More than one in eight Rhode Island babies is born prematurely. It’s a growing problem; a decade ago, it was less than one in 10. Now, a state task force wants to reverse the trend through education, better monitoring, and outreach to low-income women.
Dr. David R. Gifford, the state health director, convened the Rhode Island Taskforce on Premature Births last year after seeing the premature birth rate jump from 9.5 percent to 12.8 percent from 1996 to 2005.
Seifert Systems Invests in Energy Efficiency to Strengthen Operations
For manufacturers, energy is more than just another operating expense. It plays a critical role…
Learn More
Gifford enlisted experts from Women & Infants Hospital, Brown University, the March of Dimes Rhode Island Chapter, the R.I. Department of Health, UnitedHealthcare of New England, Rhode Island Kids Count and Hasbro Children’s Hospital, among others, and charged them with finding ways to reduce the premature birth rate.
After consulting experts in the field and analyzing both national and state data, the group focused on four key factors that affect preterm birth rates: women who have had a previous preterm birth, women with smoking or substance-abuse issues, pregnant adolescents, and women at risk for unintended pregnancies.
The task force released its recommendations Nov. 9, at the March of Dimes Prematurity Summit at Women & Infants. They are:
Encourage doctors to assess the risk of preterm birth with each pregnancy.
Seek a Medicaid waiver to provide family-planning services for low-income women who would be eligible for RIte Care if they got pregnant.
Develop a coordinated “medical home” – a consistent place to receive care – for every preterm infant.
Enforce implementation by all school districts of the R.I. Department of Education’s standards for comprehensive sex education.
Implement changes to the records kept for births, including identifying the method used to calculate gestational age and determining whether any fertility treatment was used.
Enhance family support programs, such as Early Head Start and the Nurse Family Partnership, to improve birth outcomes for teens and help prevent subsequent teen pregnancy.
Expand the range of services provided at federally funded family planning sites to include women’s health services before and between pregnancies.
Require every vendor who sells tobacco or alcohol in the state to display information on those substances’ effects on pregnancy outcomes.
Ensure that adequate programs and referral networks exist for pregnant women who smoke or are substance abusers, including treatment, home visiting programs and prenatal care.
Expand and assure access to emergency contraception for poor women.
“If we’re able to implement these recommendations and really track them … we expect that we would have a reduction in preterm delivery,” said Dr. Maureen Phipps, director of the Brown University/Women & Infants National Center of Excellence in Women’s Health and chairwoman of the task force.
Several recommendations of the task force are being acted upon already, including a work group announced by the R.I. Office of Human Services to develop a plan to enhance family support programs, as well as plans to include the tobacco risk display in the Department of Health’s 2007 legislative agenda.
Others will require action, including identifying funding opportunities to expand family planning services, and finding ways to reduce barriers to emergency contraceptives.
Gifford called the recommendations “comprehensive, actionable and feasible,” and added that “many of the reasons for preterm birth are preventable with the right kind of support and approach.”
Gifford’s call for the task force came shortly after he approved a $64 million expansion of Women & Infants, including a new, larger neonatal intensive-care unit that the hospital said was needed, in part, because of the rising prematurity rate. (The flip side is that the survival rate for premature babies has increased even more dramatically, with babies delivered as early as 24 weeks surviving – but still requiring long NICU stays.)
Gifford imposed some conditions for the expansion, including that Women & Infants develop a pilot program with community health centers to ensure continued care for infants discharged from its NICU.
While Gifford said that, while the hospital expansion and the task force report are not necessarily related, the recommendations would help control the negative trends that made the new NICU necessary.
“Do we keep expanding the NICU because of increased demand or do we decrease the demand?” he said. “I think it makes more sense to prevent.”
