Maternal and infant health in Alabama once again ranks among the worst in the United States, according to new, annual research from March of Dimes.
The nonprofit dedicated to improving the health of moms and babies in the US published its 2022 Report Card this month, giving Alabama a failing grade for its preterm birth rate. In the last year, 13.1% of babies born in the state have been preterm, meaning before 37 weeks of pregnancy.
This is the highest rate Alabama has seen since March of Dimes began its record in 2011, and it is only lower than Louisiana, with a rate of 13.5%, and Mississippi, with a rate of 15.0%.
Preterm babies can have problems with vision, learning abilities, hearing and other aspects of development.
“It’s expensive for preterm babies. When they’re born too early, they’re going to be most likely admitted to the NICU because not everything has been developed in the mom’s womb,” Alabama March of Dimes director Honor McDaniel said. “We see higher rates in minority groups, which shows that we’re not taking care of our population well.”
Some 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 preterm birth rate among Black women in Alabama is 50% higher than the rate among all other women.
Black mothers also have higher rates of infant deaths than other mothers in the state, according to the Alabama Department of Public Health.
March of Dimes put forth one potential explanation for worsening maternal and infant health in its report tracking maternity care deserts, which particularly impact women living in rural areas.
Only 21 counties in Alabama, including Montgomery, Tuscaloosa, Dallas and Jefferson, have complete access to maternity care. The other 43 counties have little to no access to maternity care.
Areas that March of Dimes designate as maternity care deserts have no hospitals or birth centers that offer obstetric care and no obstetric providers in that county. More than a third of Alabama counties, 37%, fall into this category.
Eleven counties in the state don’t have a single federally qualified health center, and besides those located in Montgomery, only one hospital in the rural Black Belt offers maternity care. That is Vaughan Regional Medical Center in Selma.
“If you think about it, women in rural areas are going to be further away, especially in these maternity care deserts, from their prenatal care, from a hospital if something goes wrong,” McDaniel said. “These maternity care deserts are associated with higher rates of poverty, lower median incomes, higher rates of uninsured, and it’s rough, especially when we don’t see any improvement in Alabama.”
McDaniel also said that Alabama’s medical insurance reimbursement rates are calculated based on data from 2009, meaning healthcare providers as a whole are not getting reimbursed as much as they need. When a rural provider sees a low number of births in their practice and does not receive adequate reimbursement, that can affect their ability to continue providing maternity care.
March of Dimes advocates for several policy actions revolving around potential solutions to poor maternal and infant health. These include expanding Medicaid for individuals who fall at or below 138% of the Federal Poverty Level, expanding access to midwifery care in all states, raising parental income eligibility levels under Medicaid and extending the Medicaid postpartum coverage period to 12 months.
Here are the counties in Alabama that March of Dimes considers maternity care deserts:
- Lawrence County
- Franklin County
- Marion County
- Winston County
- Lamar County
- Cleburne County
- Randolph County
- Clay County
- Pickens County
- Greene County
- Sumter County
- Hale County
- Perry County
- Marengo County
- Choctaw County
- Wilcox County
- Lowndes County
- Elmore County
- Bullock County
- Barbour County
- Henry County
- Crenshaw County
- Monroe County
- Conecuh County
- Washington County
Hadley Hitson covers the rural South for the Montgomery Advertiser and Report for America. You can be reached at[email protected]. To support her work subscribe to the advertiser or donate to Report for America.