March 2021 report card examining maternal and infant health in Florida

March 2021 report card examining maternal and infant health in Florida


The March of Dimes, the nation’s leading company in maternal and child health, released its 2021 report card that revealed that for the first time in six years, the rate of preterm birth in the United States had fallen slightly from 10.2% to 10.1%, with the state maintaining a score of C. . In Florida, premature births fell slightly from 10.6% to 10.5% in 2020, and the state once again earned a D+ score on this year’s report card. Despite the lack of preterm births and the continuing decline in infant mortality nationwide, the deaths of mothers and women with severe health complications due to pregnancy continue to rise. More than 700 women in the United States die from pregnancy-related causes each year, and over the past 30 years, these deaths have doubled.

These stats are much worse for mothers and children of color, as deeply entrenched structural racism directly affects their health. In Florida, there is a lot of work to be done as the rate of premature birth among black women is 53% higher than the rate of all other women.

The report card highlights stark disparities across all measures of maternal and child health and outlines the policy actions and partnerships needed to improve the health of our nation’s families. A challenge as complex as the Maternal and Child Health crisis in Miami, for example, requires the dedication and resources of partners across sectors working together. Over the past several months, the March of Dimes has formed partnerships with the local community and public and private organizations to improve the health of all mothers and children. Through a multi-year effort, Local Collective Impact Initiative partners in Miami, one in Broward County and seven others across the country will align key challenges affecting mothers and babies locally, create a shared vision, and build infrastructure and partnerships to deploy strategies and solutions that can Lead to improved and measurable health outcomes.

Miami stakeholders have finalized a common agenda to guide their work that includes a key goal of ensuring that all women and people born, especially those considered black and/or Hispanic, in Miami-Dade County are healthy before, during and after pregnancy and that They are in good health. Birth outcomes. The agenda focuses on work in three areas: increasing access to affordable, fair and respectful care. helping families achieve economic independence; and building safe, connected and supportive communities.

Even before the COVID-19 pandemic, the United States remained among the most dangerous developed countries for childbirth. The report card shows that the number of preterm births in the United States decreased from 383,061 to 364,487, but that black and American Indian/Alaska Native women were still 60% more likely to have preterm birth than white women. We note the same trend of inequalities with infant mortality, which have slowly decreased over the past several years. However, black and American Indian/Alaska Native children are still twice as likely to die as white children before their first birthdays. Additionally, black women are three times more likely to die than their white counterparts.

The complexity of this crisis rests on the fact that it has neither a single root cause nor a single solution. Factors such as where a person lives and the structural and societal systems in which they live affect the health of mothers and children and lead to a health equity gap. For example, in Florida, 17.4% of women receive inadequate prenatal care during pregnancy. More research and data collection is needed to understand and track changes in preterm birth rates during the COVID-19 pandemic. For this reason, the March of Dimes is working to develop a greater understanding of late preterm birth and data during the pandemic in general.

“Although we have seen slight improvements in premature birth and infant mortality, communities of color are still disproportionately affected,” said Stacey D. Stewart, president and CEO of the March of Dimes. “We see these same inequalities heading with maternal health and are the result of a complex web of factors that fuel this health equality gap. We know it is possible for every family to have a healthy start and we must work together to turn the trajectory of this crisis in order to ensure that they all do so.”

Existing structures and systems, rooted in racist, biased and unjust policies and practices over the centuries contribute to amplifying racial differences in access to resources, social conditions, and opportunities. These policies that have systematically denied the lack of resources and communities of color over the centuries lead to poor and unequal health outcomes for mothers and infants for communities of color.

In an effort to address these racial disparities and understand all the factors that lead to them, the report card features several new measures aimed at improving birth outcomes and reducing maternal mortality and morbidity rates, including:

  • Centers for Disease Control and Prevention’s Social Vulnerability Index Shows counties with populations that have higher levels of vulnerability and are therefore more at risk of poor health outcomes.
  • Doula Care Legislation/Policies: Both can help improve access to care in under-resourced areas, improve birth outcomes and reduce maternal mortality and morbidity rates. For example, the Florida report card shows which direct midwives and certified nurse midwives are permitted to practice in the state. However, Medicaid does not cover doulas.
  • Low-risk cesarean deliveries: a NSAn esophageal delivery is considered low-risk if one baby has been delivered head-on to a mother who is at least 37 weeks pregnant and has not given birth before. In 2019, a quarter of births (25.6%) were delivered by caesarean section that was considered low-risk. Looking specifically at Florida, 29.6% of low-risk births were delivered by caesarean section.

“By looking at the new Social Vulnerability Scale, low-risk caesarean section rates, and state adoption of Doula and midwifery legislation, we are providing additional information to help us identify under-resourced areas and improve access and quality of care,” said Mars. Senior Vice President and Interim Head of Medicine and Health Dr. Zsakipa Henderson.

Dr. Henderson noted that even in low-risk women, there are many reasons why a cesarean delivery is the safest option for mother and baby. Differences in practice patterns between hospitals nationwide may be one of the driving forces behind the overuse of this procedure.

2021 March of Dimes for Premature Birth
Each year, the March of Dimes issues its Report Card with scores for individual states, Washington, D.C., Puerto Rico, and the top 100 cities. The report card shows that premature births worsened in 13 states, with six states and Puerto Rico with failing grades, including Alabama, Arkansas and El.Louisiana, Mississippi, South Carolina, and West Virginia. Vermont is the only state with an “A” grade.

In addition, the report card considers the 100 US cities with the highest number of births, assigning a score based on the rate of preterm births. The 2021 report card reveals that Orlando has a D grade, with an 11.2% preterm birth rate.

Measures to tackle the crisis
March of Dimes leads the struggle for all mothers and children through research, education, programs and advocacy. Since its inception, the organization has worked with many partners at the national and local levels to address the biggest threats facing mothers and children. To this end, March Days mobilizes partners to urge policymakers to prioritize the health of our nation’s families. With our #BlanketChange policy agenda, we focus on all of the policy elements mentioned in our report card and the passage of the Black Mother Health Act of 2021. Join the #BlanketChange movement to demand that policymakers prioritize our country’s mothers and children and take immediate action to improve health from By visiting BlanketChange.org.

In addition to local collective impact work in nine American communities, the March of Dimes is also working to bridge the health equity gap at the national level. The March of Dimes, as an organizer, mobilizes partners at the national level through the Mother and Child Action Network (M-BAN). M-BAN will engage in cross-sector partnerships that invest in, influence and leverage collective action to drive broad changes in policy, research, funding and systems to address the root causes of inequality in maternal and child health.

To view the report card and actions you can take to support mothers and children, visit marchofdimes.org/report card.

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