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After your baby is born you have the option of continuing in the program through free home visits. The goal of the Health Start Program is to give your baby and family the best chance of success as your child grows and develops. Austin LifeCare - Free Pregnancy Tests, Ultrasound Services, Childbirth Classes, Parenting Classes, and Assistance.
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Whether you need a pregnancy test or already have a confirmed pregnancy, we can help you figure out what's next. Our parenting classes and resources will help empower you to be the best parent you can be. Austin LifeCare has been serving the Austin area for over 30 years with the goal of meeting the needs of women, men and their families, who are facing an unplanned pregnancy.
LifeCare Pregnancy Services provides education about pregnancy, abortion procedures, adoption, and parenting.
The Austin LifeChange program provides spiritual, emotional, and psychological support for the effects that can occur after an abortion experience, miscarriage, or sexual abuse. The purpose of the Austin LifeGuard Character and Sexuality Education Program is to empower teens in the Austin area with accurate information and practical tools to help them make healthy decisions, build strong relationships, and fully experience the benefits of saving sex for marriage. Learn more about supporting the programs of Austin LifeCare through donations of time, product or funds. At the age of 41, after completing a Press Secretary job, I received surprising and unexpected news - I was pregnant.
I love this work and after years of teaching I now know that HypnoBirthing® Classes are for you if you want to experience a more natural birth.
Discover natural, relaxed, stress free ways of birthing specifically designed to enable you to have a gentle and fulfilling birth. Each year about 500,000 women die+ due to pregnancy and childbirth, 7 million have serious long term complications, and 50 million have negative outcomes following delivery.
The most prominent sign of labour are the strong contractile waves that move the infant down the birth canal. Pain in contractions has been described as feeling similar to very strong menstrual cramps. Back labour+ is a term for specific pain occurring in the lower back, just above the tailbone+, during childbirth.Harms, Rogert W. Childbirth can be an intense event and strong emotions, both positive and negative, can be brought to the surface.
During the later stages of gestation there is an increase in abundance of oxytocin+, a hormone that is known to evoke feelings of contentment, reductions in anxiety, and feelings of calmness and security around the mate.
Oxytocin is further released during labour when the fetus stimulates the cervix and vagina, and it is believed that it plays a major role in the bonding of a mother to her infant and in the establishment of maternal behavior. Between 70% and 80% of mothers in the United States report some feelings of sadness or "baby blues" after giving birth. The fetal head may temporarily change shape substantially (becoming more elongated) as it moves through the birth canal. In order to avail for more uniform terminology, the first stage of labour is divided into "latent" and "active" phases, where the latent phase is sometimes included in the definition of labour, and sometimes not.
Some reports note that the onset of term labour more commonly takes place in the late night and early morning hours.
The latent phase of labour is also called the quiescent phase, prodromal labour+, or pre-labour. The latent phase is generally defined as beginning at the point at which the woman perceives regular uterine contraction+s.
Cervical effacement+, which is the thinning and stretching of the cervix+, and cervical dilation+ occur during the closing weeks of pregnancy+ and is usually complete or near complete, by the end of the latent phase.
The active stage of labour (or "active phase of first stage" if the previous phase is termed "latent phase of first stage") has geographically differing definitions. A definition of active labour in a British journal was having contractions more frequent than every 5 minutes, in addition to either a cervical dilation of 3 cm or more or a cervical effacement of 80% or more. Health care providers may assess a labouring mother's progress in labour by performing a cervical exam to evaluate the cervical dilation, effacement, and station. The duration of labour varies widely, but the active phase averages some 8 hours Some practitioners may diagnose "Failure to Progress", and consequently, propose interventions to optimize chances for healthy outcome. The expulsion stage (stimulated by prostaglandins+ and oxytocin+) begins when the cervix is fully dilated, and ends when the baby is born.
When the amniotic sac+ has not ruptured during labour or pushing, the infant can be born with the membranes intact. Complete expulsion of the baby signals the successful completion of the second stage of labour.
