Poor Pregnancy Outcomes

Alabama's #3 Health Indicator

Pregnancy outcomes remained in the top three primary health indicators for AL. Biological and social factors affecting the length of the pregnancy or the infant’s survival may impact pregnancy outcomes.

The complications and possible loss of a baby is physically and mentally difficult, and a long recovery for both parents (CDC Maternal and Infant Health). AL ranks 47th for infant mortality rate in 2019 (ADPH Perinatal Program). About 1 in 100 pregnancies result in stillbirth, which is the death of a baby before or during delivery (CDC Maternal and Infant Health).

Strategies to improve pregnancy outcomes include breastfeeding and family planning. Breastfeeding is the best source of nutrition for most infants and can reduce the risk of health conditions for both infants and mothers (ADPH Perinatal Program). Breastfeeding also helps strengthen the infant’s immune and digestive system during the first year of their life.

Family planning can help reduce unexpected pregnancies, particularly in teen mothers. Contraception can increase safe sexual practices and protect individuals from sexually transmitted infections (STIs) (ADPH Perinatal Program). Reversible birth control methods can include intrauterine contraception, hormonal methods, and barrier methods. Permanent methods of birth control include female and male sterilization, such as tubal ligation and vasectomy.

Disproportionately Affected Populations

Many social and biological factors also affect the time the mother begins prenatal care and the number of visits she receives. For AL, AA/black women have double the infant mortality rate than white women, highlighting racial and ethnic disparities present for expecting mothers to overcome (ADPH Perinatal Program). Improving generational health outcomes start with family planning, lowering maternal stress, implementing good nutritional choices, detecting and preventing diabetes.

Geographic Variation

The areas with the highest rates of teen pregnancy are in Wilcox and Greene counties. The areas with the highest rates of infant mortality are in Coosa and Greene counties. As demonstrated in this chapter, poor pregnancy outcomes mainly occur where there is a lack of public obstetrical services in the state.

Alabama Poor Pregnancy Outcomes Highlights

Data are collected by hospitals and transmitted electronically to ADPH Center for Health Statistics. Data are also retrieved from ADPH Office of Primary Care and Rural Health: 

• The infant mortality rate was 7.7 deaths per 1,000 births for 2019. In the 2015 CHA, the infant mortality rate was 8.5 deaths per 1,000 births.
• The disparity of infant mortality in minority females is two times higher when compared to white females.
• Over 1 out of every 10 births in AL were babies born with low birth weights.

Health Indicators

The following indicators have been selected for use in developing a benchmark or starting point for measuring the current state of and monitoring future changes regarding poor pregnancy outcomes in Alabama.

• Pregnancy Outcomes Overview
• Inadequate Prenatal Care (Data Download)
• Obstetrical Services in AL, 1980-2019
• Infant Mortality (Data Download)
• Low Birth Weight (Data Download)
• Teen Pregnancy (Data Download)

Resources

• CDC (Linked Birth and Infant Death Data)
• Kidscount (Infant Mortality)
• National Fetal-Infant Mortality Review Program
• HRSA (Collaborative Improvement and Innovation Network to Reduce Infant Mortality)
• Association of Maternal and Child Health Programs (Infant Mortality)
• CDC (Birth Data)
• Kidscount (Low-Birthweight Babies)
• HRSA (Low Birth Weight)
• The National Campaign to Prevent Teen and Unplanned Pregnancy
• CDC (Teen Pregnancy)
• Kidscount (Teen Mothers Ages 15-19)
• Office of Adolescent Health (Teen Pregnancy and Childbearing)
• Child Trends
• America’s Health Rankings
• Kidscount
• Child Health USA 2013
• CDC (Births - Method of Delivery)
• CDC (Tobacco Use and Pregnancy)
• Kidscount
• CDC (Unmarried Childbearing)
• ChildStats.Gov (Births to Unmarried Women)
• CDC (Preterm Birth)
• Kidscount (Preterm Babies)
• American Diabetes Association
• CDC (2011 National Diabetes Fact Sheet)