Skip to content

According to the infant and maternal health nonprofit March of Dimes, the rate of premature birth in the United States is climbing.

Recently, the organization released its annual “report card” on maternal and infant health, which involves a newly updated calculation system. They took a comprehensive look at premature births, and they found that the US preterm birth rate rose to 10.5% last year, representing an increase of 4% since 2020 and the worst national rate since March of Dimes started tracking this data in 2007, based on its new calculation system.

Dr. Zsakeba Henderson, senior vice president and interim chief medical and health officer at March of Dimes, said, “This is actually a 15-year high in the preterm birth rate in this country.”  

The National Center for Health Statistics states the US preterm birth rate peaked in 2006 at 12.8%.

Some March of Dimes reports have found US preterm birth rates much higher than 10.5%. But, those rates were founded on calculations that have been updated.

“There are too many babies being born too soon: 1 in 10. If you were to have 10 babies in front of you and one of them is having to face the complications that come with prematurity, that’s unacceptable, and we need to do better,” Henderson said, adding that those 1 in 10 are more likely to be Black, American Indian or Alaska Native.

March of Dimes data in the new report shows that “infants born to Black and Native American mothers are 62% more likely to be born preterm than those born to White women.”

The new report also featured state-by-state differences in the rate of babies born prematurely across the country.

The report grades a preterm birth rate less than or equal to 7.7% as an A and a preterm birth rate greater than or equal to 11.5% as an F.

The national preterm birth rate of 10.5% equals D+.

No state has achieved an A rate. Only Vermont has come close, with the lowest preterm birth rate in the US at 8%.

And nine states and one territory — Georgia and Oklahoma with 11.9%; Arkansas, Kentucky, and Puerto Rico with 12%; South Carolina with 12.1%; West Virginia with 12.8%; Alabama with 13.1%; Louisiana with 13.5%; and Mississippi with the highest preterm birth rate of all states at 15% — have preterm birth rates that received an F grade.

“The areas that have the worst grades are the same areas we’ve been seeing consistently for a long time, and it’s past time for us to do what we need to do to make health better and make our country a better place to give birth and be born,” Henderson said. “It’s unfortunate that we don’t have policies in place to protect the most vulnerable in our country, and without protecting our moms and babies, we can’t secure the health of everyone else.”

To address these state-by-state disparities in preterm births and to help improve the national preterm birth rate as a whole, Henderson said that March of Dimes has been advocating for certain policies like the Black Maternal Health “Momnibus” Act of 2021. But most of the bills in the package are still stuck in Congress.

March of Dimes has also been urging more states to adopt legislation expanding access to doulas and midwives, among other maternal healthcare services, reducing the prevalence of maternity care deserts across the country.

Many potential factors contribute to the nation’s rising preterm birth rate, and Henderson said the Covid-19 pandemic remains one of the biggest.

“We cannot forget about the impact of the Covid-19 pandemic and recognize that there is likely a huge contribution of that, knowing that Covid-19 infection increases the risk of preterm birth,” she said.

She added that many mothers in the United States start pregnancies later in life. In addition, there has been an increase in mothers with chronic health conditions, who are at higher risk of having to give birth early due to pregnancy complications.

Henderson also said that preterm birth is one of the top causes of infant deaths.

“The United States is one of the worst places to give birth and be born among industrialized countries, unfortunately. When we look at maternal deaths and infant deaths, we’re at the bottom of the pack among countries with similar profiles in terms of gross domestic product,” Henderson said.

About 10% of births are preterm worldwide, which is similar to the US preterm birth rate.

Each year, about 15 million babies are born preterm, amounting to more than 1 in 10 of all births around the world, according to the World Health Organization, which has called prematurity an “urgent public health issue” and “the leading cause of death of children under 5.

Apart from the March of Dimes, WHO released new guidelines Tuesday on how nations can improve survival and health outcomes for babies born too early (at 37 weeks or less) or too small, at 5½ pounds or less.

These recommendations advise that skin-to-skin contact, also known as kangaroo mother care, be provided to a preterm infant immediately after birth, without any initial time spent in an incubator.

“Previously, we recommended that kangaroo mother care to only be for babies that were completely stable,” said pediatrician Dr. Karen Edmond, medical officer for newborn health at WHO, who was the lead on the new guidelines.

“But now we know that if we put babies in skin-to-skin contact, unless they are really critically ill, that this will vastly increase their chances of surviving,” she said. “So what’s new is that we now know that we should provide kangaroo mother care immediately after birth rather than waiting until the baby’s stable.”

Dr. Edmond added that immediate kangaroo mother care could help infants better regulate their body temperature and help protect against infections. She said that these guidelines are for on-the-ground healthcare providers as well as families.

“These guidelines show that improving outcomes for these tiny babies is not always about providing the most high-tech solutions,” he said, “but rather ensuring access to essential healthcare that is centered around the needs of families.”