U.S. gets poor grade for maternal, infant health care outcomes
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For the third year in a row, high preterm birth rates earned the U.S. only a D+ in a March of Dimes report on the state of maternal and infant health.
The big picture: Black, Latina, Native American and Pacific Islander women experience disproportionate rates of preterm births, infant mortality and maternal deaths.
- People in the South and Midwest experience the worst outcomes.
Context: March of Dimes says "an alarmingly high preterm birth rate" is one of the contributing factors "to maternal and infant mortality and morbidity."
By the numbers: The rate of preterm births, defined as those happening before week 37 of gestation, was 10.4% in the U.S. during 2023, according to the report.
- That means 1 in 10 babies born, or about 370,000 births, happened preterm.
- Although the national rate has been steady for the last three years, preterm birth rates increased in 24 states compared to 2022. They include Arkansas, Indiana and Iowa.
- The rate of preterm births for Hispanics was 10.1%. It was 12.4% for American Indian/Alaska Native and Pacific Islander people and 14.7% for Black people.
The infant mortality rate rose in 2022 for the first time in two decades, the report says, in line with other studies carried out after Roe v. Wade was struck down.
- March of Dimes says the national rate reached 5.6 deaths per 1,000 births nationally, with most cases in the South and Midwest.
- Rates were especially high in heavily Hispanic states like Arizona (6.2 per 1,000 births), Florida (6 per 1,000) and New Mexico (5.9 per 1,000).
What they're saying: Public policy measures could help curb these problems, says Yadira Tabales, maternal and infant health manager for Puerto Rico at March of Dimes.
- Licensing midwives can help when women can't get to a doctor. California and Colorado, which have passing grades in the report, are among those with this policy.
- Mobile clinics in counties with no nearby OB/GYN providers, hospitals or birth centers can also make a difference.
- Complications such as preeclampsia, a spike in blood pressure that can lead to premature births, can also be avoided by prescribing low doses of aspirin to people at high risk, Tabales says.
Zoom in: Inadequate prenatal care, such as a low number of doctor visits stemming from lack of health care access, increased last year for Hispanic, Black, and Asian/Pacific Islander pregnant people.
- Another issue affecting women of color during a pregnancy are underlying health problems such as hypertension and diabetes, which are more likely to cause preterm births.
- CDC data shows that Hispanic women, for example, have pre-pregnancy diabetes rate that's 1.2 times higher than the national average.
- "Since they also face inadequate care, the diabetes can complicate the pregnancy and have very serious consequences for the woman and the baby," says Tabales.
Between the lines: Environmental factors also increasingly weigh on pregnancies.
- Heat exposure and lower air quality have been linked to prenatal births, low birth weights and neurocognitive disorders.
- Neighborhoods where most of the population is Black or Latino tend to be disproportionately hit by heat and smog due to a lack of green spaces or proximity to highways, studies have found.
The bottom line: "Every family and every pregnant person deserves to get accessible and adequate health care, for the benefit of the pregnancy and us all," says Tabales.
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