It’s no secret that Indiana’s infant mortality rates are historically high compared to the rest of the U.S. In fact, in 2017, Indiana experienced the seventh highest infant mortality rate in the nation, according to the Centers for Disease Control and Prevention (CDC). A report by the Indiana State Department of Health (ISDH) revealed that if Indiana had the same infant mortality rate as the U.S., 125 more babies would have survived in 2017.
We also know these numbers are significantly worse for minority populations, as social determinants of health play a major role in obtaining proper prenatal health. Social determinants of health are social issues that make it difficult for people to engage in the health care system in order to experience optimal outcomes. The ISDH report also revealed in 2017 the infant mortality rate for white infants was 5.9 per 1,000 live births, compared to Black infants experiencing 15.3 deaths per 1,000. If Black infants had the same infant mortality rate as white infants, 101 additional Black infants would have survived in 2017.
Additionally, maintaining proper health is only magnified by the COVID-19 pandemic. With October being Pregnancy and Infant Loss Awareness Month, as well as Sudden Infant Death Syndrome (SIDS) Awareness Month, Dr. Cameual Wright, the medical director for CareSource, a nationally recognized nonprofit health plan, is sharing information on how to combat these numbers and ensure a healthy pregnancy.
1. Raise awareness of and address health disparities
As mentioned, the infant mortality rate for Black babies is two to three times that of white babies. The reasons for this vary, but the majority of the problems are centered around social determinants of health. If an expecting mother is dealing with food or housing insecurity or unemployment, this creates competing priorities. Mothers are then less likely to achieve proper prenatal care and attend all-important appointments. Transportation can also be an issue. Because of this, at CareSource, we passed a new benefit allowing unlimited free transportation to and from the Neonatal Intensive Care Unit (NICU) to help facilitate early attachment and bonding between mothers and their newborns.
Geographic locations are also a concern and create a lack of access to proper care. In Indiana, 33 counties are considered maternal care deserts, as these counties do not have OBGYN providers. Preterm delivery rates are also much higher in Black pregnancies. In fact, according to a 2019 March of Dimes report, in Indiana, the preterm birth rate among Black women was 41% higher than the rate among all other women.
We need to raise awareness around these disparities and ultimately address them by creating additional social services that handle these concerns. Accessibility to proper providers needs to be considered, as well as adequate representation among providers, so mothers feel comfortable with a medical professional who understands their culture and their needs.
2. Maintain proper prenatal care, despite COVID-19 concerns
Receiving prenatal care is one of the most important aspects to maintaining a healthy pregnancy. Early in the pregnancy, doctors can recognize if the mother is exhibiting any symptoms or problems. Discovering preexisting health conditions early in your pregnancy or even before you are pregnant can significantly impact your delivery. Expecting mothers should also take prenatal vitamins with plenty of folic acid.
It is critical to keep up with your prenatal care appointments, despite COVID-19 concerns. Talk with your provider about telemedicine options, particularly if you’re having problems with transportation or getting off work to make appointment times.
3. Avoid negative behavior and focus on building good habits
According to an ISDH report, the rate of Indiana mothers who reported smoking during pregnancy is at 16.6%, which is considerably higher than the national average of 9.1%. Avoiding negative behavior such as smoking during pregnancy is key to delivering a healthy baby, as smoking increases the risk of infertility, preterm delivery, stillbirth, low birth weight babies and SIDS. At CareSource, we cover tobacco cessation products and have resources to help those looking to quit find the proper services. Additionally, pregnant women who are struggling with opioid abuse should seek treatment and speak with their provider about strategies for recovery.
Focus on building good habits, such as breastfeeding. It’s important to discuss this during pregnancy and to find out if you’re able to breastfeed in order to set you and your baby up for success. Women should also maintain proper nutrition and remain active throughout their pregnancy.
At CareSource, we encourage mothers to connect with our case management workers, as they can work side by side with you through your pregnancy. We are also partnering with the state of Indiana on the OB Navigator Project, which identifies women early in pregnancy and connects them with an OB Navigator, a home visitor who provides personalized support to a woman during pregnancy and the first few months of her baby’s life.
Gov. Eric Holcomb has challenged Indiana to achieve the lowest infant mortality rate in the Midwest by 2024. If we can significantly address health disparities, educate the public about the importance of prenatal care, and curb unhealthy habits, we can work toward saving 200 babies a year.
Dr. Cameual Wright is the medical director CareSource Indiana.