U.S. premature birth rate among world’s worst

Worldwide rates of premature births are increasing in both industrialized and poorer countries, with more than one out of 10 — or 15 million — babies born prematurely in 2010. More than 1 million of these infants will die in the first month of life, making prematurity the leading cause of newborn death.

Many survivors have lifelong learning disabilities, chronic lung disease, and loss of vision and hearing, according to “Born Too Soon,” a report on prematurity published May 2 by the World Health Organization, in conjunction with experts in this field from 11 countries.

The United States ranks 130 out of 184 countries. The U.S. has one of the worst rates, with 12 premature babies per 100 births. Within the U.S., the African-American prematurity rate of 17.5 percent is higher than estimated preterm birth rates in war- and famine-torn countries in Asia and Africa, and only slightly less than in Malawi, which has the highest rate in the world — 18.1 percent.

There is a wide and growing gap between rich and poor countries in survival of the most fragile babies. In low-income countries, where more than 90 percent of such births occur, infections, malaria, HIV and high rates of adolescent pregnancies are among the main known causes of preterm births. In more industrialized countries, including the U.S., medically unnecessary cesareans and inductions of labor before pregnancies reach full term contribute to premature births. However, in both rich and poor countries about half of preterm births have no identified cause. Indoor air pollution and second-hand smoke are the only environmental risks mentioned in the report.

Many premature births can be averted by universal access to free family planning — especially for teens — prenatal care to screen for and treat infections and diseases, such as diabetes; nutritional support; and prevention of violence against women. These public health measures are under attack by the right-wing of the capitalist class, which promotes free markets, privatization and austerity, both in the U.S. and around the world.

Once preterm labor has begun, a corticosteroid injection to the mother costing $1 will help the baby’s lungs develop, greatly reducing breathing problems after birth. Antibiotics may delay labor and prevent infection when the membranes surrounding the fetus rupture before the baby is full term.

More than four out of five preterm births occur between 32 to 37 weeks of pregnancy. Supportive low-tech care for these babies can save most of their lives and reduce disability. These measures include skin-to-skin contact with the mother for warmth, early and exclusive breastfeeding, and cleaning and care of the umbilical cord.

Those born very premature — from 28 to 32 weeks — or extremely premature, before 28 weeks, will need more intensive, expensive care to survive. Such babies often suffer physical and learning disabilities even when cared for in the most advanced newborn intensive care units.

The report recommends upgrading the skills of health providers to care for premature babies, providing essential medicines and equipment in poor countries, and further study into the causes and prevention of preterm labor. Countries squeezed by the global capitalist economic crisis and the for-profit health industry cannot be counted on to implement these recommendations.

Women around the world will have to struggle to make them a reality.

Catalinotto is a licensed midwife.