.
URI:	http://10.6.20.12:80/handle/123456789/54229
ISBN:	978-3-319-32715-0
Appears in Collections:	Population Studies

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