Giving birth well before your due date is a fear every parent has during pregnancy. Premature birth can cause of a lifetime of health complications, so you want to make sure your little one is the healthiest they can be. But not everyone has access to adequate, safe medical care, which has led to a high number of preterm births in some parts of the country. So which city has the worst premature birth rate in the United States?
According to The Plain Dealer, Cleveland, Ohio has the highest number of premature deliveries out of 100 cities ranked by the March of Dimes in its 2017 Premature Birth Report card. Nearly 15 percent of all live births in Cleveland are preterm, earning the city an "F" grade, according to the March of Dimes report released Wednesday. That's more than two and a half times the rate of premature birth in Irvine, California (5.8 percent), which is the March of Dimes' best ranked city, The Plain Dealer reported.
This is the second time Cleveland received an "F" grade from the March of Dimes for its premature birth rates. Last year, the northeast Ohio city saw a 13.7-percent preterm birth rate, according to the March of Dimes' 2016 report card.
The March of Dimes gave "F" grades to 13 other cities for their poor premature birth rates, according to its report. With Cleveland topping the list, the five cities with the worst numbers also include Baltimore, Maryland; Detroit, Michigan; Memphis, Tennessee; and St. Louis, Missouri.
Reproductive biology professor Sam Mesiano said of the rates, according to The Plain Dealer,
The numbers in Cleveland are what you would see in developing countries. It's really unacceptable.
But the rate of premature birth is not the same across the board. According to the March of Dimes, preterm birth rates among black women in the United States is 49 percent higher than other racial groups. In Ohio, specifically, black women are nearly four times more likely to give birth within the second trimester than white women, according to a study published last year in the American Journal of Obstetrics and Gynecology.
Several factors can contribute to preterm birth, which happens before 37 weeks of pregnancy and affects about one out of every 10 infants in the United States, according to the U.S. Centers for Disease Control and Prevention. Pregnancy-related complications, infections, sleep problems, genetic abnormalities, and a weak cervix are just some of the causes doctors have identified.
But why is the rate so high in Cleveland — and Ohio as a whole? According to the Columbus Dispatch, among other factors, adequate access to prenatal care has a significant impact on the number of premature birth. And this is specifically true for women of color, who are less likely to receive proper prenatal services and face barriers to accessing general health care, according to Our Bodies, Our Selves.
Dr. Brian Mercer, chair of the department of obstetrics and gynecology at MetroHealth Medical Center, told The Plain Dealer,
What this tells us is that there's a lot more to do and that we're going to have to start focusing on the things that are harder to do. We've done the things that are easier to do at the bedside. Many of the causes of preterm birth relate to things that we can't treat in the hospital.
As for states and territories, West Virginia, Louisiana, Mississippi, Alabama, and Puerto Rico all received "F" grades for having, on average, a 11.5-percent or higher premature birth rate, according to the March of Dimes report. The United States, as a whole, has a 9.8-percent rate, earning it a "C" grade.
Although the country ranked the same this year, the percentage of preterm births did rise slightly between 2015 and 2016, according to Kaiser Health News. This is the second year in a row that rates have increased in the United States, which signals a disturbing trend in how the country cares for and about pregnant people.
To that last point, I'd be remiss if I didn't point out one big correlation: The states with the worst premature birth rates are also the states that have chipped away at reproductive health care access. In Ohio, for example, lawmakers have worked to limit abortion rights and defund Planned Parenthood. Same goes for West Virginia, Louisiana, Mississippi, and Alabama.
Restricting access to reproductive health care has a tremendous effect on whether or not a pregnant person will access prenatal care. If clinics that provide abortions and pregnancy care continue to close, many women won't have access to adequate health care at all. If states like Ohio want to reduce their preterm birth rates, they first have to start respecting women's health.
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