October commemorates Sudden Infant Death Syndrome (SIDS) Awareness Month and Pregnancy and Infant Loss Awareness Month. Historically, Indiana has had a higher-than-average infant mortality rate (IMR) that can vary based on socioeconomic factors, like race, income and geographic location. For example, the Indiana Department of Health (IDOH) reports that the IMR for white infants was 6 per 1,000 live births in 2019, while the IMR for Black infants was 11 per 1,000 live births. Based on these numbers, 50 additional Black infants would have survived in 2019 if Black and white infants had the same IMR.
In honor of this important month, Dr. Cameual Wright, vice president and market chief medical officer of CareSource, a nationally recognized nonprofit health plan, is sharing information on how Hoosier mothers can ensure a healthy pregnancy.
Importance of prenatal care
The IDOH’s Maternal Mortality Review Committee reported that of all pregnancy-associated deaths in 2018, only 44.4% of women had access to prenatal care in the first trimester of their pregnancy. Factors that can impact a woman’s ability to access prenatal care can include income, insurance coverage, location of prenatal care facilities and other social factors. The same IDOH committee also reported that there are 33 counties in Indiana that are considered maternal care deserts, which are counties that lack easy access to maternity health services.
According to the U.S. Office on Women’s Health, babies of women who don’t receive prenatal care are three times more likely to have a low birth weight and five times more likely to die. In 2020, The The United Health Foundation reported that there was a 6.6% difference between the minority group with the highest percentage of infants with low birthweight and white infants with low birthweight. The same report cited in 2020, only 78% of women who had a live birth had adequate prenatal care in the first four months of pregnancy. Women should make routine visits to their doctor’s office to monitor their health and wellness throughout their pregnancy.
How to create a safe sleep area for your baby
According to the Centers for Disease Control and Prevention (CDC), sudden unexpected infant death (SUID) is “a term used to describe the sudden and unexpected death of a baby less than one year old in which the cause was not obvious before investigation.” Many of these deaths happen during the infant’s sleep or in their sleeping area. Types of SUID incidents can include SIDS, accidental suffocation or strangulation in a sleep area and unknown causes.
The IDOH reports that the state’s SIDS rate is 14.9 per 1,000 live births higher than the U.S. average. Across the nation, SUID rates for American Indian/Alaskan Native infants and non-Hispanic Black infants were more than double the rates for non-Hispanic white infants. Parents and caregivers can help create a safe sleep environment by observing the CDC’s following tips:
- Always place the baby on their back during sleep time and avoid stomach or side sleeping.
- Use a firm, flat sleep surface covered with only a fitted sheet to reduce the risk of sleep suffocation and SIDS.
- Keep your baby’s sleep area in the same room where you sleep until the baby is six to 12 months old. Sharing a room may decrease the risk of SIDS by 50%.
- Keep soft bedding, like pillows, blankets and stuffed animals out of the baby’s sleep area to avoid suffocation.
Gov. Eric Holcomb reported that in 2019, Indiana saw its lowest IMR in over a century. The state’s IMR fell from 6.8 to 6.5 per 1,000 live births, and the IMR for Black infants decreased from 13 to 11 per 1,000 births. The number of infants who died before their first birthdays in Indiana also decreased from 559 to 527 per year, a number even lower than the 602 infant deaths in 2017. These statistics are very encouraging, however there is still much work to be done.
At CareSource, we encourage all mothers to connect with our case managers who work side by side with them through their pregnancy to provide education and coordinate care. Through our Babies First program, we provide incentives for obtaining recommended prenatal care, well-child care, immunizations and lead testing. We are also partnering with the state of Indiana on the My Healthy Baby Program, which identifies women early in pregnancy and connects them with an OB Navigator, who provides face-to-face, personalized support to a woman during pregnancy and the first few months of her baby’s life. In addition, we are supporting the Indiana Pregnancy Promise Program, which promotes recovery from opioid use by providing maternal and infant support. Despite an improved IMR, Indiana can still make significant strides to decrease health disparities in the state. The insights taken from the information above can guide new parents through this exciting, but often challenging time in their lives. CareSource believes we can all work together to keep moms and babies healthy in 2021 and beyond.
Dr. Cameual Wright is CareSource vice president and market chief medical officer.