January is National Birth Defects Prevention Month.
March is in the name.
November is National Prematurity Awareness Month.
But for the staff of March of Dimes Tennessee, every month … every day … is another opportunity to advocate on behalf of mothers and children to build a stronger, healthier state. Each year, one of eight babies in Tennessee is born prematurely.
While the organization hosts a number of fundraisers, the premier event is March for Babies, and 76 percent of the money raised from those walking events across the state goes to fund research and programs supporting the mission.
Tamara Currin, MS, MCHES, associate director of Program Services and lead for Advocacy & Government Affairs for MOD Tennessee, noted, “For our program plan, we have three main initiatives that we’re looking at for at least three years.” She added the key objectives focus on early elective deliveries, tobacco usage in women of childbearing age, and disparities in preterm birth.
Early Elective Deliveries
Currin said March of Dimes nationally spearheaded a partnership with the Tennessee Department of Health, Tennessee Hospital Association, Tennessee Initiative for Perinatal Quality Care (TIPQC) and other interested entities in 2012 to address the issue of elective early inductions. She noted the ‘Healthy Babies are Worth the Wait’ campaign has been a successful example of how collaborative efforts can really make a difference.
Although babies are born prematurely every day naturally, Currin said the concern is over those times when labor is electively induced. “We know that the longer babies are in mom’s body, the healthier they will be,” she said. “The lungs and the brain are some of the last things to develop in utero.”
An infant’s brain at 35 weeks weighs only two-thirds what it will at 39 to 40 weeks. Even being born just a few weeks early could hamper a newborn’s ability to coordinate sucking, swallowing and breathing.
Currin credited the partnership for building awareness among the healthcare community. A letter was sent to birthing centers across the state asking them to pledge to put in a ‘hard stop’ for scheduled inductions before 39 weeks. Currin explained clinicians now have to speak with a designated physician in the facility to explain why an early induction is medically necessary.
Other efforts have included awareness campaigns for consumers. The ‘Don’t Rush Your Baby’s Birth Day’ public service announcement encourages moms with healthy pregnancies to allow labor to begin naturally.
The results have been stunning. In 2012, Tennessee ranked poorly nationally with close to 15 percent of all births being early elective inductions. By 2014, the average between January and August had fallen to around 2 percent.
“This is just a remarkable improvement and much credit to the partnership,” Currin said.
Tobacco Cessation
“We have 23 percent of women of childbearing age who smoke in Tennessee,” said Currin. “That’s a leading risk factor for prematurity and low birth weight.”
In addition to MOD programming, she said the organization also has a statewide community grant-funding effort to target specific areas or objectives. “We actually have a grant we’re funding in Johnson County,” she said of an effort in Upper East Tennessee. “As a part of a prenatal program, they are providing Baby & Me: Tobacco Free, an evidence-based approach to primarily cessation, but it also addresses the environment and other smokers in the home.” The goal is to achieve a 20 percent quit rate among participants.
Currin noted the Tennessee Department of Health also provides funding to a number of local health departments across the state to host smoking cessation programs for pregnant women.
Addressing Disparities
While Hispanic and Caucasian women in Tennessee have preterm rates of 11.4 percent and 11.3 percent respectively, African-American women have a prematurity rate of 17.2 percent.
Currin said MOD is currently funding two community grants in the Memphis area. One targets pregnant women who are homeless. The second, Fit4Me, addresses obesity among women of childbearing age and looks at a healthy body weight before and between pregnancies with a focus on overall nutrition.
In Chattanooga, Currin said a grant initiative is just wrapping up that addresses both disparities and tobacco cessation by utilizing churches, which play a prominent role in the black community, to bring about change. “They built partnerships with African-American churches and provided training on how to quit smoking to the leadership spearheaded by the ‘first lady’ of the church … the pastor’s wife,” she explained.
Healthy Babies, Healthy Business
Phil Toothman, state director of Communications and Marketing for March of Dimes, said the organization is attacking the problem of prematurity from multiple angles. Knowing businesses wind up absorbing the cost of prematurity in terms of increased health premiums, lost productivity and absenteeism, the hope is to enlist the help of state businesses to help spread the word about the importance of prenatal health.
“The average cost of caring for a preterm baby versus a healthy, full-term baby is 12 times,” Currin said. “The healthy baby is $4,389 on average, and a preterm baby is $54,194,” Toothman added of medical costs.
He also noted the medical costs could soar to $1 million or more for the tiniest babies who required months of hospitalization. MOD estimates preventing prematurity in Tennessee could equal an annual savings of up to $515 million.
Making Progress
Although there is a long way to go, Toothman and Currin said Tennessee has made measurable progress over the last several years led by the impressive improvement in the rate of elective early deliveries.
After a number of years with a failing grade, Tennessee moved to a ‘D’ on the national Premature Birth Report Card in 2012 and received a ‘C’ in 2014. Although the state’s overall prematurity rate of 12.5 percent is still higher than MOD would like to see, Toothman noted, “We’ve experienced six years of improvement in that number.”
For an organization that works hard to support Tennessee’s tiniest residents, the staff knows baby steps are something to celebrate.
RELATED LINKS:
March of Dimes 39 Weeks Campaign