High Mortality Cesarean Delivery Rate & Teen Pregnancy in Aruba

 

How we care for our children and the children who have children tell a lot about a society. Who is looking out for the most vulnerable among us? In Aruba, the numbers from a report done on teen pregnancy and infant mortality rates were staggering. Children are supposed to be our greatest treasure, aren’t they?

The enormous amount of cesareans – the Aruban percentage is one of thee highest in the world – and the many teen pregnancy, are the possible cause of the high number of babies that die during pregnancy or right after birth.  The mortality figure is at the same level as that of the South-American countries.

The percentage of babies that die during pregnancy (22 weeks or more) or right after delivery (7 days after birth) – in the medical world defined as prenatal death – is with 18.1 permillage more or less the same level as that of South-American countries (19 permillage).  That is very high, compared with the Netherlands (8 permillage).

High mortality of caesarian deliveries and teen pregnancy (Amigoe: June 9, 2008)

Aruba does not have an intensive-care for seriously ill newborns.  They are sent abroad via air-ambulance for treatment.

ORANJESTAD – The enormous amount of caesarians – the Aruban percentage is one of thee highest in the world – and the many teen pregnancy, are the possible cause of the high number of babies that die during pregnancy or right after birth.  The mortality figure is at the same level as that of the South-American countries.

These are some striking conclusions from the inquiry into the prenatal care on our island in the period of 2005 – 2007 conducted by Esther Klopper and Caroline Nierkens, two medical students of the Radboud University Nijmegen in the Netherlands.  In anticipation of a report that is currently being finished, the two students gave a closed presentation in the Horacio Oduber Hospital (HOH). 

It was sheer drudgery, said medical director Arnoud Boesten.  He is very impressed wih the work of the students.  He thinks that a continuing inquiry is necessary.  It was indeed not easy for the two; the figures were very difficult to get or they didn’t match those of institutions like the Central Bureau of Statistics (CBS).

The percentage of babies that die during pregnancy (22 weeks or more) or right after delivery (7 days after birth) – in the medical world defined as prenatal death – is with 18.1 permillage more or less the same level as that of South-American countries (19 permillage).  That is very high, compared with the Netherlands (8 permillage).  Also the number of stillborns is high; 11.4 permillage versus 5 permillage in the Netherlands.  The figure is almost as that if Central America.  The neonatal death (babies that die in the first 28 days after birth) is 8.1 permillage and is at the same level as East-Europe (South-America 14 permillage and the Netherlands 4).  It appears that of the total number of newborns that died  within 28 days after birth (32) and stillborns after 24 weeks of pregnancy (36), 50 died in the HOH; 11 babies after still in the womb of the mother were flown abroad for treatment and 7 after already born in HOH and flown abroad for treatment.  

The figure that caused most commotion in the room was the very high number of caesarians – almost one of the highest in the world.  Besides, this confirms the figures of White-Yellow Cross in January of this year.  Of the 1418 deliveries between 2005 and 2007, 471 (34 percent) were by caesarian.  Compared to Europe, Aruba is the frontrunner and after Chili, also in South-America.

The percentage of caesarians according to the World Health Organization is considered acceptable in most of the developed countries is about 15 percent.

The inquiry does not reveal that the extreme high number of caesarians is the cause of the high number of babies that die during pregnancy or right after birth.  The students say that it might be.  It is known that babies born by caesarian have a bigger chance of getting sick or die.  A caesarian is also riskier for the mother than a natural delivery.

TEEN PREGNANCY

The inquiry also doesn’t directly connect the high prenatal death with the high number of teen pregnancy (12.1 percent).  That may also be one of the causes, according to the students; besides, the younger the mother, the bigger chance on complications during pregnancy and birth and premature babies.  Compared with the Netherlands (1.1 percent) and even the Neth.Antilles (9 percent), the number of teen pregnancy in our country (12.1) is considerably higher.  The students base this on figures of the CBS, but the figures from their inquiry are even higher, 12.6 percent, which doesn’t include deliveries at home.  The figures of CBS do include home deliveries.

The Figures of the Netherlands and Neth.Antilles are from 2004 till 2006 inclusive; but they do show a striking difference; also in the age categories after 2006.  Aruba has a higher percentage of young mothers; age 20-24, 24.5 percent and 25-29, 26.1 percent.  The two students and their councilor at HOH, pediatrician Wicha Ponson-Wever, are clearly very worried about this.  In their eyes, the subject needs more society and government attention.  The students say that the enormous number of caesarians may be reduced considerably; even due to the enormous costs that are involved.  Other factors that also play a part in the prenatal death in Aruba are the multi-cultural population, the multiple appearance of overweight among pregnant women, and the obstetrical care that can be better, according to the students.