The second stage of birth will vary by factors including parity+ (the number of children a woman has had), fetal size, anesthesia, and the presence of infection. The period from just after the fetus is expelled until just after the placenta is expelled is called the ''third stage of labour'' or the ''involution stage''. Placental expulsion can be managed actively or it can be managed expectantly, allowing the placenta to be expelled without medical assistance. Delaying the clamping of the umbilical cord+ until at least one minute after birth improves outcomes as long as there is the ability to treat jaundice+ if it occurs. The "fourth stage of labour" is the period beginning immediately after the birth of a child and extending for about six weeks. Following the birth, if the mother had an episiotomy+ or a tearing of the perineum+, it is stitched. Until recently babies born in hospitals were removed from their mothers shortly after birth and brought to the mother only at feeding times.
As of 2014, early postpartum skin-to-skin contact is endorsed by all major organizations that are responsible for the well-being of infants, including the American Academy of Pediatrics+. Deliveries are assisted by a number of professions include: obstetrician+s, family physicians+ and midwives+. At one time shaving of the area around the vagina+, was common practice due to the belief that hair removal reduced the risk of infection, made an episiotomy+ (a surgical cut to enlarge the vaginal entrance) easier, and helped with instrumental deliveries. Active management of labour consists of a number of care principles, including frequent assessment of cervical dilatation. In many cases and with increasing frequency, childbirth is achieved through induction of labour+ or caesarean section+.
Health conditions that may warrant induced labour or cesarean delivery include gestational or chronic hypertension, preeclampsia, eclampsia, diabetes, premature rupture of membranes, severe fetal growth restriction, and post-term pregnancy.
Pitocin is the most commonly used agent for induction in the United States, and is used to induce uterine contractions. The American Congress of Obstetricians and Gynecologists+ (ACOG) guidelines recommend a full evaluation of the maternal-fetal status, the status of the cervix, and at least a 39 completed weeks (full term) of gestation for optimal health of the newborn when considering elective induction of labour. Induction is also considered for logistical reasons, such as the distance from hospital or psychosocial conditions, but in these instances gestational age confirmation must be done, and the maturity of the fetal lung must be confirmed by testing. The ACOG also note that contraindications for induced labour are the same as for spontaneous vaginal delivery, including vasa previa+, complete placenta praevia+, umbilical cord prolapse+ or active genital herpes simplex+ infection. The injection of small amounts of sterile water into or just below the skin at several points on the back has been a method tried to reduce labour pain, but no good evidence shows that it actually helps. Different measures for pain control have varying degrees of success and side effects to the woman and her baby. Popular medical pain control in hospitals include the regional anesthetics epidural+s (EDA), and spinal anaesthesia+.
Medicine administered via epidural can cross the placenta and enter the bloodstream of the fetus. Vaginal tears can occur during childbirth, most often at the vaginal opening as the baby's head passes through, especially if the baby descends quickly. In cases of a cephalic presenting twin (first baby head down), twins can often be delivered vaginally. Historically women have been attended and supported by other women during labour and birth.
A recent Cochrane review involving more than 15,000 women in a wide range of settings and circumstances found that "Women who received continuous labour support were more likely to give birth 'spontaneously', i.e.
For monitoring+ of the fetus during childbirth, a simple pinard stethoscope+ or doppler fetal monitor+ ("''doptone+''") can be used. A method of external (noninvasive) fetal monitoring+ (EFM) during childbirth is cardiotocography+, using a ''cardiotocograph'' that consists of two sensors: The ''heart'' (cardio) sensor is an ultrasonic sensor+, similar to a Doppler fetal monitor+, that continuously emits ultrasound and detects motion of the fetal heart by the characteristic of the reflected sound.
It is currently possible to collect two types of stem cells+ during childbirth: amniotic stem cells+ or umbilical cord blood+ stem cells.
To collect amniotic stem cells, it is necessary to do amniocentesis+ before or during the birth. The "natural" maternal mortality rate of childbirth—where nothing is done to avert maternal death—has been estimated at 1500 deaths per 100,000 births. Newborn mortality at 37 weeks may be 2.5 times the number at 40 weeks, and was elevated compared to 38 weeks of gestation. Medical researchers find that neonates born before 39 weeks experienced significantly more complications (2.5 times more in one study) compared with those delivered at 39 to 40 weeks. Secondary changes may be observed: swelling of the tissues, maternal exhaustion, fetal heart rate abnormalities.
Obstructed labour, also known as dystocia, is when, even though the uterus+ is contracting normally, the baby does not exit the pelvis during childbirth due to being physically blocked. There is tentative evidence that antibiotics may help prevent wound infections in women with third or fourth degree tears. The maternal mortality rate (MMR) varies from 9 per 100,000 live births in the US and Europe to 900 per 100,000 live births in Sub-Saharan Africa+.
