High prematurity rates earn Ohio a scolding
Sometimes, a big, fat D on your report card wakes you up.
That's the hope of the March of Dimes, which for the first time has graded states on the number of babies born early.
The grades came out last month, and Ohio, with a preterm birthrate of 13 percent, got a D. So did the United States, which has a preterm birthrate of 12.7 percent.
The highest grade was a B, earned only by Vermont.
The rates are based on 2005 data and reflect a nationwide increase in early deliveries. The federal government's goal for 2010 is a rate of 7.6 percent.
The report card also includes statistics on health insurance, smoking rates and late preterm births (those between 34 and 36 weeks). About one in seven Ohio women of childbearing age has no health insurance; about one in four smokes and about one in 11 births is late preterm.
The reasons for the high preterm numbers are many, and they include more women waiting longer to have babies and increased use of fertility drugs.
The March of Dimes and other organizations recognize that some babies risk death if they are not delivered early, and that doctors who treat preterm infants are better than ever at saving them.
"There are many times when the birth is absolutely the best thing for mom and baby at that time," said Pat Fizer-Vogel, a nurse and chairwoman of the March of Dimes Ohio chapter's executive board.
But the groups want to make sure that everything possible is done to prevent unnecessary premature deliveries.
That means fighting for better access to good prenatal care and convincing women to quit smoking during pregnancy.
It also means reining in the number of Caesarean sections. Experts say early, elective Caesareans (before 39 weeks) have surged in the past couple of decades.
Prematurity is technically before 37 weeks, but the March of Dimes and others frown on C-sections scheduled merely for convenience before 39 weeks.
A handful more days inside the womb matter, even at the end of pregnancy, said Dr. Jay Iams, a specialist in maternal-fetal medicine at the Ohio State University Medical Center.
Iams, who sits on the March of Dimes' scientific advisory committee on prematurity, is helping lead a statewide effort among hospitals to drive down prematurity rates and improve the health of those born too soon.
After just a few months, hospitals are seeing improvements, he said, and some hospital leaders say they've lowered the number of early, scheduled deliveries simply by requiring that doctors explain why they've scheduled one.
For about seven years, Riverside Methodist Hospital has monitored early C-sections to see whether they were being performed for medical reasons, said Dr. Stuart Jones, chairman of the hospital's obstetrics and gynecology department.
Now, those deliveries have all but stopped, he said.
The March of Dimes plans to issue updated report cards periodically.