The preliminary data from 2008 says that the US rate of preterm births is 12.3%, down slightly from 12.8% in 2007.  The report card is based on the following indicators:

• Preterm Birth
• Late Preterm Birth
• Uninsured Women
• Pregnant Women Smoking

What’s a birth activist to do about prematurity?  There are lots of things that you can do and lots of areas to employ your skills.  The one many birth activists have attached themselves to is the late preterm births and preventing non-medical inductions prior to the 39 week mark.  But there are other things that can be done as well, including:

• Educate women on the signs and symptoms of preterm labor.
• Know what options are in your community for uninsured women and help women in this situation seek care.
• Find out about the resources in your community for pregnancy related smoking cessation. Tell every pregnant woman in your classes or who has hired you about them in a non-judgmental way.  You may not know who is smoking, nor do you necessarily need to know, but this information can also be passed along to people that they know who need it.  (Tomorrow is the Great American Smokeout.)
• Gather a resource packet for those who have contact with pregnant women and distribute it on some or all of these topics.  The March of Dimes has many great resources that are based on your state that can be easily emailed or printed for this purpose.

What are you doing in your community to address issues of prematurity?

Many hospitals are enacting policies to prevent preterm deliveries by banning elective birth before 39 weeks.  Some have policies, some have enforcement or recommendations and others just do education.  Guess which works the best?  What’s being done in your area? Do you think that it’s just the practitioners that need the help?

We do not see Obstetric models of care including nutrition counciling, or really taking the time to say skip on this, or add that. You get a sheet of things not to eat and most are sent on their way. Which is one of the reasons I am intrigued to write about this.

According to The March of Dimes, women should be including the following into their diet on a daily basis :

• 6 Ounces of Grains Per Day
  • Slice of wheat bread
  • Wheat Tortilla (6 inches)
  • 1/2 cup of cooked rice or pasta
  • 1 cup of cereal
  • 1 large pancake (about 4 1/2 inches)
• 1 1/2 to 2 cups of fruits per day
  • 1/2 cup of 100% fruit juice (be careful of the amount of sugar in fruit juices)
  • 16 Grapes
  • 1/4 cup of dried fruit
  • 1/2 of fresh, canned or frozen fruit (My best pick would be fresh fruit since you often do not know what canned products are being preserved with)
• 2 1/2 Cups of Vegetables per day
  • 1 Cup raw or cooked veggies
  • 1 Baked Potato (skip or go light on the butter, sour cream, or bacon)
  • 2 Cups of raw leafy greens
  • 1 Cup veggie juice
• 400 Micrograms of Folic Acid
  • Most likely found in your pre natal vitamin
• 5-5 1/2 ounces of Protein per day
  • 1 Tablespoon of peanut butter
  • 1 ounce of lean meat
  • 1 egg
  • 1/2 cup of nuts
  • 1/4 cup of cooked dried beans
• 3 cups of Milk products per day
  • 1 Cup Milk
  • 2 ounces of processed cheese
  • 1 Cup yogurt
  • 1 1/2 ounces natural cheese

It really doesn’t sound like a lot of work does it?

We know the typical things to avoid… soda, sugar, caffeine, raw fish, unpasteurized foods, and make sure to keep your water intake up. This was a big one for me in both of my pregnancies. 6 to 8 glasses of water a day!  That is what I hated most of all and often got dehydrated. Which is something you want to avoid!

Remember, everything you eat, so is your baby!
You want to give your baby the best start at life, so just be picky and careful for your pregnancy.
It will pay off in the end!

Authors of Behind International Rankings of Infant Mortality: How the United States Compares with Europe explored what they refer to as the recent stagnation in the U.S. infant mortality rate that has generated widespread concern among researchers, policy makers, health care providers and activists.

Using data from the United States? Linked Birth/Infant Death Data Set and the European Perinatal Health Report, authors Marian F. MacDorman, Ph.D., and T.J. Mathews, M.S. of the CDC National Center for Health Statistics found that the main cause of the United States high infant mortality rate when compared with Europe is the ?very high percentage of preterm births in the United States.?

According to the study, while infant mortality rates for preterm (less than 37 weeks of gestation) infants are lower in the United States than in most European countries, infant mortality rates for infants born at 37 weeks of gestation or more are higher in the United States than in most European countries.

Discussions of the U.S. infant mortality rate are often countered with criticism that the U.S. records data differently than other countries, reporting very premature babies as live births. While this is true for five of the 19 European countries whose data was analyzed, 14 of the 19 European countries require that all live births at any birth weight or gestational age be reported.

The United States remains near the bottom of the rankings.

The report states, ?Reporting differences have little effect on the percentage of preterm births because most preterm births occur well after 22 weeks of gestation. For example, the percentage of preterm births for the United States in 2004 was 12.5% when all births were included and 12.4% when births of less than 22 weeks of gestation were excluded.?

MacDorman and Mathews attribute much of the high infant mortality rate in the United States to the high percentage of preterm births. Using the direct standardization method to apply the U.S. gestational-age specific infant mortality rates to Sweden?s distribution of births by gestational age, the NCHS found evidence that lowering the percentage of preterm births could have a dramatic impact on infant mortality in the United States.

November is also Prematurity Awareness Month.? Considering the risks involved in preterm birth, you may be wondering what you can do as a birth activist or as a parent.? Here are some basic things to consider:

• Let labor begin on its own. Without a valid medical reason, let your baby pick his or her birthday for the safest, easiest birth.
• Choose a practitioner with a low induction rate. If you have a midwife or doctor who rarely sees anyone who goes past their due date, it should be a red flag.? Ask the receptionist for her opinion of how many women go past 40 weeks. The answer might surprise you.
• Know the signs of preterm labor. If you think you’re having any of the signs of preterm labor, call your midwife or doctor immediately.? The sooner you get help, the more likely that premature birth can be delayed or stopped completely.
• Be mindful of the risk factors. Face it, you have responsibility for some of the risk factors.? While there are certainly some risk factors for preterm labor that you don’t control, take charge of the ones you can, including prenatal care, good nutrition, not smoking, etc.