The loss of a baby at the end of pregnancy is more common in the south than in other regions of the United States, according to a new report exclusively given to NBC News.
The difference is dramatic: compared to other parts of the country, the chances of having a high rate of pregnancy loss in the late stage are almost three times greater in the southern states.
The lack of Medicaid expansion in the south, together with the large rural population of the region and relatively low levels of adequate prenatal care, contributes to the high fetal loss rates in the second half of the pregnancy, according to the report of the United States of care, an organization of defense of non -partisan medical care.
“We are losing lives,” said Venice Haynes, lead author of the report. “When are we going to stand up and say that enough is enough?”
The new analysis found that the average fetal mortality rate for 16 southern states in 2023 was 6.05 fetal deaths at 20 weeks of gestation or more for 1,000 living births and fetal deaths, compared to an average fetal mortality rate of 5.25 for all other states. The analysis is based on provisional data from disease control and prevention centers.
Fetal deaths after 24 weeks of gestation have constantly decreased since 1990, according to a CDC report last year. The states in the south, including Mississippi, Georgia and Arkansas, had the highest rates.
The new report found that the South also has higher rates of postpartum depression and less perinatal health workers compared to other regions in the United States.
The new data is “a very significant finding,” said Dr. Amanda Williams, interim medical director of March of Dimes, who discovered that the south also has the highest rates of premature births in the country.
Williams said he is not optimistic about the prospects for mothers and babies in the south.
The Congress is considering drastic cuts to Medicaid. NATIONAL MEDICAID covers 41% of births, with especially high rates in many southern states. In addition, almost all states of the South have a strict prohibition of abortion, and research suggests that such laws are leading the obstetricians to leave and discourage young doctors who work there.
“We anticipate that it will get worse,” said Williams. “This is an area of the country that needs more investment, more support, more suppliers, no less.”
‘Your body remembers’
There are many causes of pregnancy loss in the late stage, or fetal deaths, including the infection or genetic condition of a fetus. Often the cause is never known.
A reason for the high shit rate in the south is that black women experience fetal loss more than double the rate of other groups. Black women have higher rates of underlying diseases, such as hypertension and diabetes, which can put a pregnancy at risk. More than half of the black population lives in the south, according to a recent Pew research report.
Black women also have high stress rates, which can affect pregnancy.
Kim Smith, a black woman who lives in South Carolina, developed a severe type of preeclampsia called Hellp syndrome, and when she was five months pregnant, she lost her daughter, Lauren Kelly. Some studies have demonstrated a possible link between stress and preeclampsia, a condition in which a pregnant woman develops dangerously high blood pressure.
Smith, 42, was raised in Greenville, North Carolina, by a single mother.
“My mother is minister, my aunts are ministers, my uncles are bishops. We grew up in a very loving and faithful family, ”he said.
But Smith’s family was poor and lived in a neighborhood with frequent shootings and high drug abuse rates. Racial tensions were high: remember when I was a child listening to people making racist comments, and the Ku Klux Klan sometimes marched near his neighborhood.
“I remember that when I was a child listening to shots and listening to police sirens and ambulance sirens on a regular basis,” he said.
Smith married and moved to Irmo, South Carolina. When she became pregnant with her daughter in 2011, she was a administrator in federally qualified medical care centers in disadvantaged neighborhoods with bad health results. It was a difficult job since it observed the impact of poverty and racism in the community.
“That level of stress is not exclusive to me. It was just a kind of culture, ”he said.
While working hard and trusted his faith and the love of his family, he said, it was not always easy.
“When you experience life, what are you doing? You take advantage of that and you push it. And we give each other a badge for that. But at the end of the day, our bodies remember stress, ”he said. “Your body remembers what you experience.”
After losing his baby, Smith changed his job and took other measures to reduce stress in his life. Then he had three children, all healthy pregnancies, and is now a health technology businesswoman.
‘No state is fine’
In many ways, the South is a perfect storm for bad results for pregnant women, according to an analysis for NBC News by the perinatal data center in March of Dimes.
Compared to other parts of the country, the South has the highest percentage of women without insurance from 19 to 54 years and the highest percentage of women who age in maternity care deserts, where access to maternity care is limited or absent, according to the march of the Dimes. The region also has the highest percentage of births in which mothers received inadequate prenatal care. Although the South stands out, all of the United States suffers high pregnancy rates and postpartum complications, said Natalie Davis, CEO of the United States of attention.
The maternal mortality rate in the United States is higher than in other developed countries, more than four times rates in the United Kingdom, Australia or Germany, according to the background of the Commonwealth. The group also discovered that the United States has a low supply of midwives and Ob-gins compared to most other developed countries: 16 for 1,000 living births compared to, for example, 35 in the Netherlands and 43 in France for 1,000 living births.
“Our message to all governors is that no state is fine in this, ”he said. “Each state must focus on this.”
Stop a ‘continuous cycle’ in the south
There are high technology and low technology approaches to address pregnancy complications such as fetal death.
Researchers are developing artificial intelligence tools to predict which pregnant women can enter premature birth. Programs such as Kid One in Alabama and green cars for children in Florida offer trips so that future mothers reach their prenatal appointments.
“Its appointments are being lost because bus connections are too long or there is not even a bus that goes to its neighborhood,” said Dr. Catherine Tom, president of Green Cars for Kids. Providing walks so that women can get care “is so simple, it is not space science.”
Another program, the Nursing-Family Association, connects to future low-income mothers in 40 states with nurses. Sharon Sprinkle, director of the program in several southern states, said her teams have avoided many “nearby failures” by educating their clients about early childbirth signs, preeclampsia and other complications of pregnancy.
Too often, pregnant women report that their concerns were “minimized or totally discarded, when, in fact, if they were heard, the result would have been better,” he said.
Nurses in the program teach customers to “unleash their power and feel comfortable having conversations with doctors to say: ‘This is what is happening. I need you to listen. And if you don’t listen, find someone else in their office to listen.”
Sprinkle, a registered nurse who has worked in childhood and maternity care in the south for decades, said she is not surprised by the new findings about fetal dead. Nor is Dr. Cornelia Graves, a specialist in maternal-feetal medicine and professor at the Center for Health Sciences of the University of Tennessee.
Graves said that the bad results of pregnancy in the south will continue due to the high rates of underlying diseases such as diabetes, obesity and heart disease.
“We know that women who are not healthy give birth to unhealthy babies who later become unhealthy children who later become unhealthy mothers,” he said. “It is a continuous cycle.”
