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Efforts seek to reduce high preterm birth rate in SC

Efforts seek to reduce high preterm birth rate in SC

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Mirroring a national trend, South Carolina’s preterm birth rate increased to 11.3 percent in 2018, earning the state a “D-“ in the latest March of Dimes report on infant and maternal health.
Nationally, the rate of preterm births increased for a fourth consecutive year to 10 percent.
“It’s a serious challenge,” says Tidelands Health OB-GYN Dr. Xaviera Carter, who practices at the Georgetown and Holmestown Road locations of Tidelands Health Women’s Center. “Premature birth can be debilitating both for the baby and parents.”
For children, preterm birth can cause sickness and other complications that can continue into adulthood. For parents, providing the necessary care can be time and resource intensive.
“Our goal is to prevent premature birth and delivery whenever possible,” says Dr. Carter, medical director of women and children’s health at Tidelands Health. “It is quite a challenge because the biggest risk factor for preterm labor and delivery is unknown.”
What’s clear is that high-quality prenatal care and positive lifestyle choices can make a major difference.

A broad range of care

At Tidelands Health, patients can benefit from a broad range of care that begins with preconception planning designed to help women prepare their bodies for a healthy pregnancy. Once a woman becomes pregnant, the health system offers leading prenatal care aligned with national best practices. In fact, Tidelands Waccamaw Community Hospital has earned national recognition as a Childbirth Center of Excellence by The Joint Commission.
Through Tidelands Community Care Network, a regional collaborative developed by the health system to help uninsured adults access timely medical care, qualifying women can receive help signing up for health insurance, benefit from transportation to prenatal appointments and receive no- or low-cost medications.
“TCCN works very closely with us,” Dr. Carter says. “They are an absolutely amazing partner.”

Many factors at play

Tidelands Health OB-GYN Dr. Christine Gerber, a member of the health system’s board of trustees, says a variety of factors could be negatively influencing preterm birth rates nationally and in South Carolina.
For example, she says increasing obesity and high blood pressure rates, coupled with the fact that women are having children later in life, are likely factors.
In 2016, for the first time ever, there were more women in their early 30s having babies than younger mothers.
“I feel like physicians and hospitals are more vigilant than ever before in the care and support we’re providing high-risk moms,” says Dr. Gerber, who sits on the governing board of the South Carolina Birth Outcomes Initiative, a collaboration of more than 100 stakeholders that aims improve health outcomes for moms and babies. “But I also feel like we’re seeing an increasing number of cases.”

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Health care providers are helping improve outcomes through efforts such as centering, an innovative group prenatal care program meant to improve birth outcomes by addressing both the physical and emotional aspects of pregnancy.
Clinical studies have found centering reduces preterm birth rates by 33-47 percent, says Dr. Gayle Richmond, a Tidelands Health OB-GYN who led efforts to start offering the program in the Tidelands region. It has also been show to help reduce racial health care disparities, improve attendance at care visits, lead to higher breastfeeding rates (87 percent of participating moms breastfeed), increase readiness for birth and infant care and improve overall patient satisfaction.
“Preterm birth can be devastating for mothers and babies alike, but with programs like centering and a concerted effort between patients, physicians and health systems, we’ve proven that we can make a dramatic difference,” says Dr. Richmond.

Continued support

Care after delivery is important, especially following preterm birth. Among the many ways Tidelands Health supports mothers and children after birth is through the health system’s robust support for breastfeeding, which has been shown to improve infant health and result in fewer hospitalizations and physician visits after delivery.
Tidelands Waccamaw Community Hospital has been designated as Baby Friendly, a global initiative led by the World Health Organization and United Nations International Children’s Emergency Fund to recognize hospitals and birthing centers that offer optimal care for breastfeeding mothers and their babies.

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“Not all women are able to breastfeed, but we encourage it among our patients because of the very real benefits to both mom and child,” Dr. Carter says. “We’ve made great strides on that front, especially among African-American women, who historically have high rates of preterm delivery and low breastfeeding rates.”
By promoting the benefits of the practice, the overall breastfeeding rate at Tidelands Georgetown increased 10 percent in just two years. The breastfeeding rate among African-American moms spiked by 91 percent.
Despite the many initiatives underway to help reduce preterm births, it’s not realistic to expect they will ever be completely eliminated, Dr. Gerber says. But, as the March of Dimes report reflects, there’s room for improvement in South Carolina and across the country.
“This is a complex challenge, and there’s no single or simple solution,” Dr. Gerber says. “Instead, our goal is to provide each mom with the supportive, personalized care she needs to safely deliver a healthy and happy baby.”

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