Utah, like the nation as a whole, earned a D grade from the March of Dimes, which released its first Premature Birth Report Card Wednesday.
One cause is women or doctors scheduling deliveries a couple of weeks before the due date without a medical reason. In response, there is a push by Utah doctors to refuse to electively induce labor or perform Cesarean sections unless a woman is one week or less away from her due date.
Michael Varner, who helps oversee obstetrics research at the University of Utah, has heard the pleas: "They're 38 1/2 weeks [along] and they're tired of being pregnant. Their doctor is going out of town. It's a week before Christmas."
But, he adds, "doctors should just say, 'No.' Hospitals should just say, 'No.' A spontaneous onset of labor and vaginal delivery is overall the safest."
Babies born even a couple of weeks early are at risk for respiratory and feeding problems, jaundice, long-term mental disabilities and sudden death, Varner said. A baby's brain at 35 weeks weighs two-thirds of what it will weigh at a full term of 40 weeks, according to the March of Dimes.
The nonprofit graded each state on its rate of premature births - defined as babies born at less than 37 weeks gestation. Utah's rate in 2005 was 11.4 percent, compared to the national 2010 goal of 7.6 percent. The U.S. rate was 12.7 percent.
Vermont earned the only B grade, the highest mark given. Several states, mostly in the South, got Fs.
"The United States is failing our tiniest and youngest citizens on the very day they are born," said Amy Hansen, director of the Utah March of Dimes chapter at a news conference in the newborn intensive care unit at Intermountain Medical Center.
Utah's premature birth rate has jumped 24 percent since 1995. Varner said the main reason is the number of babies delivered between 34 and 37 weeks, due to a rise in the number of twin and triplet births and improvements in care that allow doctors to deliver ill babies earlier.
Another reason is the "disturbing" trend of elective inductions or C-sections before 38 weeks, he said. It's hard to know how often that happens. Counting induced vaginal deliveries and C-sections, about half of Utah's 52,000 births are scheduled, though some of those are for medical reasons.
Noticing that such late pre-term deliveries lasted longer by several hours and caused more complications, Intermountain Healthcare created a policy a couple of years ago to reduce late-term elective inductions. Before inducing labor, women must be 39 weeks along and their body must be ready to deliver, as measured by a soft and dilated cervix.
In 1999, about 28 percent of all elective deliveries at Intermountain happened before 39 weeks. This summer, it was down to 2.6 percent, and those patients had to get the medical director's approval.
Women shouldn't schedule their labor as if it's a haircut, said Janie Wilson, operations director of Intermountain's Women and Newborn Clinical Program.
A handful of pregnant women at IMC said they had no problem with the guidelines.
"You're asking for more complications. Kids come when they're ready," said Wendy Dowdle, who is 36 weeks pregnant. She said her two other children arrived a little more than a week early naturally.
Besides reducing late preterm births, there are other ways for women to prevent premature births: stop smoking, attain the right weight before pregnancy, space out pregnancies at least by 18 months and start prenatal visits in the first trimester.
