Overview:
According to the March of Dimes, Black birthing parents are 1.5 times more likely to deliver a premature baby than whites, and a premature Black baby is twice as likely to die before their first birthday.
It’s well known that the U.S. is among the worst industrialized nations when it comes to maternal health. It’s also a given that birth outcomes are worse for Black women, who are far more likely to die during childbirth than white women.
Now, a national charity dedicated to the health of mothers and babies is spotlighting data that shows Black babies are about 1.5 times more likely to be born prematurely than white babies — and are nearly twice as likely to die before their first birthday.
In its annual report on maternal health, released Thursday, the March of Dimes also gave the U.S. a failing grade, D+, based on the number of babies born before term last year.
The data, and report, is part of Prematurity Awareness Month, when national and international organizations bring attention to the health of those infants and their mothers each November.
In an executive summary, Cindy Rahman, interim March of Dimes president, wrote that the consequences of preterm birth “extend far beyond prolonged hospital stays,” and can last a lifetime.
Premature infants “face long-term health challenges that can affect behavior, mental health, and brain development,” she wrote. The children, Rahman wrote, can suffer from “serious conditions such as asthma, hearing loss, and even death.”
While the causes of many preterm births are not fully understood, the risks are reduced if women get access to quality prenatal care, help managing chronic health conditions, and an awareness of preventive interventions such as low-dose aspirin.
Preterm birth is the leading cause of infant mortality, which in 2023 experienced its largest increase in more than 20 years, according to the March of Dimes. Black infants are also nearly twice as likely to die in their first year than the national average.
In the U.S., more than 10% of babies are born preterm, which means their births occurred before 37 weeks of pregnancy. Full-term pregnancies last between 39 and 42 weeks.
Black mothers have a preterm birth rate of 14.7%, almost 1.5 times higher than the national average, according to the March of Dimes.
Ironically, “preterm birth rates are higher for non-Hispanic Black women who have higher educational attainment than for non-Hispanic White, Asian, or Hispanic women with lower educational attainment,” according to a 2012 report from the American College of Obstetricians and Gynecologists. Experts say continues to be the case even a decade later.
“Recognizing that race is a social rather than a biological construct, the effects of structural, institutionalized, and interpersonal racism and implicit and explicit biases implicated in many health inequities are more likely than race itself to be related to elevated risk,” says ACOG.
Rahman and other experts tie premature births to quality prenatal care; but a May 2024 Harris Poll survey found that, among women who were pregnant or had given birth, just 42% were confident that they had access to the best possible medical care during their pregnancy.
That can be a challenge for Black women: Only 10.7% of OB-GYNs identify as Black/African-American, and studies show health outcomes are better for patients with caregivers who look like them.
Last year, Congress approved extending the “Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Reauthorization Act to continue funding research and education programs aimed at preventing preterm births.
The bipartisan legislation is in flux after the recent election, but it could be reintroduced next year.
Several states are also extending postpartum Medicaid coverage from the previously standard 60 days. The American Rescue Plan Act of 2021 provided states the option to extend the coverage for up to 12 months, and in 2023 this option became permanent.
“Because Medicaid pays for roughly 64 percent of births to Black women, extending this coverage is key to helping reduce racial health disparities,” says ACOG. “Postpartum care allows patients to receive treatment for chronic health conditions that can arise or persist long after delivery, such as hypertension and heart conditions.”
The American Academy of Family Physicians and ACOG recommend having prenatal visits every four weeks until the 28th week of pregnancy, every two weeks until the 36th week of pregnancy, and then weekly until delivery.
Know the signs of preterm labor so you can contact your healthcare provider immediately.
