A new report has found that nearly one in ten Iowa children are born pre-term.
The annual report by the non-profit March of Dimes gave Iowa a "C" for its pre-term birthrate. It reports 9.9 percent of babies were born pre-term last year, up from 9.2 percent in 2017. It's the highest rate the state has seen in a decade.
The national average is 10 percent.
Counties with the highest pre-term birthrates are Scott County at 10.3 percent, Woodbury at 10 percent and Black Hawk at 9.5 percent. The city of Des Moines has a rate of 10.3 percent.
The report also found stark disparities along racial lines, which have not improved since last year. The pre-term birth rate for the state's black women is 11.2 percent -- 33 percent higher than the average. That's followed by Asian and Pacific Islander women at 9.8 percent and Hispanic women at 9.2 percent. White women have the lowest rate at 8.9 percent.
March of Dimes President Stacey Stewart said one reason for the disparity is that research shows black women often report feeling less respected in healthcare settings.
"We have to make sure that the healthcare system is responsive to them -- is meeting them where their needs are, and is responding to them in a respectful and responsive way," Stewart said.
Stewart also said rural women living in "maternal care deserts" are also vunerable to premature births.
“These are counties in the country that don't even have basic access to care for a lot of pregnant women," she said, "counties that don't have a hospital that offers obstetric services and may not have an OB/GYN or even a certified nurse midwife.”
According to a report by the American College of Obstetricians and Gynecologists, Iowa ranks 49th for the number of practicing OB/GYNs in the state.
Nearly three dozen of the state's rural hospitals have shuttered their labor and delivery units in the past two decades -- including eight last year.
Pre-term babies are more likely to face health issues such as cerebral palsy, vision problems, cognitive delays and developmental delays, Stewart said.
The report recommends that states invest in programs that train healthcare workers about "implicit bias" for women of color and programs that can reach women in rural areas with limited maternal care options.
Stewart said states should also expand post-natal coverage under Medicaid to a year after birth because a third of maternal deaths occur in the year after birth.
“We need to make sure that women are healthy before, during and after pregnancy, and their babies are cared for during pregnancy and after as well,” she said.
Health experts at the University of Iowa were recently awarded a $10 million grant to study the state's increasing maternal mortality rate and find solutions over a five-year period.
According to the University of Iowa, maternal mortality nearly doubled in the state from 2015 to 2018 compared to the previous three years.