Each year, 12 percent of American babies, or nearly half a million infants, enter the world too soon. That gives us a premature birth rate on par with that of Somalia, Thailand, and Turkey, and behind 130 other countries.
That was the finding of a new report, called Born Too Soon, that is the first to look at preterm birth rates by country, published by the March of Dimes Foundation, the Partnership for Maternal, Newborn, and Child Health, Save the Children, and the World Health Organization.
Infants in the U.S. who are born before 37 weeks of completed pregnancy are more likely to survive than those born in many other parts of the world. But prematurity is still the leading cause of newborn death in the U.S. And those who survive may face breathing problems, cerebral palsy, intellectual disabilities, and other lifelong health challenges. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants.
Prematurity also takes an economic toll, adding $26 billion yearly to U.S. health-care costs according to the National Academy of Science’s Institute of Medicine.
Reasons for the high rate include more older women having babies and the use of fertility treatments that result in twins and triplets, according to Christopher Howson, Ph.D., vice president for global programs at the March of Dimes and one of the study authors. Also, some population groups are at extremely high risk. For example, nearly 18 percent of African American babies are born too soon.
But one of the main problems appears to be a health-care system that does too little to help moms enter their pregnancies healthy and too much to intervene as women give birth.
Howson points out that nearly 30 percent of pregnant women in the U.S. do not see a health-care provider during their first trimester. He says:
While we do a great job of taking care of preemies, we do not do a good job with making care universally available before conception and during pregnancy.
In addition, while the trend is shifting, the U.S. has seen a rise in the number of medically unnecessary cesarean births and inductions scheduled for convenience or because the baby’s gestational age is unknown.
The good news is that the preterm birth rate has decreased modestly over the last four years. “Improvement is not happening as fast as we would like, but it does show that people are becoming more aware of the risks of preterm birth as well of the need to improve the quality of care,” Howson says.
Women who are pregnant or may become pregnant can take specific steps to dramatically reduce their risk of premature birth. For tips on how to have the healthiest possible pregnancy and delivery as well as a list of interventions to avoid when not medically necessary, see our report What to reject when you’re expecting.