TRANSPORTATION

The objective of Klopper en Nierkens’ inquiry was mainly to get in idea of the sick- and death figures among the transported newborns.   They also wanted to see whether there are problems with the transportation of the patients and the course of the care.  Our island does not have an intensive-care ward for newborns, and because of this, newborns that are seriously ill, must be transported abroad for treatment via air-ambulance.  This transport can often be done already before birth (intra-uterien), or also after birth (neonatal).  Almost all the transports go to Colombia – paid by AZV – that has a special centre (prenatal centre) to treat these patients. 
 



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  • Comments

    8 Responses to “High Mortality Cesarean Delivery Rate & Teen Pregnancy in Aruba”

    1. ldstlou on June 10th, 2008 7:16 am

      This is a crime. It infuriates me and deeply saddens me at the same time. It also makes me count my blessings!! I had a “high risk” pregnancy and the level of care my son and I received was phenominal and yet still it was one of the scariest times of my life. Can’t imagine what it would be like going through a difficult pregnancy w/out the special care I had!!

      I get so tired of hearing about how the boycott hurts the average Aruban. No, the Aruban Government is what is hurting the average Aruban!! They had and have the ability to prosecute those that brought Natalee’s life to an end and end the boycott. But we see now how little the Aruban government values life, even the lives of their own citizens, especially how little they value the lives of their newborns. It is atrocious!! Natalee never stood a chance, her family never stood a chance at receiving justice!! Aruba needs to take a serious look at itself, and what it places the greatest amount of value on. They certainly are caring for their own citizens. And if they have such disregard for the lives of their own, how worried could they be about the safety and security of it’s tourists?

    2. ldstlou on June 10th, 2008 7:18 am

      typo…they certainly ARE NOT caring for their own citizens.

    3. MissKatie on June 10th, 2008 9:12 am

      ldstlou

      You are so right.. if they have no regard for their own than how can they care ofr others especialy vulnerable tourists with the illusion that they are safe…

      well said ..

      the people of aruba dont stand a chance with this form of govt.. they need a change..
      money and corruption is the deciding factor for those officials…

      what a pity..

    4. brie. on June 10th, 2008 10:09 am

      What a shame…it just never stops….as time goes on we find out more and more….the only people the gov’t takes care of is themselves…

      Money and corruption…Rob Smith of Ahata says that the year 2008 will close with 76.5 room occupancy, which is going to look like 2005, the best year the island has ever had….he also said because of the number of time shares in Aruba tourism will remain stable…but then Breisen says the fuel prices could be disastrous for the island….so…huh!!!!

      In my book the year 2005 only represents corruption and cover-up due to the loss of Natalee…

    5. SS on June 10th, 2008 6:43 pm

      These staggering numbers are telling me that the high school girls in Aruba are probably not getting the information and services that they need. Someone needs to start some public health clinics where these young woman will have access to correct information and care. If the teen pregnancy rate is as high as it is, what does the rate of STDs look like? I would assume that they are probably similar. Young women need to know that if they are sexually active, then there are certain responsibilities that go with that choice, and included is the responsibility for creating a new life. Perhaps Aruba needs to look carefully at the level of social services that are being delivered to it’s young citizens.

    6. ldstlou on June 10th, 2008 6:52 pm

      ss…good post…as long as it is these young girls’ choices. I have a feeling, after hearing about the gang rape in the school bathroom, and after what they did to Natalee…that sex may not always be a “choice” unfortunately.
      And if it is not a choice, we know what happens when girls step forward to tell of being drugged and raped…they are silenced!!

    7. SS on June 10th, 2008 7:06 pm

      Good point ldstlou. I am also thinking of the many party pictures that we have seen of Urine and his friends in very seductive activities with young girls. These girls need information about the consequences of what they are doing.

    8. Ray on June 10th, 2008 10:42 pm

      In the USA they say that only about one fourth of rapes are reported. With the way they silence rape victim in ARUBA with threats and POLICE PRESSURE to drop charges We will never know how many of these girls were Raped.

      BOYCOTT ARUBA JUSTICE FOR NATALEE
      SUPPORT FOR BETH AND DAVE.

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