Maternal and child health in Alabama is again among the worst in the United States, according to a new annual study by March of Dimes.
The nonprofit organization dedicated to improving maternal and baby health in the United States released its 2022 report card this month, giving Alabama an unsatisfactory mark for its preterm birth rate. Last year, 13.1% of babies born in the state were preterm, or less than 37 weeks gestation.
This is the highest rate Alabama has seen since March of Dimes took its record in 2011, and it’s only lower than Louisiana’s 13.5% rate and Mississippi’s 15.0% rate.
Premature babies can have problems with vision, learning, hearing and other aspects of development.
“It’s expensive for premature babies. If they are born prematurely, they will most likely be admitted to the NICU because not everything has developed in the womb,” said Honor McDaniel, director of the Alabama March of Dimes. “We’re seeing higher rates in minority groups, which shows we’re not taking good care of our population.”
About 16.7% of black babies born in Alabama are preterm, compared to 11.2% of white babies, 10.6% of Hispanic babies, and 9.6% of Asian and Pacific Islander babies. Overall, the rate of preterm birth among black women in Alabama is 50% higher than that of any other woman.
Black mothers also have a higher infant mortality rate than other mothers in the state, according to the Alabama Department of Health.
March of Dimes, in its report on the deserts of maternity care, has offered a possible explanation for declining maternal and child health, which is particularly affecting women in rural areas.
Only 21 counties in Alabama, including Montgomery, Tuscaloosa, Dallas and Jefferson, have full access to maternity care. The other 43 counties have little to no access to maternity care.
Areas that March of Dimes describes as midwifery deserts have no hospitals or midwifery centers offering midwifery services, and no midwifery providers in that county. More than a third of Alabama’s counties, 37%, fall into this category.
Eleven counties in the state do not have a single state-qualified health center, and other than those in Montgomery, only one rural Black Belt hospital provides maternity care. This is the Vaughan Regional Medical Center in Selma.
“If you think about it, rural women will be further away, especially in these deserts of obstetrics, from their prenatal care, from a hospital if anything goes wrong,” McDaniel said. “These deserts of maternity care are associated with higher poverty rates, lower median incomes, higher rates of being uninsured, and it’s tough, especially when we don’t see improvement in Alabama.”
McDaniel also said that health insurance reimbursement rates in Alabama are calculated based on 2009 data, which means healthcare providers overall aren’t being reimbursed as much as they need to be. If a rural provider sees a low number of births in their practice and does not receive adequate reimbursement, it can affect their ability to continue providing maternity care.
March of Dimes advocates several policies centered on possible solutions to poor maternal and infant health. These include expanding Medicaid to people at or below 138% of the state poverty line, expanding access to midwifery care in all states, increasing eligibility for Medicaid parental income, and extending Medicaid coverage after childbirth to 12 months.
Here are the counties in Alabama that March of Dimes considers deserts for maternity care:
- Lawrence County
- Franklin County
- Marion County
- Winston County
- Lamar County
- Cleburne County
- Randolph County
- Clay County
- Pickens County
- Greene County
- Sumter County
- Hale County
- County Perry
- County of Marengo
- Choctaw County
- Wilcox County
- Lowndes County
- Elmore County
- Bullock County
- Barbour County
- Henry County
- County Crenshaw
- Monroe County
- Conecuh County
- Washington County
Hadley Hitson covers the rural South for the Montgomery Advertiser and Report for America. She can be reached at[email protected]. To support their work subscribe to the advertiser or Donation to Report for America.