The Best and Worst Cities for Preemies: Where Does Yours Rank?

Preterm birth rates are falling, according to the March of Dimes' 2015 Premature Birth Report Card—but we still have far to go. See where your state and city rank in this year's list.
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The March of Dimes released its eighth annual Premature Birth Report Card, which grades the country on its preterm birth rates.

This year, the org has changed up the report card quite a bit from past years: Now it includes data by city and county—and is able to show problem areas even within states that are doing well. Plus, it looks at disparities among racial groups. The whole goal is to focus on the gaps by region or demographic, and then work to target those areas for improvement.

So without further ado, how did the U.S. do on its report card? Well, it was a mixed bag. First, the bad news: We got a C. We had a preterm birth rate of 9.6 percent last year, according to the National Center for Health Statistics, and preterm birth ranks as the No. 1 killer of babies in the country. Unfortunately, our C grade means the U.S. is one of the worst among countries with a lot of resources.

But now the great news: The 9.6 percent rate means we met the March of Dimes' goal for 2020 several years early! And as a result, the org also announced a new goal for the country to lower the preterm birth rate to 8.1 percent by 2020. Reaching that goal would mean 210,000 fewer babies will be born preterm each year.

For some more good news, we can look within specific regions: Portland, Oregon has the best preterm birth rate of the top 100 cities with the most births nationwide. Portland got an A on the report card, with a preterm birthrate of only 7.2 percent. (I was glad to see that Oxnard in my home state of California also received an A.)

On the flip side, Shreveport, Louisiana performed the worst, earning an F for its 18.8 percent rate in 2013 (which is the most recent year statistics were available for large cities).

Maine ranked best on the disparity index with the smallest gaps among racial and ethnic groups in its preterm birth rate, while Washington D.C. had the biggest gaps. Idaho, Oregon, Vermont, and Washington all got As, 19 states got Bs, 18 states and the District of Columbia got a C, six others a D, and Alabama, Louisiana, Mississippi, and Puerto Rico all got failing grades.

The March of Dimes says progress in the preterm birth rate is a result of programs and policies by state and local health departments, hospitals, and health care providers, as well as a new method of measuring pregnancy length recently adopted by the National Center for Health Statistics.

But what can individual pregnant women do right now in order to reduce their risk for preterm birth? "There are many steps a woman can take to give her baby a better chance at a healthy start in life and lower her risk of having her baby born too soon," Siobhan Dolan, a medical adviser to the March of Dimes, told Parents.com via email. "Women should plan their pregnancies and be sure to visit their doctor before they get pregnant for preconception care, and they should go to all their doctor appointments during pregnancy."

All women should strive to get to an ideal weight before becoming pregnant, she added, and work to control chronic conditions such as high blood pressure or diabetes, quit smoking and drinking alcohol, and take a daily multivitamin with at least 400 milligrams of folic acid.

Women also should wait at least 18 months after having a baby before getting pregnant again, she said. "And, if their pregnancy is healthy, they also should talk to their doctor about not scheduling a delivery before at least 39 weeks. Every week of pregnancy counts," she said. " The last few weeks are crucial to a baby's health because many vital organs, such as the brain, lungs, and liver, are not completely developed until then."

Dolan also explained that preterm birth costs the United States $26 billion annually in medical and societal costs, according to the Institute of Medicine. And it's seriously expensive for families, too. "One study of large self-insured businesses found that the average medical costs for a healthy, full-term baby from birth through the first year was $5,085. For premature and/or low-birth-weight babies (less than 37 weeks gestation and/or less than 2,500 grams) the average cost was $55,393."

In short, if you think you can't afford to take care of yourself during pregnancy to give yourself the best shot at a full-term delivery... just consider the alternative!

Alesandra Dubin is a new twin mom. She's also a Los Angeles-based writer and founder of the lifestyle blog Homebody in Motion. Follow her on Facebook, Instagram, Google+, and Twitter.

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