Risk factors for fetal birth injury include fetal macrosomia+ (big baby), maternal obesity+, the need for instrumental delivery, and an inexperienced attendant.
Untreated sexually transmitted infections are associated with congenital and perinatal infections in neonates, particularly in the areas where rates of infection remain high.

Infant deaths (''neonatal deaths'' from birth to 28 days, or ''perinatal deaths'' if including fetal deaths at 28 weeks gestation and later) are around 1% in modernized countries.
The most important factors affecting mortality+ in childbirth are adequate nutrition+ and access to quality medical care ("access" is affected both by the cost of available care, and distance from health services). A 1983–1989 study by the Texas Department of State Health Services+ highlighted the differences in neonatal mortality+ (NMR) between high risk and low risk pregnancies.
Intrapartum asphyxia is the impairment of the delivery of oxygen to the brain and vital tissues during the progress of labour. In Western and other cultures, age is reckoned from the date of birth, and sometimes the birthday is celebrated annually. Some families view the placenta+ as a special part of birth, since it has been the child's life support for so many months.
The exact location+ in which childbirth takes place is an important factor in determining nationality+, in particular for birth aboard aircraft and ships+.
Different categories of birth attendant+s may provide support and care during pregnancy and childbirth, although there are important differences across categories based on professional training and skills, practice regulations, as well as nature of care delivered.
Doula+s are assistants who support mothers during pregnancy, labour, birth, and postpartum. Midwives+ are autonomous practitioners who provide basic and emergency health care before, during and after pregnancy and childbirth, generally to women with low-risk pregnancies.
In jurisdictions where midwifery is not a regulated profession, traditional or lay midwives+ may assist women during childbirth, although they do not typically receive formal health care education and training. Medical doctors+ who practice obstetrics+ include categorically specialized obstetricians+, family practitioners+ and general practitioners+ whose training, skills and practices include obstetrics, and in some contexts general surgeon+s.
Anaesthetists+ or anesthesiologists+ are medical doctors+ who specialise in pain relief and the use of drugs to facilitate surgery and other painful procedures. Obstetric+ nurse+s assist midwives, doctors, women, and babies before, during, and after the birth process, in the hospital system. A 2013 study published in BMJ Open found widely varying costs by facility for childbirth expenses in California, varying from $3,296 to $37,227 for vaginal birth and from $8,312 to $70,908 for a caesarean birth.
Beginning in 2014, the United Kingdom National Institute for Health and Care Excellence began recommending that many women give birth at home under the care of a midwife rather than an obstetrician, citing lower expenses and better healthcare outcomes. Childbirth+ Childbirth, also known as labour, delivery, birth, partus, or parturition, is the culmination of a period of pregnancy with the expulsion of one or more newborn infants from a woman's uterus. Healthy Mothers, Healthy Babies provides free Childbirth Classes through the Florida Outreach Childbirth Education Program.
Now in my second pregnancy, I wanted to share some Free Online Childbirth Classes & Resources to help other pregnant moms prepare for a healthy and natural childbirth. This page is full of natural childbirth resources to help guide those who are wanting supplemental material and additional viewpoints as they go through their own journey and also for moms wanting natural childbirth to gain the opportunity to learn and explore information on their own if needed.
Each week is to discuss how to prepare, link to awesome materials that you can purchase on amazon to help guide you through your pregnancy, help guide you through Natural Childbirth and more!
Affiliate links to the awesome Bradley Method  and natural birth resources are throughout this page. But if that’s just not possible and you still want a comprehensive course, with accountability, you can enroll in my 11-week childbirth eCourse.
Explore pregnancy safe and beneficial exercises to help prepare you for a natural childbirth and to keep you and your baby healthy! Go through each recommendation in the Brewer Diet and understand why it is important in your pregnancy. Explore why it is important to have a healthy diet throughout your pregnancy and how it can help prevent unwanted complications later in pregnancy such as Pre-eclampsia.
Alleviating pregnancy discomforts, preparing for labor challenges, and getting into the full swing of your pregnancy exercises! Understanding how to adequately prepare for labor as a couple is crucial to prepare for the big day. From the stages of labor to birthing positions to help alleviate pain, there were some important topics to cover. Many of us face complications in pregnancy whether it is as simple as being overdue or something more serious like Strep B or having a breech baby.
