Why Are There So Many Premature Births in America?

Why Are There So Many Premature Births in America? 1

I was moved this week by Maria Cramer’s story of a baby born at 21 weeks who defied the odds, and now holds the Guinness World Record for the “most premature infant to live to a first birthday.” Curtis Zy-Keith Means was born to Michelle Butler last summer, and even though his twin sister very sadly did not survive, Curtis hung on.

“The truth is no baby has survived at this age,” a neonatologist at the University of Alabama at Birmingham who helped take care of Curtis told Cramer. “We say less than 1 percent, but it’s really closer to zero.”

Rates of preterm births in the United States are much higher than in other wealthy nations. A systematic review of global preterm birth published in 2019 showed that the U.S. was in the top ten for preterm births in 2014, ranking seventh, between Pakistan and Ethiopia. Another study found that in part, the “stresses of racism and income disparity” may be exacerbating bad outcomes for American moms and babies.

As Sema Sgaier and Jordan Downey point out in a new Times Opinion article about the “shameful trends” in U.S. maternal health, mothers who, like Butler, deliver their babies in Alabama, are particularly at risk for preterm birth, along with other major issues. “One out of every five women of reproductive age in Southern states,” they write, “live in counties with a high risk of death and other poor maternal health outcomes, such as postpartum hemorrhage, pre-eclampsia and preterm birth.”

This level of needless suffering is enough to make you scream and punch a wall. Why are we like this? For a cathartic and rueful laugh, please read the comedy writer Bess Kalb on how she might have died six weeks after her first child was born if she had not had parental leave. I swear it is very funny despite also being very enraging.

Kalb is currently pregnant with her second child, and has had some complications that may land her on bed rest for the remainder of her pregnancy, “which, as someone who has always longed for the lifestyle of a tragic Victorian heroine, is great news,” she writes. Though she notes that if she did not have paid leave through her union, she would also be experiencing the stress of worrying about how to afford keeping both herself and her baby alive.

Let’s close out with two bits of good news. First, as Sheryl Gay Stolberg reported Wednesday, the White House estimated that close to 10 percent of kids ages 5 to 11 had their first vaccine dose already: “Just 10 days into our program being in full strength, we’re at 10 percent of kids,” said Jeff Zients, President Biden’s coronavirus response coordinator. “For perspective,” Zients added, “it took about 50 days for us to reach 10 percent of adults with one shot. And when the polio vaccine was first rolled out for kids in the 1950s it took about three months to cross two and a half million shots in arms.” (And my Opinion colleagues asked three experts how you can stay Covid safe during the winter holidays.)

And second, I’m over the moon about an event I’m doing with Michelle Buteau, one of the funniest people around — whom you may know from her standup specials or movies such as “Always Be My Maybe.” Our conversation will be on Dec. 8 at 8:30 E.S.T., so hopefully you can put your kids to bed and join us. You can share your Tiny Victories and we will answer your questions.

RSVP here!

Also don’t miss the incredible essay Buteau wrote for The Times, which included this perfect description of her parenting relationship: “To my husband, I’m not just a helicopter mom. I’m a drone-on-top-of-a-snowplow mom. To me, my husband is too casual and relaxed. Toddler time is not a Jimmy Buffett concert!”



Parenting can be a grind. Let’s celebrate the tiny victories.

Putting on pajamas is a real battle with my 2-year-old so I invented a game where the pajama shirt and pants are sad and cry “boo-hoo-hoo” because they have “no arms or legs to cuddle.” Each time I do it, my daughter cracks a smile and putting pajamas on becomes fun for her; what a relief!

— Emily McCausland, Chevy Chase, Md.


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