Preterm Births on the Rise in Indiana – Indianapolis Business Journal

Another report, this time focusing on preterm birth, concludes that the United States – and Indiana in particular – is one of the most dangerous developed nations for childbirth.

The March of Dimes report concludes that 10.5% of all births in 2021 were preterm, a number that predates the lifting of nationwide abortion protections and includes stark racial disparities. Indiana fared slightly worse with a preterm birth rate of 10.9%, or around 8,458 children — up from 10.4% in 2020.

“This year’s report sheds new light on the devastating effects of the pandemic on mothers and babies in our country,” said Stacey D. Stewart, President and CEO of March of Dimes, in a press release. “While fewer babies are dying, more of them are becoming too ill and born prematurely, which can lead to lifelong problems… It’s clear we’re at a critical moment in our country, and that’s why we’re urging policymakers to do so now.” Act to advance legislation that will measurably improve maternal and infant health.”

Stewart said pregnant parents with COVID-19 had a 40% greater risk of preterm birth, but the report also identified inadequate prenatal care and other pre-existing maternal health issues as contributing factors.

The cost of premature birth

A 2020 Indiana Department of Health report on the emotional, health, and economic costs of perinatal care for infants shortly after birth states that the financial cost of preterm birth in Indiana is estimated at $655 million to $678 million annually .

The cost to parents averages $64,713 compared to $15,047 for an uncomplicated birth.

“Premature and low birth weight are associated with long-term disabilities such as cerebral palsy, autism, intellectual disability, visual and hearing impairments and other developmental disabilities,” the report states. “(Low weight) infants tend to have lower educational attainment, poorer self-reported health, and lower employment and income than adults compared to their normal weight peers.”

Innovations in healthcare mean that being born prematurely does not mean the child dies, but the effects of this ill health can haunt children as they grow into adults. The US infant mortality rate is 5.4 deaths per 1,000 live births compared to Indiana’s 6.6 deaths per 1,000 live births.

However, according to the March of Dimes, black women have a 42% higher rate of preterm birth than any other woman in Indiana. For Asian/Pacific Islander women, 8.7% of live births are premature, followed by 9.9% of White women and 10.1% of Hispanic women. But 14.1% of births to black women are preterm.

Jarnell Craig, interim executive director of the Marion County Minority Health Coalition, is part of a group of organizations working to spread information about Indianapolis maternal services. Efforts include safe sleep classes, parenting classes, and even lists of black doctors in zip codes with high mortality rates.

But Craig said funding or staffing isn’t the limiting factor to their impact, rather parental approval.

“We think it’s really a lack of understanding,” Craig said. “You can only give them what they are willing to receive, so it just depends on their attitude. Do they hear us and what we tell them?”

Still, Craig believes interest has increased, particularly with the expansion of Saturday classes.

The importance of prenatal care

One reason new parents may not get the right prenatal health care during their pregnancy: there simply isn’t one near you.

Another 2022 report, also from the March of Dimes, found that 6.9 million women were impacted by these “maternity care deserts” with little or no access, and almost 500,000 births took place there – a 2% increase compared to the 2020 report.

“Access to quality maternity care is a critical component to maternal health and positive birth outcomes, especially in the face of an ongoing pandemic,” said Stewart and Dr. Zsakeba Henderson, March of Dimes’ interim chief medical and health officer, in the report. “In the deserts of maternity care, there is a higher risk of poor maternal and infant health.”

On average, an estimated two women die every day due to pregnancy or childbirth complications, and two babies die every hour, the report said.

Although the report doesn’t include a state-by-state breakdown, a chart shows that about half of Indiana’s 92 counties have full access to maternal health care.

Across the country, Black women and Native American women had far less access to quality care. One in five Black women and one in four Native American women did not receive adequate prenatal care, compared to just one in ten white women.

In Indiana, the maternal mortality rate is 93% higher for black women than for white women. In general, educated women are less likely to die during pregnancy or childbirth, but a black woman who graduates from college is still at greater risk than a white woman who has not completed high school.

The Indiana Maternal Mortality Review Committee report earlier this year reported that 92 Hoosier women died in 2020 and that 73 of those deaths were considered preventable. Only half of the women who died in 2020 received prenatal care during their first trimester, while another 15.2% received no prenatal care at all.

Compared to the state’s live births, 69.3% of mothers accessed nursing, leading the committee to conclude that inadequate prenatal care may be a contributing factor to Indiana’s maternal mortality rate.

But these appointments serve another equally important purpose of assessing the health of the expecting child, whether that’s screening for health conditions or analyzing third-trimester movement.

suggested solutions

A program to partially reduce this disparity in access to health care — My Healthy Baby, which finds community partners for pregnant women — was expanded to its 82nd district in Porter County last month. In 2022, it was introduced in 35 counties, including Porter.

The March of Dimes report commended Indiana for expanding Medicaid to 12 months after childbirth for mothers and establishing committees to study maternal and infant health. But the state hasn’t allowed Medicaid to reimburse 90% or more for services performed by certified midwives.

While the state report analyzing the economic cost of preterm birth considered several maternal health interventions, including prescribing the hormone progesterone to expectant mothers, which could reduce preterm births by 20-40%. Other suggestions include establishing group organizations for prenatal care, using home visiting programs, reducing teenage pregnancies, expanding telemedicine, and investing in smoking cessation programs.

“…the cost of perinatal morbidity is staggering – both the financial cost to the state of Indiana and the human, social and emotional cost to its Hoosiers,” concludes the state’s report. “Investments in Indiana-specific research and programs to reduce perinatal morbidity will have rewards well beyond the cost.”

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