PRETERM BIRTH
in Western North Carolina

Why is preterm birth a key health issue in western North Carolina?

Approximately 11% (10.8%) of births in WNC were considered preterm (less than 37 weeks), which is slightly higher than the state percentage (10.2%) in 2013-2017. 

(N.C. State Center for Health Statistics, 2019)

Babies born too early (especially before 32 weeks) have higher rates of death and disability.

(CDC, 2018)

What do the numbers say about preterm birth?

Western North Carolina (WNC) Data:

While county-level examination of infant mortality by race in WNC is limited by small numbers (fewer than 20 infant deaths per 5 year period), North Carolina data indicates that:

"Black women [in North Carolina] have a higher infant mortality rate (12.2 deaths per 1,000 live births) than women of all other racial and ethnic groups."

(Institute for Women's Policy Research, 2019)

Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/ or discrimination. See our data story on the social determinants of health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families. 

Sistas Caring 4 Sistas, Mothering Asheville, MAHEC and locally trained doulas are working together to address racial disparities in the healthcare system in WNC. Click on the image to read an article in the Asheville Citizen-Times. (Photo: Sara Christensen, communications and marketing at MAHEC)

State & National Findings:

In 2017, 1 in 10 babies was born preterm in North Carolina. Compared with singleton births, multiple births in North Carolina were 7 times as likely to be preterm in 2015.  

 (March of Dimes, 2019)

In 2015, preterm birth and low birth weight accounted for about 17% of infant deaths. Babies who survive may have breathing problems, feeding difficulties, cerebral palsy, developmental delay, vision or hearing problems.

(CDC, 2018)

The Institute of Medicine estimates that the annual economic cost (medical, educational, and lost productivity) associated with preterm birth is over $26 billion in direct and indirect costs.

(Institute of Medicine, 2007)

What did the region say is the story behind the preterm birth numbers?

Source: WNCHN - Online Key Informant Survey, 2018

 The items below are paraphrased themes that emerged from a 2018 regional survey of key informants. These responses do not necessarily:

    •Reflect accurate or scientifically validated information about health determinants, outcomes, and/or strategies for change, 
    •Represent an exhaustive list of factors that can help or hurt efforts to address this key regional health issue.
The information in this section should be interpreted and used with care. It should be used only to help local health departments and agencies begin to understand community perceptions about local health issues. Communities are strongly encouraged to collect their own, local-level data to inform local planning and evaluation activities.

“Focus on pregnancy medical home, appropriate care for pregnant women, use of [local care management and federally funded programs].” 

“[A local program] does a great job working with at risk families to ensure infant and child health.” 

“Absence of a birthing center. Lack of physicians who do wellness and birthing practices for expectant mothers. Lack of education for women living in poverty around healthy prenatal care. Drug addiction.” 

“Lack of financial support at the state and local level prevent the expansion of health department and school health services.” 

How is the region prioritizing this issue?

The western North Carolina region includes 17 communities: 16 counties and Eastern Band of Cherokee Indians (EBCI)

In the 2018 community health assessment cycle, 2 communities chose a priority related to birth outcomes & infant morality and perinatal & early child health.

Learn more about how counties in western North Carolina work to determine their local community health priorities by watching the video (right). 

What is already happening regionally?

The list below represents a sample of what is happening in the region around this key health issue. Visit www.nc211.org for more resources. 

Preconception Health Screening Tool (MAHEC, March of Dimes, and the Duke Foundation) 

UNC/MAHEC Academic Partnership Award 

Project CARA (Care that Advocates Respect/Resilience/Recovery for All) (MAHEC, through partnerships with Mission, ADACT, Women’s Recovery, DSS, Patient Advocates)


Preconception Health Program (Fullerton Genetics Center, Mission Hospital)


Mother to Baby Program (Fullerton Genetics Center, Mission Hospital)

Sexual health and education in schools (Youth Empowered Solutions (YES!))

Regional maternal-fetal medicine high-risk pregnancy provider (MAHEC)

Centering pregnancy program (MAHEC)

Community Doulas (Sistas Caring 4 Sistas and MAHEC)

Rural maternal research fellowship (Buncombe and McDowell counties) (MAHEC)


The regional dataset (WNC Healthy Impact Community Health Survey and Online Key Informant Survey) is available thanks to contributions from hospitals in the 16-county region of western North Carolina. Thank you!