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For the first time in six years, the United States has improved its rate of preterm births, or premature births occurring before 37 weeks of pregnancy. A new report released by March of Dimes found that our nation’s rate of preterm births has declined by 1.3%, meaning there have been 18,574 fewer preterm births.

This might bring some reassurance if you’re a white, Asian or Hispanic woman who wants to be a mom. But for Black and Indigenous women, their preterm birth rates saw no decline — in fact, their rates increased. Our Report Card also found that Black and Indigenous babies are twice as likely to die before their first birthday compared to white babies.

There is no relief for women and babies of color who continue to be disproportionately impacted by the maternal and infant health crisis. Long-standing structural racism and social inequities are leaving these women behind, even as we see some improvement.

As a Black woman and the mother of two daughters, I know the painful reality of having to advocate for fair treatment in a system that undervalues the lives of women and babies of color. And as someone raised by a Black physician, I’ve always been very aware of health inequities and other factors that impact my health as a Black woman. We face implicit bias, systemic barriers, a lower quality of care and other dangerous conditions that threaten our lives and our babies’ lives. According to this year’s Report Card, in addition to our babies being more likely to die before their first birthdays than white babies, we are three times more likely to die from pregnancy-related causes compared to white women.

It’s unjust and frustrating that, from conception, Black babies are at a higher risk of death, as well as higher risk of suffering from serious, life-long medical conditions because of inequitable health care access and treatment rooted in racism. It’s devastating that Black women and babies are dying from preventable deaths when we have the medical expertise to prevent and manage pregnancy complications.

The data from our Report Card underscores how critical it is to pursue more research and real-time data collection to better understand what these numbers mean and whether or not the coronavirus pandemic has impacted them at all.

Still, we know that states significantly improve maternal and infant health when they take legislative action to do so — from expanding and extending Medicaid, to creating state Maternal and Mortality Review Committees, which convene at the state or local level to comprehensively review deaths of women during or within a year of pregnancy. This year, Congress enacted one of March of Dimes’ top legislative priorities: extending Medicaid and postpartum coverage from 60 days to 12 months on an optional basis. Congress also continues to work on the Build Back Better Act, which contains maternal health priorities, including the permanent, mandatory extension of 12-month postpartum coverage for mothers. Now it is up to Governors’ and state legislatures’ to take advantage of the new federal rules and funding, and enact these extensions in their state Medicaid program.

Lawmakers also need to focus on the urgent gap of legislation and policy focused on midwifery and doula care. Midwives and doulas help significantly improve access to care in under-resourced areas and lower rates of medical interventions to possibly improve birth outcomes and reduce rates of maternal death. Seven states passed legislation this year supporting the reimbursement of doula care (bringing the total up to 13); however, this policy needs to be adopted comprehensively across the U.S. to close gaps in health care equity. Congress has the opportunity to take important strides to incorporate doulas into maternity care systems federally with the Black Maternal Momnibus Act of 2021, a series of 12 bills that will holistically and comprehensively tackle disparate racial and ethnic maternal and infant health outcomes.

It is possible for every family to have a healthy start — but the U.S. remains among the most dangerous of developed nations for childbirth with the numbers of deaths of pregnant and postpartum women increasing.

The fact that the lives of moms and babies in America can depend on our race does not have to be our reality. March of Dimes is fully committed to continuing this fight for health equity and developing a further understanding of preterm birth rates during and after the coronavirus pandemic. This can look like forming partnerships with the local community, and public and private organizations, to improve health outcomes for moms and babies. But we need state and federal legislators to join the fight to protect the livelihood and health of moms, babies and families of every background, everywhere — regardless of wealth, race, gender or geography.

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Stacey Stewart is the President and CEO of March of Dimes, an organization fighting for the health of all women and babies.

Stacey D. Stewart

Writing since November 2021 · 1 story contributed