The city of Gary received an "F" in a national survey of premature birth rates.
The March of Dimes recently released its annual premature-birth report card, which, for the first time, was city-specific. Overall, the state earned a "C," while Gary had the lowest rating of the five Indiana cities that were graded.
"Prematurity is a big contributor to chronic lung disease, developmental delays, cerebral palsy," said Dr. Niceta Bradburn, an Indianapolis neonatologist and spokeswoman for the March of Dimes. "Prematurity has a big effect on our infant mortality rate in Indiana, which is very high."
A premature birth is defined as when a mother gives birth at less than 37 weeks of gestation. The March of Dimes has a goal of reducing the national premature birth rate to 8.1 percent by 2020 (it is currently 9.6 percent). Indiana's rate is 9.7 percent, an increase over last year, ranking the state 41st. Gary has a rate of 12.1 percent.
Bradburn said that besides the health risks, premature births are an economic drain, costing an average of $54,000 compared to a $4,000 to $5,000 for a full-term birth.
Risk factors for premature births include having a child less than 18 months before the birth of your last one, smoking, and obesity.
In a place like Gary, the causes are generally more of the social variety, such as the city's high-teen pregnancy rate and lack of access to prenatal care, said Dr. Cholemari Sridhar, a neonatologist at Methodist Hospitals Northlake Campus in Gary.
"Even though we've made strides, there is still a lack of education and lack of economic opportunity," he said. In 2014, 10 percent of the births at the hospital were preterm, he added.
Some things that have been done in recent years to reduce the rate of premature births include cutting back on preterm elective births, automatically enrolling pregnant Hoosiers into Medicaid, and the Baby and Me Tobacco Free program, which incentivizes pregnant women who quit smoking.
"It's basically about having support and education," said Evelyn Turner, nurse manager for the prenatal care coordination program at NorthShore Health Centers, which has several clinics throughout Northwest Indiana.
"Say we have a mom who calls in and says she has a little cramping. We say, 'Did you do A, B and C?' It could be a little thing like being dehydrated that could cause a preterm birth, or a urinary tract infection, or a stressful home life. We've gotten women out of harmful situations in the home environment."
Bradburn says it will take, for lack of a better term, a village to reduce premature birth rates.
"Every community, every church needs to figure out ways to tell mom, 'Make sure you're healthy before you're pregnant," she said. "We need to make sure every child is a wanted child and make sure women have access to good health care and nutrition."