How risky is it to have a baby?
January 18, 2010 9:12 AM Subscribe
How high is the mortality risk of pregnancy/birth for a woman in the developed world, as compared to other lifestyle choices?
I want to answer the seemingly simple question of how risky, on average, it is for a woman in the developed world to get pregnant and give birth. I want to consider this risk not as a public health problem, but from the perspective of an individual woman thinking about getting pregnant - what mortality risk is she taking, on average?
To answer this question, I think it would be helpful to compare her decision to have a baby to other lifestyle choices, e.g. boarding a plane, driving in a car for a hour, bungee jumping, changing a lightbulb, crossing a street, joining the armed forces...(really any "risky" behaviour you can think of that might ultimately lead to death).
I already found out that the common measure for maternal death is the "Maternal Mortality Ratio", defined as the number of maternal deaths per 100000 live births, and that this is 4-8 in Germany (8-11 in the US, respectively, according to UNICEF). So when a woman gets pregnant, she seems to be taking a (e.g.) 8:100.000 risk of dying in the process, for example.
But the really difficult part seems to be the comparison to other risks. I came across a lot of data on Death risk in general, e.g. in the Carnegie Mellon Death Risk Rankings. The problem is that these data are only about diseases or accidents (e.g.: how high is the risk of dying from maternal death as opposed to liver cancer, or as opposed to dying from a car accident?). But I want to compare maternal death risk to behaviours that - like getting pregnant - you choose to do, not to things that just happen to you.
Can you help me? Ideally, I'd like to come up with a list of behaviors which carry a mortality risk similar to maternal mortality, and could then state that "Having a baby is as risky as X intercontinental flights", or whatever.
Sorry if I've missed any obvious points, I don't know a thing about statistics...
(For simplicity's sake, I'd like to ignore the fact that not all women get pregnant when they decide to, and that not all women who get pregnant do so voluntarily or intentionally. Also, I'm ok with very very vague back-of-the-envelope calculations; this is not SCIENCE.)
I want to answer the seemingly simple question of how risky, on average, it is for a woman in the developed world to get pregnant and give birth. I want to consider this risk not as a public health problem, but from the perspective of an individual woman thinking about getting pregnant - what mortality risk is she taking, on average?
To answer this question, I think it would be helpful to compare her decision to have a baby to other lifestyle choices, e.g. boarding a plane, driving in a car for a hour, bungee jumping, changing a lightbulb, crossing a street, joining the armed forces...(really any "risky" behaviour you can think of that might ultimately lead to death).
I already found out that the common measure for maternal death is the "Maternal Mortality Ratio", defined as the number of maternal deaths per 100000 live births, and that this is 4-8 in Germany (8-11 in the US, respectively, according to UNICEF). So when a woman gets pregnant, she seems to be taking a (e.g.) 8:100.000 risk of dying in the process, for example.
But the really difficult part seems to be the comparison to other risks. I came across a lot of data on Death risk in general, e.g. in the Carnegie Mellon Death Risk Rankings. The problem is that these data are only about diseases or accidents (e.g.: how high is the risk of dying from maternal death as opposed to liver cancer, or as opposed to dying from a car accident?). But I want to compare maternal death risk to behaviours that - like getting pregnant - you choose to do, not to things that just happen to you.
Can you help me? Ideally, I'd like to come up with a list of behaviors which carry a mortality risk similar to maternal mortality, and could then state that "Having a baby is as risky as X intercontinental flights", or whatever.
Sorry if I've missed any obvious points, I don't know a thing about statistics...
(For simplicity's sake, I'd like to ignore the fact that not all women get pregnant when they decide to, and that not all women who get pregnant do so voluntarily or intentionally. Also, I'm ok with very very vague back-of-the-envelope calculations; this is not SCIENCE.)
I'm not sure as regards a first pregnancy, and I'm not sure as regards a pregnancy ending in a vaginal birth or second and third pregnancies, but someone did compile such statistics as regards the risks of a V(aginal) B(irth) A(fter) C(esarean) that you may find relevant.
Written by Eileen Sullivan, with assistance from her husband, Patrick.
After checking, it seems I was a bit off on the frequency of deadly lightning strikes... you are more likely to suffer a rupture than to be struck and killed by lightning, by about thirty times. Then again, how many people do you know who HAVE been struck and killed by lightning?
