U.S. delivers too many preemies. California does too

If California were a country, it would tie with Fiji for the percentage of babies born too early. In 2010, nearly 10 babies out of every 100 were born before 37 weeks of gestation. If placed on the global list, California would rank 88th -- behind Uzbekistan, Vietnam, Rwanda and Tunisia.

But California, the hypothetical country, is doing much better in reducing preterm births than the United States as a whole. 

In a report published today, The March of Dimes and other organizations give the U.S. bad marks for its high rate of babies born before 37 weeks gestation. The U.S. placed 131st out of 184 countries; twelve of every 100 babies born in the U.S. were born early in 2010. We’re the worst of the G8 countries and barely better than Nigeria.

Why does this matter? An early arrival makes infants more susceptible to a slew of medical issues, including feeding problems, lung problems, infection, brain impairments and even death.

And, treating premature babies is expensive. Preterm births in the U.S. cost about $51,500 per premature infant.

A lot of those babies are born in California. Of the approximately four million babies born in the US every year, 550,000 of them, more than one-eighth of all new American-born children, pop out in California. 

“We have more births in California typically than France, Italy and Spain,” said Dr. James Byrne, State Program Services Committee Chair for March of Dimes in California. More than 54,000 of those births are premature. 

In the U.S., preterm births are increasing for many reasons: Women are having more scheduled C-sections and inductions before the baby is ready. Chronic diseases such as hypertension and obesity can lead to pregnancy complications, as can smoking and drug abuse. And, Byrne says, some women, particularly low-income women, don't have access to adequate prenatal care that could help prevent or postpone a preterm birth.

Getting the right intervention at the right time could dramatically reduce prematurity rates and improve outcomes for babies born early, says Dr. Byrne. For example, administering steroids to a mom who goes into labor early can help the baby’s lungs develop better so he can breathe more easily at birth.

“A preterm child that has received antenatal steroids has half the rate of death compared to one who didn’t get it, far fewer complications, infections, brain bleeding...” Byrne says. “This is such an opportunity for improvement that’s not being used frequently enough.”

Babies are typically born between 37 and 42 weeks of gestation, with the official “due date” usually falling 40 weeks after conception. There’s a big national push now to encourage docs and moms to wait until at least 39 weeks before scheduling childbirth. There’s also a move to redefine “term” pregnancy so decisions aren’t made to bring a baby into the world before he or she is ready.

Despite our relatively bad grade in preterm births, U.S. preemies have a much higher rate of survival than their third-world counterparts.

In recent years, California has been a leader in reducing the number of births scheduled early for no medical reason. In partnership with the California Maternal Quality Care Collaborative, for example, the California March of Dimes created a toolkit to educate providers and patients about the importance of waiting at least 39 weeks before inducing labor without a medical reason.

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Lauren M. Whaley

Freelance journalist Lauren M. Whaley is a photographer, radio producer and print reporter specializing in topics related to mental illness, reproductive health care and health disparities. She is also a childbirth photographer.This year, She is working on a series about how low-income parents access care for perinatal mental illnesses. The project is funded in part by the Rosalynn Carter Fellowships for Mental Health Journalism.She was a 2016-17 Knight Science Journalism Fellow at the Massachusetts Institute for Technology.Her work has been recognized by the Association of Health Care Journalists, the Scripps Howard Foundation and the Public Radio Exchange (PRX) STEM story project. She has contributed radio, video, photography and written stories to KQED Public Radio, Southern California Public Radio, the San Jose Mercury News, the New York Times and other media outlets. For six years, she worked as the Center for Health Reporting's multimedia journalist. She is a past president of the national organizationJournalism and Women Symposium (JAWS) and spent her early 20s leading canoe expeditions for young women, including a solo-led 45-trip in the Canadian Arctic. She is based in Los Angeles.

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