Understand the stages of labor and preparing the environment that you want to have while giving birth and in labor.
Spend four weeks with me as I go through everything you need to do to help prepare for a newborn. Go through the Bradley Method with this great resource that includes pictures to help guide you. Are you an expectant parent looking for information on how to have your ideal labor and birth experience, or a Birth Professional interested in learning accupressure to add to your labor and delivery tool kit? The HypnoBirthing® Childbirth method is a philosophy as much as it is a technique for achieving a satisfying, relaxing, and stress-free birthing experience.
Deb Davies is a licensed acupuncturist, birth doula, and childbirth educator in San Diego, CA. We provide free pregnancy tests and have counselors on hand if you need to talk to someone. All classes are part of our "Earn While You Learn" program and participants will receive "Baby Buck" in each class that can be used for diapers, baby clothes, cribs, and more! Free and confidential services are provided including pregnancy testing, limited ultrasound, material assistance and education. All classes are part of our "Earn While You Learn" program and participants will receive "Baby Buck" in each class. The process of normal childbirth is categorized in three stages of labour: the shortening and dilation+ of the cervix+, descent and birth of the infant+, and the expulsion of the placenta+. Women are often encouraged to refrain from screaming, but moaning and grunting may be encouraged to help lessen pain. The erect posture causes the weight of the abdominal contents to thrust on the pelvic floor+, a complex structure which must not only support this weight but allow three channels to pass through it: the urethra+, the vagina+ and the rectum+. The fetal head rotates 90 degrees to the occipito-anterior position+ so that the baby's face is towards the mother's rectum.
The fetal head turns through 45 degrees to restore its normal relationship with the shoulders, which are still at an angle.
The shoulders repeat the corkscrew movements of the head, which can be seen in the final movements of the fetal head. When the presenting part is at the ischial spines the station is 0 (synonymous with engagement).
This change in the shape of the fetal head is called ''molding'' and is much more prominent in women having their first vaginal delivery.
This may be a result of a synergism between the nocturnal increase in melatonin+ and oxytocin+. During a contraction, uterine muscles contract causing shortening of the upper segment and drawing upwards of the lower segment, in a gradual expulsive motion. As pressure on the cervix increases, women may have the sensation of pelvic pressure and an urge to begin pushing.
Longer labours are associated with declining rates of spontaneous vaginal delivery and increasing rates of infection, perineal laceration, and obstetric hemorrhage, as well as the need for intensive care of the neonate.
75% of women report that they are very satisfied with either active management or normal care. Caesarean section is the removal of the neonate+ through a surgical+ incision in the abdomen+, rather than through vagina+l birth. Other methods of inducing labour include stripping of the amniotic membrane, artificial rupturing of the amniotic sac (called amniotomy+), or nipple stimulation.
In some countries of Europe, doctors commonly prescribe inhaled nitrous oxide+ gas for pain control, especially as 53% nitrous oxide, 47% oxygen, known as Entonox+; in the UK, midwives may use this gas without a doctor's prescription.
Epidural analgesia is a generally safe and effective method of relieving pain in labour, but is associated with longer labour, more operative intervention (particularly instrument delivery), and increases in cost. Oxytocin+ has been used to increase the rate of vaginal delivery in those with a slow progress of labour. Tears can involve the perineal skin or extend to the muscles and the anal sphincter and anus. In some cases twin delivery is done in a larger delivery room or in an operating theatre, in the event of complication e.g. However currently, as more women are giving birth in a hospital rather than at home, continuous support has become the exception rather than the norm. The pressure-sensitive ''contraction'' transducer, called a ''tocodynamometer'' (toco) has a flat area that is fixated to the skin by a band around the belly.
Amniotic fluid contains mesenchymal stem cells while umbilical cord blood contains both hematopoietic and mesenchymal stem cells. In Western countries, such as the United States and Sweden, the current maternal mortality rate is around 10 deaths per 100,000 births. These "early term" births were also associated with increased death during infancy, compared to those occurring at 39 to 41 weeks ("full term"). Health problems among babies delivered "pre-term" included respiratory distress, jaundice and low blood sugar.