[Uterne] Ruptures are also more common than dying in a plane crash. Henci Goer's review of the literature on VBACs found 46 ruptures in 15,154 labors. This equates to a 0.3% rate... or 1 in 333, if you prefer. Your annual risk of dying in a plane crash is 1 in 4000, according to one source, and 1 in 700,000 according to another. I can't explain the massive discrepancy between the two figures, except to quote Mark Twain about "lies, damn lies, and statistics."
Since you asked, here are some more probability statistics for you:
Your risk of dying in a car accident, over the course of your lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5 times greater than the risk of uterine rupture.
You're about twice as likely to have your car stolen (that's an annual risk) than to experience a uterine rupture.
Your odds of being murdered are 1 in 140 over the course of your lifetime. That's 2 times more likely than the risk of rupture.
The annual risk of having a heart attack is 1 in 160, 2 times more likely than rupture. Your risk of dying from heart disease is roughly 1 in 6, or 55 times greater than your risk of rupture.
If you're a smoker, your risk of dying from lung cancer is 1 and a half times more likely than a VBAC mom rupturing during her labor.
You're about 17 times more likely to contract an STD this year than you are to have a uterine rupture; more likely to contract gonorrhea than to rupture, as well.
You're 13 times more likely to get food poisoning than to rupture.
You're more likely to have twins than a uterine rupture. Odds of twins: 1 in 90. That's about 3 1/2 times the likelihood of rupture.
If you ride horseback, you're 3 times more likely to die in a riding accident than you are to experience a uterine rupture.
If you ride a bike on the street, you are 4 times more likely to die in an accident (annual risk) than you are to suffer a rupture.
Having a serious fire in your home during the next year is twice as likely as experiencing a rupture.
You're ten times as likely to win at roulette as you are to have a uterine rupture.
If you flip a coin, you'll be more likely to get heads (or tails) 8 times in a row than to rupture.
The risk of cord prolapse is 1 in 37 (2.7%), or nearly ten times more likely than that of rupture.
And a final irony (heads up, those of you who want a doc to give his/her opinion on your likelihood of rupture next pregnancy!)...
You're 6 times more likely to have a doctor who is an impostor than you are to suffer a rupture. Two percent of docs are phonies (1 in 50), according to several sources I found.
So instead of worrying about rupture, why not take a few minutes to check up on your doctor's credentials? It'd be a more profitable use of your time, and a substantially more likely cause for alarm.
http://www.gentlebirth.org/archives/vbacrisk.html
posted by zizzle at 9:43 AM on January 18, 2010
Written by Eileen Sullivan, with assistance from her husband, Patrick.
After checking, it seems I was a bit off on the frequency of deadly lightning strikes... you are more likely to suffer a rupture than to be struck and killed by lightning, by about thirty times. Then again, how many people do you know who HAVE been struck and killed by lightning?
[Uterne] Ruptures are also more common than dying in a plane crash. Henci Goer's review of the literature on VBACs found 46 ruptures in 15,154 labors. This equates to a 0.3% rate... or 1 in 333, if you prefer. Your annual risk of dying in a plane crash is 1 in 4000, according to one source, and 1 in 700,000 according to another. I can't explain the massive discrepancy between the two figures, except to quote Mark Twain about "lies, damn lies, and statistics."
Since you asked, here are some more probability statistics for you:
Your risk of dying in a car accident, over the course of your lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5 times greater than the risk of uterine rupture.
You're about twice as likely to have your car stolen (that's an annual risk) than to experience a uterine rupture.
Your odds of being murdered are 1 in 140 over the course of your lifetime. That's 2 times more likely than the risk of rupture.
The annual risk of having a heart attack is 1 in 160, 2 times more likely than rupture. Your risk of dying from heart disease is roughly 1 in 6, or 55 times greater than your risk of rupture.
If you're a smoker, your risk of dying from lung cancer is 1 and a half times more likely than a VBAC mom rupturing during her labor.
You're about 17 times more likely to contract an STD this year than you are to have a uterine rupture; more likely to contract gonorrhea than to rupture, as well.
You're 13 times more likely to get food poisoning than to rupture.
