Why Wear Purple in November? It's Prematurity Awareness Month

Why Prematurity Awareness Month Matters

Prematurity Awareness Month is an entire month dedicated to bringing awareness and focus on infants that are born too soon; premature infants and their families.  I am sure you all know a family (and it may be your own) that has experienced the blessing and challenge of a baby born premature; either premature or late pre-term. November is a month dedicated to bringing awareness, with many businesses, associations, and families coming together to amplify the voices of families and organizations that are committed to reducing the incidence of prematurity.     

In 2019, the CDC reported 1 in 10 infants (10%) are born premature in the United States. Premature birth is defined as an infant born early, before 37 weeks gestation. The earlier a baby is born, the higher the death or serious disability; preterm birth and low birth weight accounted for about 17% of infant deaths. Premature infant birth and the associated complications are the largest contributors to infant death in the U.S. 

Lowering the rate of premature birth is a national public health and global priority. The World Health Organization (WHO) reports that every year an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising. Across 184 countries, the rate of preterm birth ranges from 5% - 18% of babies born. There has been a rigorous effort to reduce the number of babies born premature. Despite a great deal of effort, including community programs, public reporting, awareness campaigns, fundraisers, and policy changes, the incidence has not decreased over the past four years. Unfortunately, the incidence has instead gradually increased during this time.

Infants that are born pre-term require considerable care and, in most cases, require hospitalization in the  NICU. They are at the highest risk for developing prematurity-related morbidities, including late-onset sepsis, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and retinopathy of prematurity (ROP). These infants often are at risk for lengthy hospitalization and readmission.

Lakshmann and Associates surveyed parents of preterm infants in their cross-sectional study during the first two years post-NICU discharge to understand the impact preterm birth has on parents and families. In their research, they categorize the impact on family functioning, including increased debt, financial worry, unsafe home environment and social isolation. What was most encouraging from their findings is the fact that they also included modifiable determinants associated with lessening the impact; to share a few, community based resources and clinic, use of public housing, and receiving Medicaid.

March of Dimes has been the strongest advocate for supporting mothers and babies. MOD has an 80-year history of influence and innovation offering and “they empower every mom and every family.” They have been working tirelessly to reduce the rate of premature births. March of Dimes has been an avid leader in the fight to decrease premature births, with the goal to achieve a rate of 8.1% by 2020. They have expanded their efforts to include reporting on maternal and infant health context and actions needed to improve health outcomes for moms and babies and bringing awareness to declining maternal health conditions.

What to Know About Prematurity Awareness Month

Every year in November, the March of Dimes monitors and reports on the preterm birth rate progress on key indicators and assigns a grade. The Report Card assigns premature grades by states comparing the preterm birth rate to the goal (8.1%). The March of Dimes 2020 Report Card will be released very soon, usually in early November. The full report includes the national and state prematurity birth rate, premature birth by race/ethnicity of the mother, birth disparity measures, and social determinants of health. The annual report is available on their website: MarchofDimes.org/Reportcard.

World Prematurity Day is November 17th, however, there is a lot of great work and awareness that occurs throughout the month. Many business and organizations support by bringing awareness through posting information and links on their website to support and publicize the efforts by others. If you want to support and are not able to wear purple every day in November, I recognize finding other ways to show your support can be a challenge.  If you are only able to show your support during one day this month, please join in on November 17th! Many families recognize World Prematurity Day and Prematurity Awareness Month by wearing ribbons and making modest donations to organizations that support, bring money, and donate resources to awareness around this important health crisis.

In my early years working in the NICU (as a night-shift nurse), we supported fundraisers to bring awareness and support prevention of premature birth.  One of the ways we supported was by making a donation and receiving a MOD t-shirt that we would wear. This fundraiser was called Blue Jeans for Babies.  The hospital where I worked during that time allowed us to abandon our scrubs and wear the t-shirt and blue jeans (denim) on Fridays to show our support. We could also include our friends and families by asking them to make a donation and they also then would receive a t-shirt. I remember doing this for many years as a way to support the MOD and their efforts to reduce prematurity, as this has been important to me for many years.  And, in case you are wondering, yes – I will be wearing purple this November 17th!   

If you want to get involved, here are a few ways that you can support and take action:

• Support comprehensive Medicaid coverage extensions for all women to at least one year postpartum. In many states, Medicaid maternity coverage ends sixty days after giving birth which then ends access to care during a critical time when risks of maternal complications and death continue.
• Make a tax deductible donation to support research and community programs, or to the March of Dimes.
• Start a fundraiser through your Facebook or social network to recruit the support of your family and friends. Use the Facebook profile picture tool to change your profile photo and post all your photos wearing purple to inspire others in your network and circle.2
• Wear a purple shirt or all purple gear on November 17th. Other workplace-friendly options could include the idea of “light it purple” - illuminate your office, lobby, or the outside your workplace or home with a purple light
• Go to the March of Dimes website for additional ways to take action

References

1. Centers for Disease Control and Prevention (CDC). Reproductive health: Prematurity. Retrieved from https://www.cdc.gov/reproductivehealth/features/premature-birth/index.html
2. March of Dimes. Prematurity Awareness Day.  https://www.marchofdimes.org/mission/world-prematurity-day.aspx
3. World Health Organization (WHO). Preterm Birth. 19 February 2018. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
4. Johnson T, Patel A, Bigger HR, Engstrom JL, Meier PP. Economic benefit and costs of human milk feedings: A strategy to reduce the risk of prematurity-related morbidities in very low birth weight infants. American Society of Nutrition. 2014. 5:207-208
5. Lakshmann A, Agni M, Lieu T, Fleegler E, Kipke M, Philippe S, Friedlich PS, McCormick MC, Belfort, MB. The impact of preterm birth < 37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit. Health and Quality of Life Outcomes. 2017. 15:38.
6. MarchofDimes.org/ReportCard.