These markers are more likely to be signals for other abnormalities as forceps or vacuum are not used in normal deliveries. Hormones and enzymes work together to produce ligamentous relaxation and widening of the symphysis pubis during the last trimester of pregnancy. The work of Ignaz Semmelweis+ was seminal in the pathophysiology and treatment of puerperal fever+ and saved many lives.
Heavy blood loss leads to hypovolemic shock+, insufficient perfusion of vital organs and death if not rapidly treated. Specific situations that can contribute to birth injury include breech presentation and shoulder dystocia+. The overall perinatal mortality rate associated with untreated syphilis, for example, is 30%. This may exist in a pregnancy already impaired by maternal or fetal disease, or may rarely arise ''de novo'' in labour.

Before the 20th century and in some countries to the present day it has more typically occurred at home.
The placenta may be eaten+ by the newborn's family, ceremonially or otherwise (for nutrition; the great majority of animals in fact do this naturally). They are not medical attendants; rather, they provide emotional support and non-medical pain relief for women during labour.
Midwives are trained to assist during labour and birth, either through direct-entry or nurse-midwifery education programs. These physicians and surgeons variously provide care across the whole spectrum of normal and abnormal births and pathological labour conditions.
They may contribute to the care of a woman in labour by performing epidurals+ or by providing anaesthesia+ (often spinal anaesthesia+) for Cesarean section+ or forceps delivery+. Obstetric nurses hold various certifications+ and typically undergo additional obstetric training in addition to standard nursing training+. Childbirth in Sri Lanka+ Issues and practices related to childbirth in Sri Lanka are influenced by the sociocultural composition, political history and violence within the country. Childbirth classes are available at community locations throughout Palm Beach County and are held in English and Spanish.
I am also not a Bradley Method instructor and my posts are a combination of those experiences, my own births, research, classes taken, workshops visited, and information gathered over 3 years. Though I have no affiliation with The Bradley Method, I highly encourage taking the class with a local instructor. From providing necessary nutrients for specific aspects of fetal development to helping sustain energy for you, nutrition is one of the most important aspects of your pregnancy so prepare adequately!
From understanding how to time contractions to knowing the stages of labor and what they mean.
There is no need to panic in any of these situations because there are both preventative and natural solutions for almost all of them. With the winding down of the Bradley Method weeks, it is probably very apparent that you are progressing very quickly in your pregnancy. You can also find a nutrition worksheet I made for $0.99 by clicking this link or get it FOR FREE by subscribing to my weekly newsletter!
This would be an ideal resource for anyone not able to attend a class because it has so many visuals. HypnoBirthing® teaches you and your birthing companion the art and joy of experiencing birth in a more comfortable manner. Since graduating from Pacific College of Oriental Medicine in 2008, she found her passion working with children and women’s health issues, especially related to fertility, pregnancy, and birthing.
Among the services provided by Austin LifeCare are free pregnancy tests, limited free ultrasound services, Childbirth classes, Parenting classes, mentors (PALS), and material assistance (clothing, baby items, etc.).
Then almost instantly high risk pregnancy difficulties reared early in the first trimester forcing me to cancel contracts and close my company. Click here to see our Abortion Education section, or contact us with any questions you may have.
The infant's head and shoulders must go through a specific sequence of maneuvers in order to pass through the ring of the mother's pelvis.
Its head is tilted forwards so that the crown of its head leads the way through the vagina.
If the presenting fetal part is above the spines, the distance is measured and described as minus stations, which range from –1 to –4 cm. The Bishop score can also be used as a means to predict the success of an induction of labour+.
At the beginning of the normal second stage, the head is fully engaged in the pelvis; the widest diameter of the head has passed below the level of the pelvic inlet+.
Delayed clamping of the cord decreases the risk of anemia but may increase risk of jaundice.
Opioid+s such as fentanyl+ may be used, but if given too close to birth there is a risk of respiratory depression in the infant.
Generally, pain and stress hormones rise throughout labour for women without epidurals, while pain, fear, and stress hormones decrease upon administration of epidural analgesia, but rise again later. There is not enough evidence to make conclusions about unwanted effects in mothers or babies.
