Birth decline at AMC follows state average

Essex County births decline faster; Franklin County’s stay level. Other local trends include older mothers, fewer C-sections

SARANAC LAKE — On the whole, fewer children are being born in the United States, and the average mother giving birth is getting older. New York, and the Adirondacks, are no exception to those trends.

According to data from the state Department of Health from 2006 to 2016, the number of children born in New York has fallen by an average of about half a percent each year.

Adirondack Medical Center in Saranac Lake shows a similar decline, according to data from 2008 to 2018.

According to data from the DOH, the number of total births in Franklin County stayed about even on average between 2006 and 2016. In Essex County, total births declined by an average of 2.8% each year in the same time frame.

For a nationwide perspective, according to the Census Bureau, the general fertility rate, or births per 1,000 females aged 15 to 44 years old, dropped 3 percent, from 2016 to 2017.

Despite a declining birth rate, the total population in the U.S. is still increasing, due to immigration and a birth rate that exceeds the death rate.

For example, according to a U.S. Census study in January, 2019, there was an expected birth every eight seconds and one death every 11 seconds. International migration was expected to net one person to the population every 34 seconds.

That combination of deaths and birth and migration was expected to increase the U.S. population by one person every 19 seconds that month.

An effect of this is a graying population. The Census Bureau has estimated that by 2030, people over 65 will outnumber children — with one in five of the U.S. population being seniors. By 2020, there are estimated to be about three-and-a-half working-age adults for each retirement-age individual. By 2060, that ratio is estimated to drop to two-and-a-half working-age adults for each retirement-age individual, if current trends continue.

Older mothers

Jessica Duhaime, nurse manager at the Women’s Health Center at AMC, said she hasn’t seen a decline in the number of births — but has noticed a change in who’s having babies. In her 16 years at AMC, she said she’s seen a significant increase in age as mothers trend older.

Data from the DOH reflects this — with the percent of annual total births to mothers over 30 increasing over the last ten years in New York state as a whole, but also in Franklin and Essex Counties.

“In my experience as a nurse, 39, 40-year-old moms have a harder time than the 19-year-olds,” Duhaime said.

Another change — since the Women’s Health Center opened at AMC in 2016, Duhaime said the number of cesarean section births has dropped dramatically.

“Our cesarean section rate four years ago was in the mid 40s, if not in the 50s, for primary cesarean section rate, which is the first time having a C-section,” Duhaime said. “Since this clinic started, that trend has dramatically decreased. Our cesarean section rate for 2018 was 17%.”

The center, which currently has two full-time midwives, one full-time physician and three per diem, has been pushing for this.

“Which is pretty significant,” Duhaime said. “We’re kind of going back to our roots and encouraging physiologic birth. Natural birth.”

She said natural births, when possible, are healthier for both the mother and child. For one thing, the pressure of squeezing through the birth canal helps the newborn switch to breathing air. Additionally, she said it helps the mother with milk production and lowers the risk for hemorrhaging, blood clots or infection — all which would come with a major abdominal surgery like a C-section.

“Treating pregnancy as it should be treated, as a natural process, a healthy process that doesn’t need medical intervention, but just medical supervision, should anything go awry,” Duhaime said. “We’re there for them, but it’s more to support natural birth versus intervene medically.”



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