You're more likely to have twins than a uterine rupture. Odds of twins: 1 in 90. That's about 3 1/2 times the likelihood of rupture.
If you ride horseback, you're 3 times more likely to die in a riding accident than you are to experience a uterine rupture.
If you ride a bike on the street, you are 4 times more likely to die in an accident (annual risk) than you are to suffer a rupture.
Having a serious fire in your home during the next year is twice as likely as experiencing a rupture.
You're ten times as likely to win at roulette as you are to have a uterine rupture.
If you flip a coin, you'll be more likely to get heads (or tails) 8 times in a row than to rupture.
The risk of cord prolapse is 1 in 37 (2.7%), or nearly ten times more likely than that of rupture.
And a final irony (heads up, those of you who want a doc to give his/her opinion on your likelihood of rupture next pregnancy!)...
You're 6 times more likely to have a doctor who is an impostor than you are to suffer a rupture. Two percent of docs are phonies (1 in 50), according to several sources I found.
So instead of worrying about rupture, why not take a few minutes to check up on your doctor's credentials? It'd be a more profitable use of your time, and a substantially more likely cause for alarm.
http://www.gentlebirth.org/archives/vbacrisk.html
posted by zizzle at 9:43 AM on January 18, 2010
Taking an utterly random UK Office for national statistics mortality dataset, which happens to be 2005 - that year 36 women (in the age group bands between 15 and 44) were categorised as dying due to 'pregnancy, childbirth and the puerperium'.
Unfortunately you can't use those to compare like for like in proper statistical way, but that compares to zero women dying that year in helicopter, hang-gliding or kayaking accidents. Or indeed rat bite.
Pregnancy: probably less likely to kill you than you are to be nibbled by rats and then die of it.
Yeah, slogan there needs work.
posted by Coobeastie at 9:59 AM on January 18, 2010
Unfortunately you can't use those to compare like for like in proper statistical way, but that compares to zero women dying that year in helicopter, hang-gliding or kayaking accidents. Or indeed rat bite.
Pregnancy: probably less likely to kill you than you are to be nibbled by rats and then die of it.
Yeah, slogan there needs work.
posted by Coobeastie at 9:59 AM on January 18, 2010
In the US, carrying a fetus to term and delivering has the ballpark risk of death of being a firefighter for nine months. I can't remember the exact data sources I used to find this.
posted by ROU_Xenophobe at 10:16 AM on January 18, 2010
posted by ROU_Xenophobe at 10:16 AM on January 18, 2010
So when a woman gets pregnant, she seems to be taking a (e.g.) 8:100.000 risk of dying in the process, for example.
I'd argue that this isn't quite accurate. Pregnancy and birth aren't safe activities, just like air travel isn't a safe activity. Pregnancy and birth, and air travel, are inherently quite risky activities that have nearly all of their risk mitigated through massive training, regulation, intervention, and so on. But this mitigation happens precisely because the inherent or natural risks are quite high.
posted by ROU_Xenophobe at 10:20 AM on January 18, 2010
I'd argue that this isn't quite accurate. Pregnancy and birth aren't safe activities, just like air travel isn't a safe activity. Pregnancy and birth, and air travel, are inherently quite risky activities that have nearly all of their risk mitigated through massive training, regulation, intervention, and so on. But this mitigation happens precisely because the inherent or natural risks are quite high.
posted by ROU_Xenophobe at 10:20 AM on January 18, 2010
Your odds of being murdered are 1 in 140 over the course of your lifetime. That's 2 times more likely than the risk of rupture.
This cannot possibly be true-- unless maybe you live in a seriously bad neighborhood. There are about 10,000-20,000 murders each year in the U.S.-- a country of some 300 million people. If this were true, there'd be a helluva lot more murders so I'd be dubious of the rest of those stats.
posted by Maias at 2:37 PM on January 18, 2010
This cannot possibly be true-- unless maybe you live in a seriously bad neighborhood. There are about 10,000-20,000 murders each year in the U.S.-- a country of some 300 million people. If this were true, there'd be a helluva lot more murders so I'd be dubious of the rest of those stats.
posted by Maias at 2:37 PM on January 18, 2010
This thread is closed to new comments.
posted by BusyBusyBusy at 9:33 AM on January 18, 2010