The odds of measles complications are high at 1/1000…

The CDC says that 1 in 1,000 people with measles will develop encephalitis and that 1 in 1,000 people with measles will die. 1 in 1,000 is pretty high.

…But the odds of maternal death from blood clots are low at 1/1,000

On the other hand, the risk of maternal death is concerning but relatively low. Here’s what Dr. Shilpi Mehta-Lee, MD Assistant Professor of Maternal Fetal Medicine at NYU Medical Center says about maternal death from blood clots: “We actually know the risks are between 1:500 and 1:2000, which makes 1:1000 about average. When you put the statistic that way, it sounds pretty bad, but what that really breaks down to is about a 0.25 to 0.1 percent risk. That means more than 99.5 percent of women won’t have this problem.”

Amniocentesis is safe, VBAC’s aren’t?

Amniocentesis has a 0.6% risk of miscarriage- a slight risk according to the Mayo Clinic. But a VBAC is pretty risky. Which is why many doctors and hospitals don’t do them. No one wants to mess around with a 0.07% uterine rupture rate.*

Which is more likely to kill you, an alligator or a deer?

There were 9 alligator and crocodile related deaths during 1999-2007Nine. Isn’t that crazy? Better cancel your trip to Florida. You’ll be much safer driving on the interstate in October where vehicle collisions with deer cause only 200 deaths a year. (And an estimated $4 billion in damage annually.)

But you can’t any get safer than going to the doctor…

Except that 1.7 million Americans develop nosocomial (healthcare-acquired) infections each year, and 99,000 die from them every year. And 3/4ths of these infections start in places like nursing homes and doctor’s offices- the other 25% mostly come from hospitals. The total economic burden of nosocomial infections may be as high $45 billion per year. That’s billion, with a “b“. (For a point of comparison, consider that a measles outbreak can cost state and local health departments about $2 million to $3 million.)

What kills more people than emphysema, HIV/AIDS, Parkinson’s disease, and homicide combined?

Antibiotic resistant methicillin staphyoloccocus aureus infections (MRSA).

How we perceive risk

What if I tell you that vitamin A reduces the risk of measles death and complications? What if I tell you that c-sections increase the risk of deadly blood clots? Do you feel differently about measles? About c-sections? Should you be less concerned about measles or more concerned about maternal death? Both? Neither? Equally concerned?

We like to think of ourselves as rational human beings, but the truth is that we make decisions based on emotion. Sometimes we listen to the loudest screams rather than what is most likely. But on the other hand, being that one in a thousand isn’t fun.

The bottom line is that every decision we make has some kind of risk associated with it. When you make a choice about your health or your child’s health, there is no such thing as risk free. You will always be choosing a set of risks and benefits. The question will always be which benefits and which risks are worth committing to for you?

*Yeah, I had to do a double take on this too because I had heard the 0.4-0.7% statistic most often quoted. Apparently the risk of rupture is even lower than previously described. This is from newer research: “From 1976-2012, 25 peer-reviewed publications described the incidence of uterine rupture, and these reported 2,084 cases among 2,951,297 pregnant women, yielding an overall uterine rupture rate of 1 in 1,146 pregnancies (0.07%).”

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