The United States faces an ongoing crisis with preterm births. Recent statistics are alarming.
A continual D+ grade highlights systemic health disparities affecting mothers and infants across the nation.
Unexpected Journey to Motherhood
Ashley O’Neil’s first pregnancy became a harrowing experience when she had to be rushed to a hospital two hours away during a severe storm. At 21 weeks, she experienced unusual bleeding, prompting a hurried visit to her local hospital in Maryland. Her request for an evaluation by an obstetrician was met with delays, leaving her anxious and waiting for hours.
Upon finally being examined, a doctor discovered her amniotic sac was exposed, increasing the risk of complications. The small hospital lacked the facilities to handle a preterm birth, necessitating a stressful two-hour drive to a larger hospital, exacerbated by dreadful weather conditions. Her ordeal is a stark reminder of the struggles faced by many in “maternity care deserts.”
A Grim Reality in Infant Mortality
Preterm birth remains a principal cause of infant mortality in the United States. Recent CDC data revealed that for every 1,000 babies born in 2023, approximately six did not survive. The infant mortality rate, unchanged from 2022, underscores the persistent risks associated with preterm labour.
Alarmingly, 10.4% of births in the US in 2023 were preterm, a figure that remains steady from 2022 data, according to March of Dimes. Interim chief medical officer Dr. Amanda Williams highlights this stark reality: “Over 370,000 babies, or 1 in 10, are born prematurely.” Such statistics bring to light significant healthcare disparities across regions and races, particularly affecting Black communities.
Healthcare Deserts and Their Consequences
Maternity care deserts, areas with limited to no access to essential maternity services, contribute significantly to high preterm birth rates. In such areas, inadequate prenatal care can lead to increased risks for expectant mothers.
If access to prenatal care is compromised, the likelihood of preterm births rises. March of Dimes urges Medicaid expansion to improve maternity care access, potentially reducing maternal and infant mortality. Many high preterm birth rate areas coincide with chronic health issues like hypertension and diabetes, complicating pregnancy outcomes.
Diverse Impacts of Racial Disparities
The racial disparities in preterm births are glaring, with Black communities experiencing rates 1.5 times higher than other groups. These differences are not merely statistical; they represent deep-seated issues within healthcare access and quality.
In urban areas with high preterm rates, inadequate prenatal care and socioeconomic factors exacerbate these disparities. Addressing racial health inequities is crucial to improving maternal and infant health overall.
The March of Dimes report card continues to reflect these disparities, grading many US cities poorly based on their preterm birth statistics. Enhancing healthcare access in these areas is a major step toward more equitable outcomes.
Policy Recommendations for Improvement
To combat high preterm birth rates, experts recommend policy changes including extending paid family leave, increasing Medicaid support for doulas, and expanding midwife services. These measures aim to ensure comprehensive care for expectant mothers.
Increasing the availability of midwifery care is linked with reduced preterm birth risks. Countries with advanced midwifery practices report significantly lower maternal and infant mortality rates. The call for systemic changes in the US healthcare system is urgent.
Continuous efforts include endorsing low-dose aspirin for expectant mothers at risk of preeclampsia, a condition heightening preterm birth risks. Conversations about these strategies between healthcare providers and patients are essential.
The Role of Midwifery in Maternal Care
Midwifery has the potential to profoundly impact maternal and infant health. Research suggests midwifery could significantly reduce deaths and severe pregnancy complications, yet the US lags in midwife utilisation.
With only four midwives per 1,000 live births in the United States, there’s a striking contrast to countries with lower maternal mortality rates, where midwives are more prevalent.
Advocating for greater midwifery involvement in obstetric care, alongside legislative changes, could enhance outcomes for mothers and infants. Equitable compensation and increased workforce are part of the broader reforms needed.
Ashley O’Neil’s Advocacy Mission
Following personal tragedies and triumphs, Ashley O’Neil dedicates herself to raising awareness about preterm birth. Her experiences have inspired her to support others in navigating similar challenges.
Through a podcast and published works, she shares insights and support with other families facing the NICU journey. Her advocacy underscores the societal impact of preterm births and the extensive resources required for affected families.
O’Neil’s story is a testament to resilience and advocacy in the face of personal loss, illuminating broader systemic issues needing urgent attention.
Efforts to address preterm births are ongoing, but challenges remain. Future improvement hinges on systemic healthcare changes.
