"The U.S. is facing an ongoing maternal and infant health crisis and in 2020 we are still among the most dangerous developed nations for a woman to give birth," says Stacey Stewart, president and CEO of March of Dimes.
Stewart says that March of Dimes created its grading system for each state—as well as the country as a whole—by gathering the latest data from the Centers for Disease Control and Prevention's National Center for Health Statistics. The data took into account preterm birth rates (meaning when a baby is born before 37 weeks), infant death rates, states’ efforts on Medicaid expansion and extension, health insurance status, and inadequate prenatal care, among other factors.
"The report card shows that for the fifth year in a row, the U.S. preterm birth rate increased to 10.2 percent of births, earning the nation a C- grade compared to last year’s C grade," Stewart says. This is a huge problem, she says, since preterm birth is one of the leading causes of infant mortality. While overall infant mortality rates in the U.S. have slowly declined, "two babies die every hour and two women die from pregnancy complications every day," she adds.
While the statistics are concerning for anyone giving birth in this country, they are even worse for BIPOC (Black, Indigenous, and people of color) people giving birth. According to the report, women of color are up to 50 percent more likely to give birth preterm, and their children can face a 130 percent higher infant death rate. "Racism is a public health crisis," Stewart says. "Chronic inequities and unequal access to quality health care contribute to higher rates of maternal and infant health complications, particularly for communities of color." Their data showed that women who identified as Black, American Indian, Alaskan Native, and Hispanic were less likely to be uninsured, live in poverty, and receive inadequate prenatal care compared to white women—all social determinants of health that contribute to health disparities between communities.
Stewart says a lot has to change in order to improve these numbers—and March of Dimes has launched several initiatives to do just that. "We launched an implicit bias training for health-care providers to uncover institutionalized racism in the health-care system and train health-care workers to not perpetuate the cycles of discrimination," she says. "We have trained more than 1,000 health-care professionals and have plans to train an additional 10,000 over the next two years."
Stewart says policies must be changed at state and federal levels to provide everyone giving birth with adequate access to pre- and postpartum medical care. "[One example of this is] extending Medicaid coverage for postpartum moms, as well as providing quality public health coverage to women before pregnancy," she says.
She also points out that maternal and infant mortality is directly connected to overall health; if someone has a pre-existing health condition, they are more at-risk. For this reason, she says addressing preventable health conditions through expanding research and treatment needs to be done as well.
"There is no single cause to this complex crisis," Stewart says. "Not only is it impacted by medical factors, it can be traced back to systemic challenges with health-care systems, social determinants of health like access to care, and poverty and deeply entrenched, structural racism that is fueling a health equity gap. But everyone can do their part to drive real, positive change."
The report is a reminder of just how much needs to change. Every two minutes, a life depends on it.
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