Preterm birth

November is prematurity awareness month, and with the recent release of the March of Dimes Maternal and Infant Health Report Card, preterm birth — and the egregious rates across the United States — are top of mind. 

Every year, 380,000 babies are born early in the United States. That’s about one in every ten. According to the March of Dimes, a premature baby spends an average of 25.4 days in the NICU at an average cost of $144,692. The cost associated with preterm birth adds $26.2 billion to U.S healthcare costs each year.

As with many maternal health complications, the root of the problem cannot be pinned to a single cause. However, the data show that rates of preterm birth are higher for low-income and minority women, leading to assumptions about health inequality and other systemic problems that have less to do with biology and more to do with geographic and racial barriers. 

Women in these circumstances are less likely to access prenatal care, one of the major contributing factors to preterm birth, due to difficulties of access — inability to take off work, lack of childcare, financial insecurities, food insecurity, geographic distance, and the list goes on. In Washington, DC, a pregnant mother living east of the Anacostia River in Wards 7 or 8 — DC’s so-labeled “maternity care desert” — will take an average of 3 modes of public transportation to attend a prenatal care appointment, which typically lasts 5-10 minutes. 

Is it any wonder that areas heavily populated by low-income and minority populations show such discouraging statistics when it comes to prenatal visit attendance? 

The connection between adherence to prenatal visits and bringing a baby to full term is less tied to the in-person nature of appointments, and more importantly to the education that a woman receives at her visits — and what the doctor can learn about her. 

Much of preventing preterm birth comes through education — empowering women to take care of their health, eat nutritious foods, form healthy habits, and be aware of the steps they need to take to protect themselves and their baby. This can easily happen outside of the office — and it often does, to a detrimental effect — as women Google search questions or crowdsource opinions instead of receiving information from reliable sources. 

It’s essential that health providers have control of the content that women are receiving about their pregnancy, both for the security of the mother and for the effectiveness of their care plan. A solution like Babyscripts myJourney delivers content to a mother through a mobile app, providing them access to educational sources as easily accessible as their phone, and prompting them through texts and push notifications to comply with certain milestones. 

For women living in disadvantaged communities, however, there is often a need for more than educational resources. Eating nutritional meals isn’t always an easy or cheap option, especially in rural communities where fresh produce is difficult to come by. Avoiding stressful or sometimes violent domestic situations, overcoming substance use disorder — these habits take more than a friendly reminder from an app to overcome. Providers should look for solutions like Babyscripts that can connect pregnant mothers to community resources and aid in care coordination. As technology becomes more sophisticated, we can look forward to a day when a woman’s activity within an app automatically connects her to these resources. 

Until that day comes, technology still provides the opportunity for healthcare providers to extend care to the vulnerable outside the office, leveraging the data collected by a mobile app to the same effect that they can use the data gathered in an in-person appointment. For example, an app can prompt a user to add in their prior medical history — previous C-section, history of preterm birth, history of high blood pressure, etc. — and allow a provider to tailor a medical plan to suit a patient’s medical history: for example, prescribing a course of progesterone or remote monitoring of blood pressure. 

Far outweighing the financial costs of preterm birth are the long term health and societal effects on mothers, infants, and families — and the perpetuating cycle that it can set off. We have tools to immediately reduce these statistics — the barrier to entry is low and the effect on outcomes significant. There’s no excuse not to do better.

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