It’s not just fetal restlessness, it’s ER care

The consulting firm IHS Markit released a study today that found that women in Western countries who get health care at the emergency room rather than a hospital may be at a higher risk of having a stillbirth.

The study, which focused on the U.S., found that 17 percent of all pregnant women, and 25 percent of women who sought prenatal care at an emergency room, had to give birth before 34 weeks gestation. For women in the U.S., that rate is higher than in most other countries. This isn’t something that’s surprising, considering our short gestational age requirement and high rate of unintended births.

A stillbirth is when a baby or fetus dies soon after birth. The International Federation of Pediatricians estimates that about 1 in 25 births occur with a stillbirth. This means about 90,000 babies die around the world from stillbirths.

But to blame ER care is too simplistic. The study takes a look at deaths in the U.S. period — from the first week after conception until about 28 weeks into pregnancy. IHS Markit also found that ER visits were up sharply in some Western countries that might seem atypical, like Spain, Israel and Costa Rica. But these countries have longer gestational ages and high rates of unintended births — factors that are likely to contribute to those stillbirths.

All that said, a CT scan using fetal perfusion can help reassure the mother if a hemorrhage is happening, in which case she can be taken by ambulance to a neonatal intensive care unit. If a woman in the U.S. still visits a doctor or clinic for a blood pressure increase or other issues with the baby or its lungs, though, that should be followed up with a hospital. Emergency room doctors have the best idea of what’s going on with the baby.

This sounds like a great time to remind readers that, as the name implies, an emergency room could be a good place to be. But sometimes the in-between places (a family member’s home, an emergency room in a different state, etc.) are good too.

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