By Leslie Kowalewski
Associate State Director, March of Dimes California Chapter and Director of the Big 5 State Prematurity Initiatives
National Manager, Prematurity Campaign Outreach
November is Prematurity Awareness Month, and the March of Dimes invites AMCHP, our Prematurity Campaign alliance organization, AMCHP members and MCH colleagues to learn more about the seriousness of premature birth, donate, or create a virtual band to celebrate, honor or remember a baby in their life at the March of Dimes website – marchofdimes.com/fight.
On November 17, the March of Dimes will mark the 8th annual Prematurity Awareness Day by issuing its 2010 Premature Birth Report Card, which grades the nation and the states on their preterm birth rates.
“We are helping everyone understand the importance of a full-term pregnancy,” said Dr. Jennifer L. Howse, president of the March of Dimes. “The last few weeks of pregnancy are critical to a baby because many important organs, including the brain, need this time to completely develop.”
More than two-thirds of new or expectant moms do not know the correct definition of preterm birth, (less than 37 weeks gestation), and most have not discussed the risks and consequences of preterm birth with their healthcare provider, according to a survey by the March of Dimes and its partners. Dr. Howse said early prenatal care, and a discussion about lifestyle habits, any chronic illnesses, and medical history, can give more babies a better chance of a healthy birth by identifying risks early.
Following three decades of increases, the nation achieved its first two- year decline in the preterm birth rate in 2008, a four percent drop from 2006. The preliminary preterm birth rate dropped to 12.3 percent in 2008, down from the 2006 final rate of 12.8 percent. The March of Dimes says 79 percent of the decline occurred among babies born just a few weeks too soon.
This improvement is modest, the March of Dimes says, and the fact remains that more than half a million babies are born preterm each year. Preterm birth is a serious health problem that costs the United States more than $26 billion annually. It is the leading cause of newborn death, and babies who survive often face the risk of lifetime health challenges, including learning disabilities, cerebral palsy and intellectual disabilities.
In addition to creating awareness about the seriousness of premature birth the March of Dimes wants people to know that there are known strategies that can lower the risk of an early birth, such as avoiding unnecessary c-sections and inductions before 39 weeks of pregnancy. This past year March of Dimes launched “Why the Last Weeks of Pregnancy Count,” a consumer brochure that explains the important development that occurs to a baby’s brain during the last few weeks of pregnancy. Used by doctors and nurses nationwide, it describes the baby's growth and development in the last few weeks of pregnancy and the importance of having a full term pregnancy.
Most recently, in 2010, the Joint Commission established a new perinatal care core measure set that includes the number of elective deliveries (both vaginal and cesarean) performed at > 37 and < 39 weeks of gestation completed. In order to support hospitals in eliminating non-medically indicated deliveries before 39 weeks, March of Dimes, California Maternal Quality Care Collaborative (CMQCC), and the California Department of Health, Maternal Child and Adolescent Health Division collaborated on the development of a quality improvement toolkit.
March of Dimes and CMQCC are pleased to make the toolkit available to all hospitals across the country. Interested clinicians, hospitals, insurers and regional collaboratives are invited to download this document to assist in the development of a comprehensive quality improvement program to address elective deliveries <39 weeks. If your hospital is interested in implementing the toolkit, please consider working with your March of Dimes chapter. To find your local chapter, visit here.
March of Dimes, together with its partners, is collaborating with 25 hospitals from across California, New York, Florida, Texas, and Illinois on piloting the toolkit. Together, these five states account for nearly 40 percent of the births and nearly 38 percent of the preterm births in the United States. Lessons learned from this pilot will guide and support the rollout of the toolkit nationwide.
The toolkit was funded by federal Title V MCH Block Grant funding provided by the California Department of Public Health; Maternal, Child and Adolescent Health Division and March of Dimes. A free copy of the toolkit can be downloaded at marchofdimes.com or you may purchase the “Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age” toolkit for $22.50 through the online catalog. The toolkit offers practices for clinicians and patients to better understand the consequences of early elective delivery and the importance of the last weeks of pregnancy. It includes case studies, which can serve as models, from leading healthcare institutions nationwide that implemented policies and practices successfully lowering elective deliveries and preterm births.
March of Dimes Prematurely Awareness Day® is sponsored by CIGNA, FedEx, Destination Maternity and Hologic. On November 17, Farmers Insurance, a March of Dimes sponsor, is sponsoring a six-hour marathon of the Discovery Health series NICU, which shows the experiences of babies fighting for their lives in a newborn intensive care unit.
As part of Prematurity Awareness Month®, March of Dimes staff and volunteers nationwide will host vigils, and light buildings in purple to draw attention to the epidemic of preterm birth. The March of Dimes also has been working with organizations in Africa, Australia and Europe that are raising awareness about the consequences of preterm births. To learn more, visit marchofdimes.com/fight.