SEATTLE — Premature birth rates in the Pacific Northwest are among the lowest in the nation, but the March of Dimes says that only earns Washington, Oregon, Idaho and Alaska C’s on the organization’s premature birth report card.

Oregon has the lowest rate of premature births in the region — 10.3 percent — and that gives it the third lowest rate in the nation after Vermont and New Hampshire, according to the March of Dimes 2009 Premature Birth Report Card, which was released late Monday.

Also among the states with the lowest premature birth rates were Alaska with a rate of 10.4 percent, Idaho at 10.5 percent and Washington at 10.6 percent.

The national goal is 7.6 percent of live births by 2010. The United States earned a D grade this year with an average of 12.7 percent.

The organization can’t point to one factor that gives the Pacific Northwest an edge over states in the Midwest and South, said Elaine Noonan, state director for March of Dimes’ Washington chapter.

“Preterm birth is a common and complex problem with many contributing factors,” she said.

In Washington, state officials have made a strong effort to help women stop smoking. Idaho, which showed the most improvement in the Pacific Northwest, has the second lowest cesarean section rate in the nation, and its report card grade improved from a D to a C this year.

Earlier this year, the Oregon Legislature approved a bill extending Oregon’s smoking cessation program, and March of Dimes officials in that state are hopeful that premature-birth numbers will go down as a result.

Noonan expressed concerns that the Washington Legislature cut money for its stop-smoking program earlier this year.

Every state could improve women’s access to health insurance, she added. In Washington, 15 percent of women of childbearing age have no insurance. That number is over 20 percent in the other Pacific Northwest states.

Information and education are both key to preventing premature births.

After losing their first child, Blake, who died after being born 13 weeks premature with multiple health problems, Jill and John Johnston of Bainbridge Island weren’t sure if they wanted to try again to start a family.

But Jill said she changed her mind after attending a March of Dimes event and picking up a brochure about a program at the University of Washington Medical Center for preventing premature birth.

She met with a doctor at the university who said they could have a better outcome if she worked with a specialist for prematurity.

“After a consultation there we felt a little more hopeful,” Jill said.

Her second pregnancy ran into trouble at 23 weeks. But because she was being monitored weekly by the UW doctors, they were able to do a minor medical procedure. And after 13 weeks on strict bed rest, Jill gave birth to a healthy daughter, Rachel.

While doing volunteer work for the March of Dimes, Jill saw one of the nurses she worked with while pregnant with Rachel. The nurse told her about a new progesterone treatment that seemed to help prevent premature births.

Thanks to that information, Jill’s third pregnancy went smoothly, and she and John had another healthy daughter, Gretchen.

“I had a totally nonexciting, full-term pregnancy,” Jill said, adding that her family feels complete at four. “If we wanted another, I would feel much more confident about it because the last one went so well.”