But aren't all babies born at night?

A doctor in California analyized the outcomes of more than three million babies born over a seven year period in the nineties and found that babies born at night were more likely to die in their first month of life than babies born at other times. [Apparently the rest of the world learned about this at the beginning of August, but it took our local paper until today to pull the story off the wire and fill a few column inches with it; so if this is old news to you, I apologize.]

What? How could time of birth affect longevity? Should we be listening more closely to astrologers?

My first reaction was disbelief. It seemed impossible that there could either be some biological advantage to being born during the day or, conversely, that the overall fitness of a baby would be reflected in the time of day it chose to arrive.

Fortunately for my sensibilities, my disbelief was well placed. But it was also short-sighted. I had not considered that factors EXTERNAL to the birth (i.e. the quality or capacity of hospital care) could vary by time of day. It appears this last explanation might be at the heart of the story. As another article on the research reports:

[T]here was evidence to suggest structure, staff and diagnostics might have a role. To study structure, the researchers compared singleton non-very low birth weight babies to more higher-demand very low birth weight multiple births. Interestingly, the low-risk singletons showed the higher mortality risk than the multiples. Dr. Gould and colleagues suggested delivery rooms might be understaffed should a low-risk birth suddenly develop problems.

"This paradoxical findings suggest a compromised system that retains some ability to identify and mobilize for a high-risk delivery," they wrote, "but fails to optimally address unexpected problems that arise in low-risk deliveries."

Hospitals could well be better prepared for newborn complications during the day, when high risk patients are being brought in for inductions and Cesareans.

Having had my initial confusion cleared up, one detail remains to confound me. 56.7% of the births occured between 7:00 a.m. and 6:59 p.m. More than half the babies were born during the day or early evening. My impression of birth is that it's an affair of night's darkest hours. The drives through town when all the lights are flashing red instead of cycling through their colors, the surprise of walking out of the hospital to night air twenty degrees colder than when I walked in, the bedrooms and labor rooms eerily lit by only a computer monitor. These are what I think of when I think of birth.

But I looked through my records just now and 8 of 18 births that I've attended have been between 7 a.m. and 7 p.m. When I remember those births, I do recall sun shining in the windows, or heading home in time to share lunch with the family. Interestingly, my brain has labeled those daytime deliveries anomalies. It holds the close, quiet night as the norm.