2021 Preterm Birth Statistics and Birth Rate: Did the Pandemic Have an Impact?

Patrice Hatcher, MBA, BSN, RNC-NIC / November 2021

What are the Latest 2021 Preterm Birth Statistics?

November is Prematurity Awareness Month and, for the past 80 years, the March of Dimes (MOD) has helped millions of babies survive and thrive while leading the fight for the health of all moms and babies. Their annual Report Card is only one of the ways they advocate to prevent preterm births. The data in their annual Report Card includes a national rate and an grade by state, along with a comprehensive analysis. In recent years, MOD has extended their report to include the country’s maternal and infant health crisis and policies needed for change. In addition to the report, their Supplemental Report Card is a compilation of vigorous data that highlights frightening disparities across race/ethnicity within these factors.

The 2021 MOD Report Card, which analyzes the preterm birth natality data for 2020, is now available. The U.S. preterm birth rate is 10.1% and the grade is a C-. I was thrilled to see that the rate had decreased ever so slightly compared to the previous year and, although the overall grade is still a C-, the score is down from 10.2%. The preterm birth rate has been holding at a steady rate without decreasing for the past six years (since 2015). Every bit of a decrease in percent counts as a win, especially when it comes to preterm births.

Unfortunately, the report reveals progress is not being made with pre-term infant health for the five bridged racial and ethnic groups. Black (14%), American Indian/Alaska Native (11.7%), and Hispanic racial/ethnic (9.8%) groups continue to be at the highest rate of preterm birth, compared to the combined rate for all other groups.  The report reveals that disproportionally, “in the U.S., the preterm birth rate among Black women is 51% higher than the rate among all other women.”

The infant mortality rate has seen a slight decrease (to 5.6% in 2021, from 5.7% in 2020), which parallels the decrease in preterm birth rate. Infant mortality rate by race and ethnicity indicates the highest rate of infant mortality continues to be amongst non-Hispanic Black women. These numbers have significantly increased for Black infants, up from 9.4 to 10.9 (per 1,000 births). These statistics are alarming and, because the U.S is considered to be one of the greatest countries in the world, these results are unacceptable. A lot of work needs to be done to improve these outcomes, which I will get to shortly.

How Does the Pandemic Factor Into the Preterm Birth Rate?

Soon after the pandemic started and the mandatory shutdowns began, there were early reports about preterm birth rates decreasing. I remembering hearing that national and global rates were at record lows. Many of the neonatal intensive care units were even reporting a drop in census and in very low birth weight preterm infants. It was so exciting! The national news did a segment titled, “Where are the preemies? Number of premature births plummets in pandemic”.

 If you have read similar reports, you may have felt like I did – which was hopeful that there could be a positive (or silver lining) in what seemed to be an overwhelming time during a global pandemic. I was also hopeful that if this were true, meaningful information could be learned and then applied to continually decreasing the overall preterm rate. The high rate of preterm births (defined as infants born before 37 completed weeks gestation) can have a significant impact, both on the infant’s life due to increased complications related to being born premature, as well as long-term impacts with the possibility of facing learning disabilities and visual and hearing problems.

It is well understood that there is a vital connection between infant health, maternal health, and the health of a family. As the pandemic progressed, it became clear that COVID-19 was having a negative effect on mothers and infants beyond pre-existing health disparities influencing outcomes. The devastating impact of the pandemic included:

  • Decreased prenatal care visits
  • Strained healthcare infrastructure
  • Potentially harmful policies implemented with little evidence

Social determinates of health have a direct impact and indicate those populations that are at greater risk of experiencing poor health outcomes. These factors also contribute to poor maternal and infant health outcomes. It is important to know by state which counties have the highest risk and therefore most vulnerable. The MOD Report Card provides a comprehensive analysis of the data highlighting these indicators. The latter part of the report card recommend state clinical and policy actions that can be taken to address disparities in maternal and infant health outcomes. The recommended actions that can be taken to improve the health and outcomes for mothers and babies include clinical and policy changes, such as:

  • Clinical measures, including access to quality healthcare before, during, and after pregnancy and limiting unnecessary cesarean births for first time mothers.
  • State and policy legislation, such as Medicaid expansion to increase access and utilization of healthcare, Medicaid extension beyond the current 60 days after pregnancy to one year, increasing access to care with standalone midwifery programs, and doula care programs with insurance coverage for doula support.

The full report is available and it is very much worth reviewing. In my opinion, it is a must read!

How Can We Improve Current Preterm Birth Statistics and Outcomes?

There is a lot of work that needs to be done in order to improve outcomes for mothers and infants. If you want to get involved, here are some ways to join the progress being achieved by March of Dimes:

  • Seek opportunities to be an advocate! One of the ways you can do this is by participating in your state or federal advocacy initiatives to influence both legislative and regulatory activities.  #BlanketChange is a movement established by the MOD. Details can be found here.
  • March of Dimes provides a social tool kit to make it easier to share the latest national and state reports on your personal social outlets or through your organization’s social media accounts.
  • Participate in a fundraiser. MOD offers several different programs throughout the year, including March of Babies. You can also learn how to develop your own fundraiser and fundraise your way.
  • Donate by making a monetary contribution to the MOD. The funds will be used to protect and support all mothers and babies. Every year, MOD hosts their annual Support for Giving campaign on Tuesday, November 30th. If you are interested in supporting, here’s where you can find out more.

November is Prematurity Awareness Month and there is still time to show your support by raising awareness around the infant health crisis of preterm birth. Consider taking action by starting with one of the ideas listed above.

Medela is Committed to Supporting Moms, Babies, Communities, and Professionals

As I wrap-up this blog post and in the spirit of gratitude, I would like to conclude with sharing how proud I am to work for a company that has a 60 year history of supporting families by providing lactation support, breastfeeding resources, and human milk education. Medela features a robust portfolio of products to aide in the collection and delivery of the best nutrition for babies, mother’s own milk. Medela is also dedicated to providing ongoing education and clinical support all infants, especially those who were born premature, by putting the nutritional care of all infants first.


1. 2021 March of Dimes Report Card. March of Dimes Report Card. March of Dimes Report Card

2. WGN News Report. Where are the preemies? Number of premature births plummets in pandemic - YouTube  Retrieved November 24, 2021

3. World Health Organization. Preterm Birth. Preterm birth (who.int)

4. Kotlar et al. The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review.  Reproductive Health. (2021) 18:10

About the Author

patrice hatcher author nicu specialist headshot

Patrice Hatcher, MBA, BSN, RNC-NIC, began her practice more than 24 years ago as a neonatal nurse working in NICU. She has experience in various nursing leadership roles including neonatal transport nurse, outpatient nurse manager, and administrative nurse manager overseeing operations of large intensive care units. She has special interest in quality improvement and improving clinical outcomes for neonates. Patrice currently works full-time as a Clinical NICU Specialist for Medela LLC.

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