Kentucky receives “F” for prenatal care.

By Rochelle Haliburton

Kentucky has received an “F” in a national ranking on premature births, a national charity dedicated to improving prenatal and infant health announced this week.

In a report released Wednesday, the March of Dimes rated Kentucky 46th out of 50 states.

The grading method of the March of Dimes’ 2008 Premature Birth Report Card is based on grades “A” to “F,” with the preterm birth rate for infants in each state determining the grade. An “A” would mean a state has a preterm birth rate less than or equal to 7.6 percent, while “F” would mean a state has a preterm birth rate greater than or equal to 13.2 percent. Kentucky’s rate is 15.2 percent.

Lisa Echsner, state director of  the March of Dimes for Kentucky, says three factors mentioned in the report card were whether or not a woman smokes, whether a woman goes to the doctor and whether the woman will have an early Caesarean section to deliver her baby.

“Kentucky got an ‘F’ because the state had some high risk factors, such as a high number of women that smoke and women not having insurance, which results in them not getting to a doctor in the early stages of pregnancy, if at all,” Echsner said.

The March of Dimes will release a new report every year but will not have good data for a few years, Echsner said.

Echsner said the biggest factor that needs to be worked on in Kentucky is smoking, especially if pregnant women are smoking.

“We also want women to stop smoking. One in five women smoke nationally, and one in three women smoke in Kentucky, even when they are pregnant,” Echsner said.

Echsner also said there were many other states that got an “F,” and no states received an “A.” Vermont was the only state to receive the highest grade, a “B.”

Roger Clapp, state director of the March of Dimes for Vermont, believes Vermont received the highest grade because as of 2005, they had a premature rate of 9 percent, which is a full percentage point below any other state in the country.

“The reason for this decline is that there is a real system of prenatal care in Vermont that is more comprehensive than most other states,” Clapp said. “It’s because of the sharing of information among different health facilities across the state, and also the fact that Vermont has a relatively high rate of access to health care and health insurance relative to other states.”

At a news conference in Frankfort on Wednesday, leading Kentucky lawmakers and legislative representatives gathered to discuss the formation of a new legislative caucus to address maternal and child health issues.

State Rep. Kathy Stein (D-Lexington) believes this is an important issue for the Kentucky legislature to deal with, and that it can be dealt with effectively.

“The failing score of Kentucky is absolutely horrid, but unfortunately we have neglected the need for prenatal care for all young women, and this is where we must correct our actions,” Stein said.
Stein said more education is needed for pregnant women, and the state’s cigarette tax needs to be raised.

“We know that one of the primary reasons women in Kentucky are giving birth to premature babies is because they smoke,” Stein said. “Babies can not thrive in smoke-filled wombs.”

The committee will work closely with other committees in the state legislature, Stein said.

“When we bring people together, I think we can be more effective in tackling the problems,” Stein said. “This is going to be a concentrated effort.”

Dr. Henrietta Bada, a professor of pediatrics at UK, defines neonatal care as any medical care given to babies. She defines premature infants as infants born before 37 weeks of gestation.

A premature infant may have differences in physical and neurological characteristics and may also be high-risk from complications relating to prematurity, such as respiratory ailments and learning disabilities and delays, she said.

The most important advice Bada said she could give to expectant mothers is to go for prenatal care because a lot of the problems and issues associated with pregnancy can be addressed at an early stage and a mother can figure out, with a doctor’s help, how to maintain a healthy pregnancy.

“Smoking and drugs during pregnancy is associated with the births of premature infants,” Bada said. “Women should maintain healthy habits from childhood until the time they reach childbearing age, to ensure delivery of a healthy baby.”