Michigan Moms-to-Be are Smoking More; Premature Births are Increasing

A baby born healthy means mom has to be healthy too. And a new study shows that Michigan mothers-to-be have slipped in how well they're taking care of themselves. The rate of expectant mothers in Michigan who reported smoking while pregnant increased by 18 percent between 2008 and 2014, according to the report released Thursday. The number of premature births also increased significantly over the time period, with the rate going up by 20 percent statewide.

This information and other surprising data are found in the Michigan League for Public Policy’s Right Start: 2016 annual report on maternal and child health, which reviews eight indicators on maternal and child health from 2008 to 2014 for the state, by race, by county and for 22 of the state’s larger cities and townships.

In 2008, 21,966 Michigan mothers, or 18 percent of all births, reported smoking during pregnancy (see charat below). That number increased to 24,273 and 21 percent of births statewide in 2014. Smoking during pregnancy is associated with preterm births, babies with low birthweight, infant deaths and other complications.

Not surprisingly, the number of preterm births also went up in Michigan, from 12,619 preterm births (10 percent of all births) in 2008 to 13,855 preterm births (12 percent) in 2014. Premature and low-birthweight babies face immediate health concerns, but also suffer from long-term issues.

“To ensure that Michigan kids count, we have to help them and their mothers get the right start, and this report shows that more needs to be done to promote and support healthy pregnancies” said Alicia Guevara Warren, Kids Count in Michigan Project Director at the Michigan League for Public Policy. “With all of the information out there on the risks of smoking, the increase in pregnant women who are smoking in this day and age is particularly startling. With these numbers, you would think it is 1986, not 2016. Funding and programming cuts clearly have consequences, and the state urgently needs to reinvest in evidenced-based smoking prevention and cessation efforts for pregnant women.”

While the rate of births to white mothers smoking during pregnancy remains the highest of the state’s three largest racial/ethnic groups (23.5 percent), the rate of births to Hispanic mothers smoking while pregnant increased the most—rising by over 46 percent between 2008 and 2014. The rate increased by 16 percent for African-American mothers and 17.5 percent for white mothers. Similarly, the rate of Latina mothers whose babies are born too soon rose by more than 26 percent over the trend period. The report also found that generally rural counties with smaller populations experienced the highest rates of mothers smoking during pregnancy.

Reduced budget funding (see chart below) is a primary culprit in the lack of targeted outreach and services to help pregnant mothers quit smoking, resulting in the increase in pregnant women smoking and the number of preterm births in the state. In the 2017 budget, including state and federal funds (excluding Medicaid dollars), smoking prevention and cessation initiatives were funded at $3.78 million, which is down 34 percent from budget year 2008. Currently, there is $10,800 targeted to prenatal outreach, up $800 from the 2008 budget. These funds are for local and statewide programs and one goal is to eliminate disparities by race/ ethnicity, geography, income level, type of job and gender and sexual orientation.

There is some good news on maternal and child health in Michigan, as five of the eight indicators saw improvement across the state between 2008 and 2014. This included a 30 percent rate decrease in births to women under age 20 statewide, a 10 percent rate decrease in repeat teen births, and a 21 percent rate decrease in births to mothers with no high school diploma or GED. The other two areas of improvement were a nine percent rate decrease in the number of pregnant women who received late or no prenatal care and a one percent rate decrease in the number of low-birthweight babies.

A mother’s education level is one of the better predictors of whether she will access adequate prenatal care, smoke during pregnancy and be financially secure, which are all connected to both the mom’s and child’s well-being. The improvement in teen births is likely the result of a combination of factors, such as fewer teens having sexual intercourse, increased access to long-acting reversible contraceptives (LARCs), and an increase in the use of postpartum contraception. The 2015 Right Start report focused more in-depth on the state’s decline in teen births.

Image by John Ted Daganato via Flickr Commons