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California Lowers Rate of Premature Births

The March of Dimes recently released a set of report cards grading progress on the rate of premature births in each state. California received one of the six ‘A’ grades, meeting the organization’s low rate goal for 2020 early.

The report card used National Center for Health Statistics data on preterm birth rates. California’s rate declined by 0.2% in the last year, to 9.6% of births. By comparison, the US as a whole has a rate of 11.5%, corresponding to a ‘C’ grade. Some states, particularly in the South, have rates as high as 17.1%. The US has the highest rate amongst industrialized countries.

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Premature birth can result in significant health problems, such as respiratory and developmental issues, and is the top cause of death for newborn infants. The costs associated with preterm births are very high, about $26 billion in the US per year. The March of Dimes estimates that $9 billion has been saved since 2006 from efforts to reduce the premature birth rate.

Factors like smoking, poor nutrition, and lack of prenatal care can contribute to a preterm birth. The report considered some of these factors. The rate of women who are uninsured declined 1.5% between 2009-2011 and 2010-2012, yet still a shocking 23.8% of women between the ages of 15-44 are uninsured. The number of women who smoke increased by 0.6% from the previous year. Preterm birth rates by ethnicity show that minority women, particularly African Americans, have more premature births.

The A rating and declining premature birth rate reflects the great progress California has made over the last several decades. Many efforts and coverage expansions have led to this accomplishment. In California, pregnant women, regardless of immigration status, can be covered by Medi-Cal up to 200% FPL and Access for Infants and Mothers (AIM) up to 300% FPL These programs cover about half of all births,  however members lack continuity of coverage. Woman can participate in the Comprehensive Perinatal Services Program (CPSP) through Medi-Cal, which provides health education, psychosocial counseling, prenatal vitamins, and nutrition counseling. In 2011, the legislature passed SB 222, which requires all individual health plans to provide maternity coverage. These coverage options make prenatal care affordable and accessible, which helps achieve positive birth outcomes. As more young uninsured women gain access to continuous health insurance through the Covered California and Medi-Cal expansions for working individuals and families, more babies will be born on time and healthy and the whole nation benefits. Pregnancies and poor birth outcomes will no longer be grounds for pre-existing condition exclusions.

But more work may need to be done. The Brown administration is considering improvements to the interfaces between Covered California, AIM and Medi-Cal coverage to further improve birth outcomes for California women and couples. This arrangement was discussed as a part of AB 50 (Pan), which was vetoed with a message indicating the Governor wanted to see a full-scale comprehensive reform package as opposed to piecemeal efforts.

Many of the states with the highest premature birth rates are still debating expanding Medicaid.

Read the full report card on the March of Dimes website. Also read ITUP’s report on improving birth outcomes.


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