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Maternal and infant health at risk in Alabama as health care deserts worsen

Maternal and Child Health in Alabama again ranks among the worst in the United Statesaccording to new, annual survey from March of Dimes.

The non-profit organization dedicated to improving the health of mothers and babies in the US published her Report Card 2022 this month, giving Alabama a failing mark on its preterm birth rate. In the past year, 13.1% of babies born in the state were premature, meaning before 37 weeks of gestation.

This is the highest percentage Alabama has seen since March of Dimes began its record in 2011, and it is only lower than Louisiana, at 13.5%, and Mississippi, at 15.0%.

Babies born prematurely can have problems with vision, learning, hearing and other aspects of development.

“It is expensive for premature babies. If they are born prematurely, they are most likely to be admitted to the NICU because not everything is developed in the mother’s womb,” said Honor McDaniel, director of the Alabama March of Dimes. “We see higher percentages in minority groups, which shows that we are not taking good care of our population.”

About 16.7% of black babies born in Alabama are premature, compared to 11.2% of white babies, 10.6% of Hispanic babies, and 9.6% of Asian and Pacific Islanders . Overall, the rate of preterm birth among black women in Alabama is 50% higher than the rate among all other women.

Black mothers also have higher infant mortality rates than other mothers in the state, according to the Alabama Department of Public Health.

March of Dimes put forward a possible explanation for the worsening health of mothers and babies in its report on tracking maternity deserts, which mostly affect women living in rural areas.

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Only 21 counties in Alabama, including Montgomery, Tuscaloosa, Dallas and Jefferson, have full access to maternity care. The other 43 provinces have little or no access to maternity care.

Areas that March of Dimes designates as maternity deserts have no hospitals or birth centers that provide 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 do not have a single federally qualified health center, and besides the one in Montgomery, only one hospital in the nationwide Black Belt provides maternity care. That’s the Vaughan Regional Medical Center in Selma.

Vaughan Regional Medical Center in Selma, Ala., on Wednesday, March 25, 2020.

“If you think about it, women in rural areas are going to be further away, especially in these maternity deserts, from their antenatal care, from a hospital if something goes wrong,” McDaniel said. “These maternity care deserts are associated with higher poverty rates, lower median incomes, higher uninsured rates, and it’s tough, especially if we don’t see an improvement in Alabama.”

McDaniel also said that Alabama’s health insurance reimbursement rates are calculated based on 2009 data, meaning health care providers as a whole aren’t getting reimbursed as much as they need to be. When a rural provider sees a low number of births in their practice and does not receive adequate compensation, it can affect their ability to continue to provide maternity care.

March of Dimes advocates for various policy actions that revolve around possible solutions for poor maternal and child health. These include expanding Medicaid to individuals who are at or below 138% of the federal poverty level, expanding access to obstetric care in all states, increasing parental income levels under Medicaid, and extending Medicaid’s postpartum coverage period up to 12 months.

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Here are the counties in Alabama that March of Dimes considers deserts for maternity care:

  1. Lawrence province
  2. Franklin province
  3. Marion province
  4. Winston County
  5. Lamar Province
  6. Cleburne County
  7. Randolph County
  8. Clay province
  9. Picken County
  10. Green province
  11. Summer County
  12. Hale County
  13. Perry County
  14. Marengo County
  15. Choctaw County
  16. Wilcox County
  17. Lowndes County
  18. Elmore County
  19. Bullock County
  20. Barbour County
  21. Hendrik Graafschap
  22. Crenshaw County
  23. Monroe county
  24. Province of Conecuh
  25. the province of Washington

Hadley Hitson covers the rural South for the Montgomery Advertiser and Report for America. She can be reached at hhitson@gannett.com. To support her work, subscribe to the advertiser or donate to Report for America.

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