My daughter, Annalise, was born on September 21, 2007 – four weeks before her due date.  She weighed 4 lbs. 0.4 oz at birth; we took her home weighing 3 lbs. 15 oz.   We knew she would be a small baby, even if she had been delivered to term, because she experienced intrauterine growth restriction (“IUGR”) throughout her prenatal development.  This condition, where the baby weighs 90% less than other babies of the same gestational age, can result in premature labor and overall stress on the baby.  Multiple stress tests were therefore conducted throughout the pregnancy to ensure that the baby was not in distress.  Each test came back with good results.   That said, Annalise’s premature delivery was not due to her IUGR, but was due to a condition I had.  At 34 weeks of pregnancy, I was diagnosed with preeclampsia, a condition during pregnancy where the mother’s blood pressure rises to unsafe levels for both her and the baby.  The causes of preeclampsia are unknown, though it is known to contribute to IUGR.   Because of this diagnosis, I was on strict bed rest for the two weeks prior to her delivery.  I was discouraged from getting out of bed to bathe, and required to rest on the left side of my body as much as possible, in order to promote as much blood flow to the baby.  When my blood pressure had risen too high, I was admitted to the hospital and induced to give birth.  In my birthing room, a team of four neonatal nurses and doctors, along with my obstetrician, were waiting with special equipment for Annalise’s arrival.  She arrived two hours after contractions began, and was delivered without the need for a cesarean.   She scored an 8 on the Apgar test, which was an excellent score.  After I delivered the placenta, we discovered a chilling reason for Annalise’s IUGR.   The placenta had not connected properly to the umbilical cord, a dangerous condition known as a velamentous cord insertion.  Stillbirth is a common outcome of this condition because the placenta eventually ruptures from the umbilical cord.   Annalise’s early arrival due to my preeclampsia was lifesaving.   She spent three nights and four days in the pediatric intensive care unit.  She is thankfully a healthy girl, all due to the skilled prenatal and postnatal care she received.  

In another region, such as sub-Saharan Africa, Annalise’s birthing story would have been quite different.  In fact, she sadly would not have had a story.  According to the organization World Birth Aid, 1 in 13 women die of causes related to pregnancy and childbirth. The risk of dying as a result of pregnancy  in the industrialized world stands at 1 in 4,100.  The multiple prenatal and postnatal complications in Annalise’s birth could not have been handled in a region like Africa.  Consider that the mission of World Birth Aid is to provide a basic clean birth kit to women who do not have a clean birthing environment.   This kit includes soap, a clean string, and a clean razor blade.  This birthing experience has no comparison to my own when fetal  survival, as opposed to healthy fetal development, becomes the primary aim.  It also makes a safe birthing experience the realm of privileged nations.