## 'Murica

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Witness
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### Re: 'Murica

Found this interesting (and it's a vid with some rhythm to it). Is the US part reasonably well discussed?
Grammatron
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### Re: 'Murica

I saw it on reddit. In the comments it was mentioned that it only applies to passenger trains, the freight train system in the US is world class.

Personally, the few times I've tried trains in the US it's been a horrible and slow experience. Cars and/or planes are just far quicker and more convenient.
Witness
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### Re: 'Murica

Grammatron wrote:I saw it on reddit. In the comments it was mentioned that it only applies to passenger trains, the freight train system in the US is world class.

Personally, the few times I've tried trains in the US it's been a horrible and slow experience. Cars and/or planes are just far quicker and more convenient.
Yes, the vid also stressed the difference in scale & population density between Europe and the US of A. (A fact that we often tend to forget here.) Freight trains are in no hurry, like ships.

Yet I had very entertaining experiences with slow trains, e. g. in Poland or Ireland.
Witness
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### Re: 'Murica

The Guardian wrote:Texas has highest maternal mortality rate in developed world, study finds

As the Republican-led state legislature has slashed funding to reproductive healthcare clinics, the maternal mortality rate doubled over just a two-year period
[…]
The finding comes from a report, appearing in the September issue of the journal Obstetrics and Gynecology, that the maternal mortality rate in the United States increased between 2000 and 2014, even while the rest of the world succeeded in reducing its rate. Excluding California, where maternal mortality declined, and Texas, where it surged, the estimated number of maternal deaths per 100,000 births rose to 23.8 in 2014 from 18.8 in 2000 – or about 27%.

But the report singled out Texas for special concern, saying the doubling of mortality rates in a two-year period was hard to explain “in the absence of war, natural disaster, or severe economic upheaval”.

From 2000 to the end of 2010, Texas’s estimated maternal mortality rate hovered between 17.7 and 18.6 per 100,000 births. But after 2010, that rate had leaped to 33 deaths per 100,000, and in 2014 it was 35.8. Between 2010 and 2014, more than 600 women died for reasons related to their pregnancies.
[…]
In 2011, just as the spike began, the Texas state legislature cut $73.6m from the state’s family planning budget of$111.5m. The two-thirds cut forced more than 80 family planning clinics to shut down across the state. The remaining clinics managed to provide services – such as low-cost or free birth control, cancer screenings and well-woman exams – to only half as many women as before.
https://www.theguardian.com/us-news/201 ... cs-funding
Anaxagoras
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### Re: 'Murica

If true, that is huge. In 2014 there were 3,988,076 births in the US. Let's just call that 4 million. That's an increase of 5 per 100,000. So that would be about 200 more maternal deaths in 2014 than if the rate had stayed the same.

Could there be another explanation?

One possibility is that the mortality risk increases with age (by a lot over age 35):

And indeed, women are having babies at older ages than they used to:

Average Age Of First-Time Moms Keeps Climbing In The U.S.
Fifteen years ago, the mean age of a woman when she first gave birth was 24.9 years old. In 2014, that age had risen to 26.3.
I don't think that accounts for all of it though.

ETA: Here's one more trend that may be playing a small role here:
More Women Are Choosing to Give Birth Outside of Hospitals
A new study of U.S. births in 47 states, from 2004 to 2014, indicates a small but growing trend: More women are foregoing hospitals in favor of birthing their babies at home or in natural birth centers.

The study finds that, overall, the percentage of out-of-hospital births rose from less than 1 to 1.5 percent overall in that 10-year period.
Apparently no studies (that I could find) have compared the risk of maternal mortality between out-of-hospital and in-hospital births, but the risk of infant mortality is about double.
A fool thinks himself to be wise, but a wise man knows himself to be a fool.
William Shakespeare
Witness
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### Re: 'Murica

Anaxagoras wrote:Apparently no studies (that I could find) have compared the risk of maternal mortality between out-of-hospital and in-hospital births, but the risk of infant mortality is about double.
Wikipedia wrote:A 2014 US survey of medical studies found that perinatal mortality rates were triple that of hospital births, and a US nationwide study over 13 million births on a 3-year span (2007-2010) found that births at home were roughly 10 times as likely to be stillborn (14 times in first-born babies) and almost four times as likely to have neonatal seizures or serious neurological dysfunction when compared to babies born in hospitals, while a 2007 UK survey found that perinatal mortality rates were only slightly higher in that country than planned hospital births for low-risk pregnancies. Both baby's and mother's higher mortalities are associated with the inability to timely assist mothers with emergency procedures in case of complications during labour, as well as with widely varying licensing and training standards for birth attendants between different states and countries.
(my emphasis)
https://en.wikipedia.org/wiki/Home_birth (with slightly NSFW picture)

