Washington, DC Scores a C- on the March of Dimes 2023 Report Card

Each year, the March of Dimes hands out report cards to every state in the country regarding maternal and infant health. This year, for the first time, they are including maternal mortality, leading causes of infant death, and risk factors for preterm birth. Washington, DC has scored a C- on the report card this year, with a preterm birth rate of 10.2%, meaning about one out of every 10 babies born in the District is pre-term. Last year the rate was 10.1%, and the overall rate for the United States is 10.4%. An “A” rating is the March of Dimes goal of no more than 7.7%.

What is the March of Dimes Report Card?

According to the March of Dimes:

The 2023 March of Dimes Report Card highlights key indicators to describe the current state of maternal and infant health. We continue to provide updated rates and grades for preterm birth and data on infant mortality and maternal health. New this year is the inclusion of maternal mortality, leading causes of infant death, and data describing selected risk factors for preterm birth. Indicators by maternal race/ethnicity are included to call attention to the need for addressing racism in our systems and communities in order to eliminate health disparities. Detailed analyses of these measures inform the development of policies and programs that move us towards improving health for birthing people and the millions of babies born each year in the U.S., D.C. and Puerto Rico. The Report Card presents policies like Medicaid extension and programs like Maternal Mortality Review Committees, which can help to achieve equity in maternal and infant health outcomes.

Per the March of Dimes report, “[m]aternal mortality refers to the death of a birthing person from complications of pregnancy or childbirth that occur during the pregnancy or within 6 weeks after the pregnancy ends … Rates are calculated by dividing the number of maternal deaths by the number of births in the same geographic region during the same data year(s) and multiplying by 100,000.”

Preterm birth is “a birth with less than 37 weeks gestation based on the obstetric estimate of gestational age.” Preterm birth grades range from F to A.

The report card notes that the “preterm birth rate among babies born to Black birthing people is 1.8x higher than the rate among all other babies.” Black mothers have a 13.3% preterm birth rate, as compared to 6.6% for white people. Asian/Pacific Islanders have a preterm birth rate of 7.6%, and for Hispanic mothers the rate is 9.3%.

What factors make birthing mothers more likely to have a preterm birth?

The following factors can lead to a preterm birth, according to the March of Dimes:

• Smoking (1.2% of all births)
• Hypertension (3.2% of all births)
• Unhealthy weight (28.3% of all births)
• Diabetes (1.8% of all births)
• Previous preterm delivery (2.9% of all births)
• Carrying multiples (3.1% of all births)

More than one factor can occur at the same time.

What is the infant mortality rate for Washington, DC?

The infant mortality rate here in DC is 6.8 (out of every 1,000 live births), well above the rest of the country’s rate of 5.4. However, among Black mothers, the mortality rate is 9.4 per 1,000 live births, as compared to 1.9 for white people and 3.5 for Hispanics. The leading causes of infant death include:

• Birth defects
• Accidents
• Maternal complications

What factors are related to maternal vulnerability?

Factors related to maternal vulnerability include:

• Reproductive healthcare
• General healthcare
• Physical health
• Socioeconomic determinants
• Physical environment
• Mental health and substance abuse

Washington, DC has a maternal mortality rate of 30.7 for every 100,000 births. This compares to 23.5 for the rest of the country. There is also a lack of prenatal care, with 23% of birthing mothers “who received care beginning in the fifth month or later or less than 50% of the appropriate number of visits for the infant’s gestational age.”

The report also discusses the adoption of policies and funding in DC to improve maternal and infant healthcare. These include:

• Medicaid extension and expansion
• Paid family leave
• Doula reimbursement policy
• Fetal and infant mortality review team

The March of Dimes notes that DC still has not implemented a Maternal Mortality Review Committee (MMRC) to identify and improve causes of maternal death, or a Perinatal Quality Collaborative (PQC) which identifies and improves quality care issues in maternal and infant healthcare.

You can view the United States report card here. The preterm birth rate across the country is 10.4, or a D+ letter grade. The worst grades occurred in the southern region of the United States.

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