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Death before BirthFetal Health and Mortality in Historical Perspective$
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Robert Woods

Print publication date: 2009

Print ISBN-13: 9780199542758

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780199542758.001.0001

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Comparative Historical Trends and Variations

Comparative Historical Trends and Variations

(p.56) 4 Comparative Historical Trends and Variations
Death before Birth

Robert Woods (Contributor Webpage)

Oxford University Press

This chapter is concerned with international and regional variations in late-fetal mortality. It considers four groups of countries. Members of the first group (Sweden, Norway, Denmark, and the Netherlands) have histories of stillbirth registration dating back to the early years of the 19th century, or the 1750s in the case of Sweden. For this group, it is possible to demonstrate the effects of variations in registration practice (how stillbirths were defined); the impact of improvements in the training, regulation, and effectiveness of midwives; and, from the late 1930s, the influence of successive advances in drug and medical technology (antibiotics, blood transfusion, incubators, ultrasound). The second group includes the USA and Britain. Here stillbirths only began to be registered in the 20th century so that a long-term perspective requires the estimation of mortality rates. Estimates of the stillbirth rate for England are derived using neonatal mortality as the base. The third group of countries is illustrated by France, Italy, and Spain. Here Catholic tradition encouraged the baptism in utero of unborn fetuses, especially if they were in great danger. A number of high mortality African countries will be used as examples for group four. The World Health Organization has recently derived new estimates of late-fetal and intrapartum mortality which show that in some West African countries more than 5% of fetuses that have reached twenty-eight weeks gestation will be born dead. This fourth group offers a sharp and reasonably well-documented perspective on historical patterns.

Keywords:   geographical variations, registration practices, stillbirths, WHO, demographic estimates, Europe, USA, Africa

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