The midwife or obstetrician may decide to make a surgical cut to the perineum (episiotomy) to make the baby's birth easier and prevent severe tears that can be difficult to repair. When women became pregnant any time before the 1950s the husband would not be in the birthing room. In addition, women were less likely to use pain medications, were more likely to be satisfied, and had slightly shorter labours. Although there are many potential future applications of such stem cells, there are few current therapeutic applications of such stem cells. Each year about 500,000 women die due to pregnancy, 7 million have serious long term complications, and 50 million have negative outcomes following delivery. The American Congress of Obstetricians and Gynecologists and medical policy makers review research studies and find increased incidence of suspected or proven sepsis, RDS, Hypoglycemia, need for respiratory support, need for NICU admission, and need for hospitalization > 4 – 5 days. Most fetal birth injuries resolve without long term harm, but brachial plexus injury+ may lead to Erb's palsy+ or Klumpke's paralysis+. Most recently there is a category of birth professionals available who will encapsulate placenta for use as placenta medicine by postpartum mothers. A ''maternity ward'' or ''maternity unit'' may include facilities both for childbirth and for postpartum+ rest and observation of mothers in normal as well as complicated cases.
Like childbirth educators and other assistive personnel+, certification to become a doula is not compulsory, thus, anyone can call themself a doula or a childbirth educator. Jurisdictions where midwifery is a regulated profession will typically have a registering and disciplinary body for quality control, such as the American Midwifery Certification Board in the United States, the College of Midwives of British Columbia (CMBC) in Canada or the Nursing and Midwifery Council+ (NMC) in the United Kingdom. Categorically specialized obstetricians are qualified surgeon+s, so they can undertake surgical procedures relating to childbirth. Pregnant women typically attend these classes within the seventh month (third trimester) of their pregnancy. I am so excited to be able to share the natural childbirth love and share my experiences and information that I have learned from the classes, from my chiropractor, from midwives, from doctors, and just from doing my own research. All posts are informative, based off of my experience in labor and birth, with my care providers, and on the classes that I attended. You will get a workbook on top of what you can get online and tons of information and handouts that are invaluable when preparing for labor. Dig deeper into the relationship that the mother and coach have and the open communication they need to be successful during childbirth. Prepare your coaches and make sure they are confident and comfortable in their understanding of childbirth. It is a great, comprehensive guide, but it completely in a regular book format with few pictures.
When you understand the birthing process, you can work WITH the natural intelligence and design of your body. Additionally, Deb is a certified HypnoBirthing instructor where she teaches expectant couples techniques for a more relaxing and natural labor and delivery.
It wasn't easy for sure but when my baby came, I felt so much more prepared mentally, spiritually, and emotionally.Read more. Even women who show little reaction to labour pains, in comparison to other women, show a substantially severe reaction to crowning. If the presenting part is below the ischial spines, the distance is stated as plus stations ( +1 to +4 cm).
Latent phase ends with the onset of active first stage, and this transition is defined retrospectively.
Full dilation is reached when the cervix has widened enough to allow passage of the baby's head, around 10 cm dilation for a term baby. The fetal head then continues descent into the pelvis, below the pubic arch and out through the vaginal introitus+ (opening). A 2012 Cochrane review compared episiotomy as needed (restrictive) with routine episiotomy to determine the possible benefits and harms for mother and baby. It did not matter if it was a home birth; the husband was waiting downstairs or in another room in the home. True intrapartum asphyxia is not as common as previously believed, and is usually accompanied by multiple other symptoms during the immediate period after delivery. What you will find below is a compilation of basic information and exercises that I have done and revamped over the last 3 years. ALL FOR FREE. So I urge you to familiarize yourself with complications that arise in pregnancy and find ways you can help prevent them and help cure them.
The review found that restrictive episiotomy policies appeared to give a number of benefits compared with using routine episiotomy. Monitoring might show up problems during birthing, but the interpretation and use of monitoring devices is complex and prone to misinterpretation. Childbirth in Thailand+ This article documents traditional and some modern childbirth practices in Thailand.
Set yourself up for an empowered, satisfying, and relaxing birth experience with this powerful childbirth education class! Intrapartum asphyxia can cause long-term impairment, particularly when this results in tissue damage through encephalopathy+. Traditional principles are largely influenced by the folk beliefs in Central and North Thailand, and modern practices by the western medical model.
Childbirth in Iraq+ Childbirth in Iraq is marked by a fertility rate of 4.0 births per woman, a contested but high maternal mortality rate and a moderately high infant mortality rate.

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