Preterm Birth Rose for Black Mothers in 2024. Here Is What Helps

CDC's National Center for Health Statistics released its final count of 2024 U.S. births on June 9, 2026. One line in that report matters most for Black families: "The preterm birth rate increased for Black mothers from 2023 to 2024 (14.65% to 14.86%)." It did not change significantly for any other group.

Preterm means born before 37 completed weeks of pregnancy. In 2024, 473,377 babies were born to Black mothers, and 70,231 of them came early. That is about 1 in 7 (our arithmetic from the report's table). Of those, 22,913 were born before 34 weeks, the stage the report calls early preterm. For all U.S. births combined, the preterm rate held steady at 10.41%.

Low birthweight (under 5 pounds, 8 ounces) also rose for babies born to Black mothers, from 14.80% to 15.01%. The preterm rate for Black mothers has climbed from 13.77% in 2016 to 14.86% in 2024.

Many preterm births happen to people with no known risk factor, and CDC says race is not a biological cause of these differences. The steps below come from federal guidance and from ob-gyns.

CDC's first prevention steps for preterm birth are simple: "Get prenatal care early and throughout pregnancy," and "Talk with your doctor if you had a previous preterm birth." Your first visit is also where your clinician takes your history and decides whether you are at high risk for preeclampsia, which is the trigger for aspirin (more below).

If cost or coverage is what is holding you back, start there. Medicaid paid for 62.4% of births to Black mothers in 2024. Our state Medicaid guides list your state's income limit for pregnancy, how long coverage lasts after birth, and the phone line to apply. No ob-gyn yet? Search our directory of Black clinicians, or start at Get started.

The American College of Obstetricians and Gynecologists (ACOG) lists these signs and symptoms of preterm labor:

• Mild belly cramps, with or without diarrhea
• A change in vaginal discharge: watery, bloody, or with mucus
• More discharge than usual
• Pressure in your pelvis or lower belly
• A constant, low, dull backache
• Regular or frequent contractions or tightening of the uterus, often painless
• Your water breaks, with a gush or a trickle of fluid

Those medicines are why speed matters. ACOG says corticosteroids "can help speed up development of the fetus's lungs, brain, and digestive organs." Magnesium sulfate, given before 32 weeks, "may reduce the risk of cerebral palsy." Other drugs can delay delivery, sometimes for up to 48 hours, to make time for those treatments.

The U.S. Preventive Services Task Force (USPSTF) recommends "the use of low-dose aspirin (81 mg/day) as preventive medication after 12 weeks of gestation in persons who are at high risk for preeclampsia." The task force calls preeclampsia "one of the most serious health problems that affect pregnant persons," and it accounts for 19% of preterm births that doctors start early for medical reasons. The task force found aspirin lowered the risk of preterm birth too, by about 20% in people at increased risk, and trials did not show harm from daily low-dose aspirin.

You are at high risk if you have one or more of these: preeclampsia in a past pregnancy, twins or more, chronic high blood pressure, type 1 or type 2 diabetes before pregnancy, kidney disease, or an autoimmune disease such as lupus. Clinicians may also count a combination of moderate risk factors, such as a first pregnancy, a body mass index over 30, a mother or sister who had preeclampsia, being 35 or older, or lower income.

The task force adds that Black people face higher risk "due to environmental, social, and historical inequities," not biology. Ask at your first visit whether aspirin is right for you, and take it as prescribed rather than starting on your own.

Our guide to preeclampsia warning signs covers the condition in more detail.

If you had high blood pressure before pregnancy, treatment now starts sooner than it used to. In a 2022 trial of 2,408 pregnant women with mild chronic hypertension, nearly half of them Black, treating blood pressure at 140/90 instead of waiting for 160/105 lowered a combined measure of serious problems from 37.0% to 30.2%. Preterm birth fell from 31.4% to 27.5%, and the share of small-for-age babies did not rise significantly (Tita et al., New England Journal of Medicine). ACOG now recommends 140/90 as the point to start or adjust medicine during pregnancy.

If you already take blood pressure medicine, do not stop it on your own when you find out you are pregnant. ACOG says people on these medicines at the start of pregnancy can usually stay on them. Ask your clinician whether your current drug is one used in pregnancy.

CDC says women and their partners can lower the risk of preterm birth if they "wait at least 18 months between pregnancies." Ask about birth control at your postpartum visit, or before you leave the hospital.

A past preterm birth is a significant risk factor. ACOG says women with a past preterm birth "are 2 to 3 times more likely to deliver preterm in the future." Tell every new clinician about it at your first visit.

Two treatments may help. Vaginal progesterone, a daily gel or suppository, may be given if an ultrasound before 24 weeks shows a short cervix. Cerclage, a stitch that closes the cervix, may be done if you have a short cervix and a past preterm birth. ACOG also says bed rest is not recommended, because it can raise the risk of blood clots and weaken bones and muscles.

You may have heard of hormone shots called Makena (17-OHP, or hydroxyprogesterone caproate). The FDA withdrew approval of Makena and its generics on April 6, 2023, because they "are not shown to be effective for reducing the risk of preterm birth." The FDA looked at Black women specifically and found the drug "is not shown to be effective in Black women," or in any other group.

A doula gives physical, emotional, and informational support before, during, and after birth. A Cochrane review of 26 trials found that continuous one-on-one support during labor was linked to more spontaneous vaginal births, fewer cesarean births, shorter labors, and fewer negative feelings about the birth. The review rated the evidence for each of those results as low quality. A 2026 review of doula trials in JAMA Network Open found the most consistent benefits for lower maternal anxiety, more postpartum follow-up, and more breastfeeding at the start, while evidence on cesarean birth "was more variable." Trials that measured preterm birth "generally reported no differences between groups."

So a doula can make birth better supported and help you speak up when something feels wrong, but the trials do not show that a doula prevents preterm birth. Whether Medicaid pays for a doula depends on your state. Each of our state Medicaid guides has a doula coverage page, for example Maryland, and you can find a Black doula in our directory.

In 2024, 47.3% of Black mothers got food for themselves from WIC during pregnancy, according to the same CDC report. WIC is the federal Special Supplemental Nutrition Program for Women, Infants, and Children. If you are on Medicaid, federal rules count you as meeting WIC's income test. Our WIC guide explains who qualifies and links to every state's program. Your state's Medicaid pregnancy page, such as the one for Georgia, lists the income limit and how to apply.

USDA's WIC program marks November as National Prematurity Awareness Month. World Prematurity Day now falls on November 15: the World Health Organization added it to its official calendar in 2025 and moved it from the traditional November 17 date to avoid overlapping other world days. This month, book that first prenatal visit, or ask about aspirin at the next one.