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Preterm birth rate declines, but island still earns an ‘F’ from March of Dimes


The preterm birth rate in Puerto Rico declined from 11.8% to 11.6% in 2020 -- still high enough to earn the island an “F” grade from the March of Dimes.

By The Star Staff


Puerto Rico obtained an “F” grade on the March of Dimes Report Card, which also revealed that for the first time in six years, the United States preterm birth rate declined slightly from 10.2% to 10.1%, with the nation keeping its C- grade.


This year’s Report Card offers a comprehensive overview of the health of mothers and babies across the U.S. The report grades the U.S. states, Puerto Rico and 100 cities on preterm birth rates, and includes other information such as infant death, social vulnerability, low-risk cesarean section births, and state efforts on Medicaid expansion and extension, doula and midwives’ legislation/policies, among other factors, and outlines important policy solutions that can make a difference.


In Puerto Rico, the preterm birth rate declined from 11.8% to 11.6% in 2020, earning the U.S. territory the F grade. Despite fewer preterm births and a continued decline in infant deaths nationwide, maternal deaths and women suffering from severe health complications due to pregnancy are continuing to rise. More than 700 women in the U.S. die from pregnancy-related causes each year and over the last 30 years those deaths have more than doubled.


Those statistics are far worse for moms and babies of color, as deeply entrenched structural racism is directly impacting their health, the March of Dimes said. The Report Card highlights the stark disparities that cut across all measures of maternal and infant health and outlines the policy actions and partnerships needed to improve the health of the nation’s families.


Even before the COVID-19 pandemic, the U.S. remained among the most dangerous developed nations for childbirth. The latest Report Card shows the number of preterm births fell from 383,061 to 364,487, but Black and American Indian/Alaska Native women are still up to 60% more likely to give birth preterm compared to White women. We see the same disparities trend with infant death, which has slowly declined over the past several years. However, Black and American Indian/Alaskan Native babies are still twice as likely as White babies to die before their first birthdays. Additionally, Black women are three times more likely to die than their White counterparts are.


The complexity of the crisis is anchored in the fact that it does not have one root cause, nor a single solution. Factors such as where a person lives and the structural and societal systems they live under all impact the health of mothers and babies and lead to a health equity gap. More research and data collection are needed to better understand and track changes in preterm birth rates during the COVID-19 pandemic. For that reason, March of Dimes is working to develop a greater understanding of late-preterm birth and the data during the pandemic overall.


“While we’ve seen a small improvement in preterm births and infant deaths, communities of color are still disproportionately impacted,” said March of Dimes President and CEO Stacey D. Stewart. “We see these same disparities trend with maternal health and they are a result of a complex web of factors that are fueling this health equity gap. We know it is possible for every family to have a healthy start and we must work together to change the course of this crisis to ensure that they all do.”

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