With 29,000 babies born each year in the St. Louis metropolitan area, pregnancy and prenatal issues are significant community concerns.  As a major urban hub, St. Louis is simultaneously home to some of the best and worst examples of perinatal health.  For example, St. Louis Children’s Hospital, which ranks 11th nationally in Neonatal Care (US News and World Report), resides in the 63110 ZIP Code, where the rate of inadequate prenatal care is 3.8 times the national average, and the infant mortality rate is 3.5 times the national average.

Every year 4,500 babies are born too early or too small in the St. Louis region and approximately 300 babies die before their first birthday.¹ Prenatal care and pregnancy outcomes are affected by a variety of factors regarding the mother’s physical and mental health, her behavior and health habits, and the characteristics of the family and culture into which the child is born.  Some of the predominant factors affecting pregnancy outcomes are:

• Breastfeeding
• Maternal Behavioral Health
• Parent Education, including safe sleep practices
• Preconception Care, Prenatal Care and newborn doctors visits
• Pregnancy Prevention
• Pregnancy Risks: disease, low birth weight, premature birth, etc.
• Substance Use
• Teen Pregnancy and Teen Parents
• Unintended Pregnancy

The Local “At Risk” Population

A large majority of St. Louis metro area births occur to moderate to middle income families and are uncomplicated by birth defect, disease or family hardship.  Certain at-risk groups, however, face far greater obstacles.  The following factors have a significant impact on St. Louis pregnancies and births.

Geographic Concerns – Poor birth outcomes, such as low birth weight, inadequate prenatal care and higher infant mortality rates are associated with certain geographical areas. The ZIP Codes most affected by these indicators are generally found in mid to north St. Louis City, north St. Louis County, and some urban ZIP Codes in East St. Louis, IL.

Racial and Ethnic Disparity – in the St. Louis region, births to African American women are disproportionately more likely to result in poor outcomes.  “African Americans are almost twice as likely to have a child with low birth weight, and 2.7 times more likely to receive no prenatal care.”²

Other risk factors include low socio-economic status of the parents and family system, single parenthood, and low educational achievement among parents.  Age of the parents is also a factor; very young parents are less likely to have monetary and social independence, and older parents are at an increased risk of having pregnancy and birth complications, and of having children with certain health issues and special needs.

Behavioral health habits also affect outcomes.  Risk factors include tobacco, alcohol and substance abuse, obesity, poor nutrition, lack of physical exercise and untreated health concerns such as diabetes and high blood pressure.

Data and statistics on local birth outcomes can be found through the following online databases:

• IL DPH, Health Statistics
• MO DHSS, Community Data Profiles.  County and state-level data on a variety of perinatal and related indicators
• MO DHSS, MICA.  ZIP code level data on birth indicators, Missouri Information for Community Assessment)
• PeriStats.  State-level birth data, including pregnant women who smoked, infant mortality rates, birth rates, etc.

The St. Louis area has a large work force of professionals in hospitals and clinics that provide prenatal care and pregnancy-related services.  There is a smaller group of health centers and clinics that work specifically with at-risk patients, such as Grace Hill and Myrtle Hilliard Davis health centers.  Within the City of St. Louis, Barnes Jewish Hospital delivers the majority of babies who’s families are covered by Medicaid.

Organizations and Groups Addressing Pregnancy-Related Issues in St. Louis

There are a few small non-profit organizations that target the at-risk population in the perinatal arena.  The Maternal, Child & Family Health Coalition and the county health departments most actively deal with the public health concerns.  Nurses for Newborns and local Parents as Teachers groups provide at-home visits for mothers and their newborns.

Another local group of agencies provide supportive services to pregnant mothers.  State departments provide information, resources and a variety of services.  (See Key Stakeholders for a list of agencies and governmental offices that are actively addressing systemic issues of pregnancy and prenatal outcomes.)  Several local social service agencies provide services including case management, clothing and food pantries, shelters and group homes for teens, for the homeless and victims of domestic violence.  A group of local agencies specialize in services involving reproductive rights, unplanned pregnancy, pregnancy counseling, services for teens, and pregnancy prevention.

¹MCFHC (2009).  Investing in Healthy Mothers & Babies: Lessons Learned and New Directions.

²Health Department, City of St. Louis.  (April 20, 2010).  Newsgram:  Health Disparities: What is the Health Department Doing to Reduce Them? Accessed on 4/20/10.

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