Kentucky's premature birth rate is slowly declining, but it still falls above the national average, according to a report released Thursday.
The report, called the March of Dimes Premature Birth Rate Report Card, gave Kentucky a "C" grade.
The state's premature birth rate was 12.6 percent in 2013; in 2012 it was 12.7 percent.
The national rate in 2013 was 11.5 percent.
"Although our rates are dropping and dropping very, very slowly, it's still an issue we need to continue to address. I believe that everyone is working and looking at getting that prematurity rate down," said Katrina Smith, director of program services for the Kentucky March of Dimes.
The report said 21.6 percent of women in Kentucky are uninsured, which can contribute to pregnant women not receiving the prenatal and postpartum care necessary to identify and manage conditions that contribute to premature birth.
"If a woman is uninsured, she is far less likely to go to her physician early," Smith said.
"She is far less likely go to the physician of her choosing and she is less likely to look for a physician or doctor's office that will take her payments if she doesn't have insurance. It affects a lot of things but particularly her entrance into prenatal care."
The percentage of women smokers decreased from 32.7 percent in 2012 to 30.8 percent last year. Smoking during pregnancy can cause preterm births or low birth weight, making it more likely the baby will be sick and have to stay in the hospital longer, according to the Centers for Disease Control and Prevention.
The report also broke down racial disparities in preterm birth rates. Blacks in Kentucky had the highest rate of preterm births at 16.7 percent; the preterm birth rate for whites was 12.4 percent; Hispanics it was 11.5 percent; and for Asians it was 10.4 percent.
The rate of late preterm births—babies born between 34 and 36 weeks—remained the same at 8.9 percent.The United States also received a "C" on the report card, and still has the highest rate of preterm births of any high-resource nation, according to the report.
"Part of the problem has been that many women elect to have an early birth through caesarian section or induction," Smith said. "That's one of the things that we really work on is to teach women that a normal pregnancy is 39 to 40 weeks and we don't want women asking their health care provider to certainly deliver the baby anytime before that unless there is a medical reason for that."
Smith would like hospitals to adopt a "hard stop policy" that would prohibit any early elective deliveries unless there is medical necessity.
A previous version of this story misstated where Kentucky's premature birth rate falls in relation to the national average.
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