Montana’s premature birth rate is too high, and the state urgently needs to take action to prevent more deaths and disabilities, according to a March of Dimes report released Wednesday.

Montana received a “D” grade in the March of Dimes report card on premature birth rates. The nation as a whole also received a “D.”

According to Debra Donovan, director of program services for the Montana March of Dimes Chapter, the chapter will ask the Montana Legislature to take action in the upcoming session by increasing access to health insurance for pregnant women and supporting smoking-cessation programs.

The March of Dimes cites smoking during pregnancy and a lack of health insurance as two of the underlying reasons for premature births.

The report compared actual preterm birth rates to the national Healthy People 2010 objective. In 2005, the latest year for which data is available, Montana had a premature birth rate of 11.4 percent of all live births. The Healthy People objective is for a 7.6 percent premature birth rate.

The nation as a whole had a prematurity rate of 12.7 percent.

St. Peter’s Hospital physician Dr. Richard Sargent said the high prematurity rate, both in Helena and in the nation, is partly a result of a trend in doctors and women scheduling births out of convenience rather than letting nature take its course. He said it’s a trend that needs to stop.

Sargent said that even though medicine has made great strides in caring for premature babies, the best place for a baby until the 40th week of pregnancy is still inside the mother’s womb.

“There’s really very little reason to deliver ahead of time, and good reason not to,” Sargent said. “There’s an amazing amount of growth in the last few weeks. You don’t want to mess with Mother Nature.”

According to the March of Dimes, premature birth is the leading cause of death in the first month of life.

Babies who survive a premature birth have a higher risk of serious health problems later in life, including learning disabilities, cerebral palsy, blindness, hearing loss and asthma. Even infants born just a few weeks too soon have a greater risk of breathing problems, feeding difficulties, hypothermia, jaundice and delayed brain development.

Other factors that contribute to premature birth rates, Sargent said, are lack of health coverage for pregnant women and smoking among pregnant women.

According to the March of Dimes report, most states have a lot of work to do to shore up their prematurity rates. No state received an “A,” meaning no state meets or betters the 7.6 percent objective for prematurity rate. Only one, Vermont, graded as high as a “B,” or a rate of less than 9.5 percent.

Eight states received a “C,” 23 states received a “D” and 18 states plus Puerto Rico and the District of Columbia received failing grades. States with a rate of higher than 13.2 percent received an “F.”

In addition to providing state rankings, the March of Dimes report analyzed contributing factors and prevention opportunities, including rates of late preterm birth, smoking and uninsured women of child-bearing age. In Montana, the rate of late preterm births is 8.7 percent; the rate of women smoking is 24.4 percent, and the rate of uninsured women is 21.5 percent.

Sargent cited a program called Centering Pregnancy, which St. Peter’s started recently through a March of Dimes grant, as a positive step toward improving prematurity rates.

The program brings mothers together in a group setting with a doctor’s supervision for 10 two-hour sessions to discuss pregnancy issues.

Sargent said women who enter the program are less likely to smoke while pregnant and less likely to have preterm labor and other complications. He said another positive outcome of the program are increased breastfeeding rates among participants, which also improves many health factors for infants.

Click here to view an online petition March of Dimes is conducting asking federal and state lawmakers to improve premature birth research, prevention and care.

Features editor Joe Menden: 447-4087 or joe.menden@helenair.com