In Los Angeles (And The U.S.) More And More Babies Are Born Too Early
In Los Angeles, in California, and across the country the percentage of premature birth has ticked up for the third year in a row.
Bad news on this subject isn't new. The U.S. consistently lags on three of the major indicators of maternal and child health. Dozens of other developed countries do better than the U.S when it come to rates of preterm births, infant mortality and maternal deaths.
One in 10 babies in the U.S. are born premature. But the likelihood of a baby being born too early — that means prior to 37 weeks in the womb — varies widely across the country. Race is a key factor in those disparities, according to an annual report by the nonprofit March of Dimes.
This year, California scored a B, with a rate of 8.7 percent. When you look deeper into that "passing" grade, you'll find deep racial disparities. The preterm birth rate for black women in California is 44 percent higher than the rate among all other races.
"We're seeing that racial disparities persist," said Mashariki Kudumu, maternal and child health director for March of Dimes, Greater Los Angeles. "We're seeing that black women have a higher preterm birth rate than any other group."
The report calls on policymakers to raise awareness about the risks and interventions for premature birth. That means taking a hard look at the social factors, like racism, that influence health.
This is one more example of how where someone lives and how they are treated can affect their health. Los Angeles scored a C grade, with a rate of 9.5. Down the road, Irvine has one of the lowest preterm birth rates in the country - just 5.5 percent.
The inequities in preterm birth are directly linked to the disparities in the infant mortality rate. Nationwide, black babies are two times more likely to die in their first year of life than white babies. The rate in L.A. County is even higher. Black babies here are three times higher to die in that time frame Babies who are born preterm are at higher risk for developmental disabilities and health care costs take and economic toll.
"So you reduce preterm birth, you're gonna reduce infant mortality," Kudumu said.
WHY ARE RATES GOING UP?
Here's what people who have studied this issue for years say about why it is still a persistent problem:
- Consistent concerns remain about support for policies that support moms and babies and access to affordable prenatal care.
- Lack of awareness about risks and interventions among patients and providers.
- Caregivers who aren't hearing expectant moms when they raise concerns or describe symptoms that could lead to a premature birth
"So if women are saying, 'I'm showing up with what I feel like is preterm birth and my doctor is not listening to me, then we have to address that,' " said Kudumu.
And it's important to remember that the high rates for black babies aren't solely about education or income. A black woman with a college degree is more likely to have a baby preterm than a white woman without a high school diploma.
There's growing attention to what researchers call the social determinants of health and how a women's experience over the course of her life affects the outcomes of her baby. More research points to the links between racism, chronic stress and birth outcomes.
There are a lot of unknowns, and with its report, — and March of Dimes is highlighting the need for more research.
"And I hope with that we're taking the shame out of it and really taking this and compelling this to action," said Kudumu. "And that's what I'm seeing in the community that people are really wanting action around this issue."
There's also a need for greater awareness among health providers. Dr. Diana Ramos, a obstetrician-gynecologist who works in L.A. and Orange County said it's important to remember that prenatal and obstetric care may be given by a family practitioner or a nurse practitioner, who are less likely to have received training about the signs of preterm birth.
"When you have a patient that is African American we have to remind ourselves, 'OK, as a group, they're at higher risk for having preterm birth, so did I do everything that I possibly could?'" said Ramos.
WHO'S DOING WELL?
The report highlighted some success stories in Rhode Island, Knox County, Tenn., and Raleigh, N.C., which have all seen major improvements. These very different places all made a concerted effort to focus on addressing the racial disparities. In addition to increasing access to healthcare and raising awareness about the risks and interventions, health officials in each of these areas took a stance to reverse the long-term results of institutional racism.
Another thing they have in common is really being collaborative and getting support from different sectors.
COULD LOS ANGELES DO THE SAME?
That's the goal. Earlier this year, the L.A. County Department of Public Health announced an action plan aimed at closing the black-white infant mortality gap by 30 percent in the next five years. Health officials are being very upfront that racism is part of the problem and are in the process of rolling out more specific steps.
Awareness is key. Visit this March of Dimes resource page to earn more about the symptoms and signs of preterm labor and interventions that might help. You'll find tips for starting this conversation with your doctor.
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