It was a regular Friday at Trinity Hospital on Nov. 4. However, by day's end, there were 14 births, including a set of twins and triplets. These multiples -- along with one singleton (a baby born alone) -- were all born prematurely.
One in eight babies are born premature, said Dr. David Billings, an OB/GYN at Trinity. In North Dakota, the prematurity rate is about 10.2 percent -- 2 percent less than the national average, he added.
The March of Dimes, a charity that focuses on the health of babies, graded each state in the country to determine where they rank on premature births. According to the charity's website (www.marchofdimes.com), North Dakota has a B. The majority of the midwest and Pacific Northwest states have a B, while other parts of the midwest and parts of New England have a C rating.
James C. Falcon/MDN - - Dr. Linda Zak, a neonatologist and pediatrician at Trinity Hospital, tends to a premature baby in the hospital’s Newborn Intensive Care Unit Friday.
The southern states, as well as Nevada, have a D. Puerto Rico, Louisiana, Mississippi and Alabama earned an F. Only Vermont, which has a prematurity rate of 9.3 percent, has an A. Billings believes that North Dakota has a low prematurity rate because mothers here are more likely to take advantage of prenatal care.
There are a variety of causes that contribute to premature births. Uninsured women, women who smoke and women who participate in late preterm births are more likely to have premature babies, Billings said.
"Health care before and during pregnancy can help identify and manage conditions that contribute to premature birth," the March of Dimes states on its website. This causes about 15 percent of premature births.
Any time that a woman who smokes enters Billings office, he said he gives her a pamphlet for Quitline, a smoking cessation program. According to March of Dimes, smoking causes a little more than 20 percent of prematurity.
About 8 percent of prematurity is caused by late pre-term birth, which occurs when labor is induced too soon. In order to prevent this, Billings said that C-sections should be elective and that if labor is induced, it should be done at or after 39 weeks the traditional nine-month pregnancy lasts 40 weeks especially for first-time mothers. Billings pointed out in addition to causing prematurity, a late pre-term birth is the leading cause of newborn deaths in the United States.
Women with high blood pressure, diabetes and other health problems also have an increased risk in giving birth early, Billings said.
"If we can see them early enough, we can control that," he said, as well as reduce the chances of premature birth.
However, premature birth can lurk anywhere, even in women who don't display risk factors, Billings said. For women who don't display these factors, but have a history of premature birth, they are advised to get a shot of progesterone every week from 16 to 30 weeks.
Depending on the cause of prematurity, the chances of another premature baby can vary; factors such as different paternity, a lack of progesterone or other prevention methods, can play a part.
Trinity is doing its part to make sure that premature births are avoided. Prenatal visits, something that Billings stresses as being very important and beneficical to the overall health of the mother and child, are advertised.
Also, women in their childbearing years Billings said those years typically range from 18 to 40 are encouraged to take vitamins with folic acid. The March of Dimes, on its website, states that folic acid prevents neural tube defects, which affect the brain and spinal cord.