Doctors say nearly half of all births are premature, preventable, caused by social, economic and environmental factors, as well as inadequate access to prenatal health care.
ER Productions Press / Getty Images
hide caption
toggle caption
ER Productions Press / Getty Images
Doctors say nearly half of all births are premature, preventable, caused by social, economic and environmental factors, as well as inadequate access to prenatal health care.
ER Productions Press / Getty Images
Tamara Etienne’s second pregnancy was fraught with danger and anxiety from day one – exacerbated by her first pregnancy which had ended in miscarriage.
A third-grade teacher in the Miami-Dade County Public Boat Service at the time, he spent his days struggling with his feet. The singles were heavily burdened financially, including health insurance and some paid time off from their job.
And as a Black woman, experiencing a phyletic life, Etienne is wary of the vague emotions she left behind in her daily life and exhausted by the derogatory and unequal treatment at work. It is a form of stress that can release cortisol, which studies have shown increases the risk of premature labor.
“Every day I experience it – not walking alone, walking with someone I have to protect,” he said. “So the cortisol balance in my body when I’m pregnant? immense.”
Two months into the pregnancy, the relentless nausea suddenly stopped. “I started to feel like my pregnancy symptoms were going away,” she said. Then a new back pain started.
Stephen and her husband rushed to the emergency room, where the doctor confirmed that she was in serious danger of having a miscarriage. A cascade of medical interventions — progesterone injections, fetal monitoring at home, and bed rest while she took months off work — saved the boy, who was born at 37 weeks.
About 1 in 10 live births in the US in 2021 occurred prematurely — before 37 weeks of gestation — according to a March of Dimes report released late last year. Premature birth is more common than in most developed countries; Research in recent years has cited rates of 7.4% in England and Wales, 6% in France, and 5.8% in Sweden.
It’s a distinction that coincides with high rates of maternal and infant mortality, billions of dollars in intensive care costs, and often a lack of life expectancy for the children who survive.
“It is difficult to know that the patient has spontaneously given birth,” said Dr. Elvire Jacques, a maternal-fetal medicine specialist at Memorial Hospital in Miramar, Fla.
Doctors say nearly half of all preterm births are preventable, caused by social, economic and environmental factors, as well as inadequate access to prenatal health care. Risk factors include conditions like diabetes and obesity, as well as more subtle issues like stress or even dehydration.
In its 2022 report card, the March of Dimes found that fertility rates in almost every state increased from 2020 to 2021. The worst results occurred in Southern states, with preterm birth rates of 11.5% or higher. Mississippi (15%), Louisiana (13.5%), and Alabama (13.1%) were the worst performers.
He claims that abortion restricts maternal care to fewer people
Many maternal-fetal experts are concerned that the incidence of premature birth could rise quickly, since abortion is now banned in at least 13 states and severely restricted in 12 others – claims that restrict abortion have fewer maternal care providers than states with abortion access, according to a. recent analysis by the Commonwealth Fund.
That includes the state of Florida, where Tamara Etienne lives, and where Republican lawmakers have enacted a series of anti-abortion laws, including a ban on the procedure after 15 weeks of gestation. Florida is one of the least liberal states when it comes to public health insurance. About 16 percent of women of childbearing age in Florida are singled out, reducing access to quality prenatal care and making it more difficult to start a healthy pregnancy. A comparison of maternal mortality rates suggests that women are twice as likely to die from pregnancy and childbirth-related causes in Florida as in California.
Social and biological stressors can interact to trigger infertility
The causes of premature birth are varied. About 25% are medically induced, Jacques said, when the woman or fetus is in distress because of conditions such as preeclampsia, a pregnancy-related hypertensive disorder. But research suggests that far more births are thought to be based on a mysterious physiological condition.
At Memorial Hospital in Miramar, part of a large public health system, Jacques receives referrals from other OB-GYNs in South Florida for her high-risk uterus.
When he meets the patient for the first time, he asks: Who else is in your house? Where do you sleep? Do you have substance abuse issues? Where do you work?
“If you do not know your works, be patient in the workshop [standing] “Jacques,” he said, “so what are you going to tell him to wear compression stockings because that helps prevent blood clots?”
Jacques encouraged the store manager to sit the pregnant patient while he worked. He persuaded the imam to take a bite out of a religious fast to cure diabetes.
Because the risk of diabetes is greater, he often talks to patients about eating healthily. For those who eat fast food, he asks them to try cooking at home. Instead, “Can you give me some food?” He asks, “Of the foods we’re dealing with, which one do you think you can afford?”
A lack of access to affordable health care separates Florida from states like California and Massachusetts — which have returned uninsured families and low-income residents — and separates the U.S. from other countries, health policy experts say.
In countries with socialized health care, “women have to worry about the financial cost of care,” said Dr. Delisa Skeete-Henry, chair of obstetrics and gynecology at Broward Health in Lauderdale. “I have taken many places for permission; [and pregnant patients] do not have to be tired around not being at work.
However, wealth does not improve pregnancy outcomes, the US is learning, as premature births rise across the country.
Statistics on gender and premature abortion reveal a tragic trend
Unsurprising new research shows that at every level of US income, black women and their children experience far worse birth outcomes than their white counterparts. In other words, all the wealth that comes with wealth does not protect black women or their babies from premature birth complications, according to a study published by the National Bureau of Economic Research.
Jamarah Amani has seen this first hand as the executive director of the Southern Justice Network and an advocate for midwives and doulas in South Florida. When evaluating new clients, he looks for clues about the risks of premature birth in the patient’s family history, lab work, and ultrasounds. Those homes quickly become stressed at work, relationships; Food issues or developing interest.
To offer meaningful help, you have the right to ask
“I find that black women working in high stress environments, even if they’re not struggling financially, can make a bad impression,” she said. She develops “health plans” that include breathing, meditation, stretching and walking.
Recently, when a patient showed signs of overactive labor, Amani overdue a woman’s electricity bill and threatened to cut off utility service. Amani found an organization to pay back the woman’s debt.
Tamara Etienne had six pregnancies, two miscarriages, and four miscarriages. After an onslaught of medical interventions, she found a local doula and midwife who helped her conceive her two youngest children.
“They allow me to walk in healthy natural ways to alleviate all of these complications,” he said.
The experience of her pregnancy left a deep impression on Etienne. She is a doula because she became fertile.
KHN (Kaiser Health News) is a national, editorially independent program KFF (Kaiser Family Foundation).
#high #rate #premature #births #abortion #prescriptions #worse