From what I read (in French, so I don't link), it is still widespread in the Netherlands: good counseling, good teams to assist the mothers at home, and hospitals at ~ 10 min drive in case of complications, even if the percentages declined from 29,4 % in 2005 down to 15,9 % in 2013.
But some hospitals have also made an effort to make things look less "technical", hiding the gear, &c.
JEROME DA GNOME
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### Re: 'Murica

Witness wrote:Why trains suck in America
Because government ruined the industry.
What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious.
JEROME DA GNOME
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### Re: 'Murica

Anaxagoras wrote: Could there be another explanation?
People illegally crossing the border into Texas with an advanced pregnancy, coming now because of the fear mongering about Trump closing the crossings?
What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious.
Anaxagoras
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### Re: 'Murica

JEROME DA GNOME wrote:
Anaxagoras wrote: Could there be another explanation?
People illegally crossing the border into Texas with an advanced pregnancy, coming now because of the fear mongering about Trump closing the crossings?
No, this is years ago. Trump has nothing to do with it.
A fool thinks himself to be wise, but a wise man knows himself to be a fool.
William Shakespeare
JEROME DA GNOME
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### Re: 'Murica

Anaxagoras wrote: One possibility is that the mortality risk increases with age (by a lot over age 35):
Right, its been increasing nationwide.

Liberals sold women the lie that they could start a career and then try to have kids in their 30's, and its not working out.

What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious.
JEROME DA GNOME
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### Re: 'Murica

Anaxagoras wrote: No, this is years ago. Trump has nothing to do with it.
You don't think people that were thinking about jumping the border are not taking the opportunity to jump now before the possibility of a Trump shutdown of crossings?

That is denying basic human behavior.
What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious.
Anaxagoras
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### Re: 'Murica

Before 2015, nobody seriously thought Trump might be president, so no.
A fool thinks himself to be wise, but a wise man knows himself to be a fool.
William Shakespeare
JEROME DA GNOME
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### Re: 'Murica

What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious.
JEROME DA GNOME
Posts: 5231
Joined: Sat Sep 29, 2007 1:13 am

### Re: 'Murica

Liberalism is killing women by promoting late in life childbirth.
What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious.
gnome
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### Re: 'Murica

How dare those liberals, telling women they can have a career. Line em up!
"If fighting is sure to result in victory, then you must fight! Sun Tzu said that, and I'd say he knows a little bit more about fighting than you do, pal, because he invented it, and then he perfected it so that no living man could best him in the ring of honor. Then, he used his fight money to buy two of every animal on earth, and then he herded them onto a boat, and then he beat the crap out of every single one. And from that day forward any time a bunch of animals are together in one place it's called a zoo! (Beat) Unless it's a farm!"
--Soldier, TF2
JEROME DA GNOME
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### Re: 'Murica

gnome wrote:How dare those liberals, telling women they can have a career. Line em up!
No, the lie was you can have both.
What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious.
Abdul Alhazred
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### Re: 'Murica

No. The lie is that most working class women would even have the choice.
The arc of the moral universe bends towards chaos.
People who believe God or History are on their side provide the chaos.
ed
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### Re: 'Murica

gnome wrote:How dare those liberals, telling women they can have a career. Line em up!

Thats an interesting question. I've met not a few women who had their careers and either didn't have kids or had them late. They have a rather jaundiced view of the rosy "have it all" philosophy.

As an employer I'd be very careful about hiring a young married woman into a position where I really really depended on her being there. As an entrepreneur it would be irresponsible.
Grammatron
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### Re: 'Murica

ed wrote:As an employer I'd be very careful about hiring a young married woman into a position where I really really depended on her being there. As an entrepreneur it would be irresponsible.
Is it based on evidence or do you just assume someone having a child is incapable of being a productive employee?
JEROME DA GNOME
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### Re: 'Murica

Abdul Alhazred wrote:No. The lie is that most working class women would even have the choice.
Worked out for the tax man, now it takes two people to provide the same as only one before.
What a man believes upon grossly insufficient evidence is an index into his desires -- desires of which he himself is often unconscious.