Louisiana gets an F for prematurity rate, maternal and child health

According to the latest March of Dimes report, Louisiana ranks as one of the worst states in the nation for maternal and child health, particularly for black and Native American women.

According to experts, the state ban on abortion, which came into effect immediately after the repeal of Roe v. Wade was enacted by the US Supreme Court earlier this year, making pregnancy and childbirth even more dangerous.

The report found Louisiana again one of the highest preterm birth rates in the country, when a baby is born before 37 weeks gestation and therefore has a higher rate of complications, death and disability. The state rate was 13.5% compared to the national average of 10.5%, earning the state an “F.” Baton Rouge and New Orleans each received low marks for their individual preterm birth rates: 12.3% and 14.4%, respectively.

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Louisiana was among the nine states and Puerto Rico that received an “F,” including Alabama, Mississippi, and Georgia.

The March of Dimes evaluates states on infant mortality and maternal health data in addition to preterm births. For every measurement collected in the report, Louisiana performed worse than the national average. The results are similar to reports from previous years.

“I’m not surprised,” said Maeve Wallace, an assistant professor at Tulane University’s School of Public Health, which studies maternal and child health. “This is just a hostile place for maternal and child health.”

dr Veronica Gillispie-Bell, an OBGYN and medical director of the Louisiana Department of Health’s Maternal and Child Health Improvement Program, the Louisiana Perinatal Quality Collaborative, said she wasn’t shocked by the report either.

Gillispie-Bell said the pandemic has worsened maternal and child health across the country, part of the March of Dimes report’s findings. It reflects a spring report from the Centers for Disease Control and Prevention that was noted Maternity-related mortality increased by 20% in 2020.

Wallace and Gillispie-Bell said Louisiana’s near-total abortion ban could make the state an even more dangerous place for pregnant women and babies.

A number of studies have found that abortion restrictions are associated with higher rates of maternal mortality and complications for both mother and baby, including a study Wallace co-authored that found that women living in states with higher numbers of abortion restrictions a 7% increased risk of death during pregnancy or within a year after birth.

“Our research has shown that decreasing access to abortion is associated with increases in maternal mortality and poor birth outcomes, including preterm births,” Wallace said. “So I think we can expect to see even worse trends in these outcomes as abortion access declines more.”

A study published in July found that Texas A 6-week abortion ban resulted in a 24 percent increase in serious pregnancy complicationswhat researchers call maternal morbidity.

Though no studies have yet been conducted on the impact of Louisiana’s strict abortion ban, Gillispie-Bell said she believes the state ban could have similar effects to the Texas ban.

“My suspicion is that we’re going to have worse outcomes for the mother and baby,” Gillispie-Bell said.

The March of Dimes report found that nationally, preterm birth rates are dramatically higher for black and Native American women. These groups are 62% more likely to have preterm births compared to white women, and their babies are twice as likely to die.

In Louisiana, the preterm birth rate was 11% for white women, but increased to 14.7% for Native American women and 16.9% for black women. Black women were by far the most frequent seekers of abortion services in Louisiana prior to the state ban. In 2021, they reportedly accounted for 64% of all abortion patients in Louisiana Data from the state health authority.

Louisiana was also ranked as one of the worst states for infant mortality, according to the March of Dimes — a rate of 7.5 per 1,000 live births compared to the national average of 5.4 per 1,000 live births. That rate is slightly better than last year’s rate of 8 per 1,000 live births.

Louisiana’s poor grade comes despite a series of steps the state has taken to improve maternal health, including a new law that allows health insurance to cover doulas. The state has implemented all but one key policy recommendation from the report: it has not expanded health insurance for midwives.

The health department did the same reduce dangerous complications of pregnancy and childbirth through a program that established evidence-based practices in Louisiana hospitals to treat hemorrhage and hypertension in pregnant patients, the two leading causes of maternal deaths in Louisiana.

But Gillispie-Bell said to dramatically increase the safety of pregnancy and childbirth in Louisiana, the state must address the web of underlying factors that affect health, including poverty, education, access to health care, violence and the environment.

“The minimum wage has to be a living wage,” she said. “Until we address the social determinants of health, our rates will not improve.”

The March of Dimes also ranks each municipality and county based on the complex factors that affect maternal and child health, including access to reproductive health care, physical and mental health, and socioeconomic factors, which it calls the Maternal Vulnerability Index designated. It turned out that the majority of Louisiana communities ranked lowest on these factors as well.

Louisiana also has higher rates of cesarean births in low-risk patients than nationwide, which can lead to medical complications, and a higher rate of women who did not receive the full recommended prenatal and infant health care — meaning they did not have their first prenatal Visit until they are more than five months pregnant or that their baby has not had the recommended number of check-ups.

Previous March of Dimes reports have found that more than half of Louisiana’s communities are “maternal care deserts” — meaning they lack access to maternal health care. Wallace’s previous research has shown that women in these parishes “significantly increased” rates of maternal mortality.

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