Walk through an old graveyard, and you’ll see an unthinkable number of graves in which the two listed dates are less than a year apart. In the early 1900s, as many as one or two of every ten babies born could be expected not to make it to their first birthday.
In the century since, modern medicine, vaccines, sanitation, and other developments have helped us decrease this rate drastically, to fewer than seven deaths for every 1,000 babies born. Now, though, those numbers are rising again, and one state has declared a health crisis.
The Mississippi State Department of Health has plans to turn things around if cooperation is available to do so.
Mississippi’s State Health Officer Issues A Statement
By 2011, the Centers for Disease Control (CDC) was reporting that the nationwide infant death rate (defined as the number of babies that die before their first birthday) had fallen from about 100 in every 1,000 births to 6.89 since 1900.
Unfortunately, these numbers aren’t consistent, and the CDC acknowledged at that time that infant mortality was still higher for babies born to Black, Native American, and Puerto Rican mothers compared to those born to white women. The agency also recognized that income inequality and access to healthcare are significant factors.
Now, Mississippi’s Department of Health (MSDH) says the state’s infant mortality rate has risen to 9.7 deaths in every 1,000 births, and is citing some of the same contributing factors. State Health Officer Dr. Dan Edney said:
“Improving maternal health is the best way to reduce infant mortality. That means better access to prenatal and postpartum care, stronger community support and more resources for moms and babies. Healthy women of childbearing age are more likely to have healthy pregnancies, which in turn lead to healthier babies.”
Leading Causes Of Infant Death
In Mississippi, the leading causes of death to children under a year of age include congenital malformations, preterm birth, low birth weight, and Sudden Infant Death Syndrome (SIDS). (Nationwide, these also top the CDC‘s list, followed by accidental deaths such as car crashes, and pregnancy complications.)
That’s why the MSDH hopes that a robust effort to improve maternal health will also improve infant health and bring infant mortality back down. Dr. Edney explained:
“We cannot and will not accept these numbers as our reality. Declaring this a public health emergency is more than a policy decision; it is an urgent commitment to save lives. Mississippi has the knowledge, the resources and the resilience to change this story. It will take all of us — policymakers, healthcare providers, communities and families — working together to give every child the chance to live, thrive and celebrate their first birthday.”
Six Specific Measures To Improve Outcomes
The MSDH cited 6 changes they hope will help save the lives of babies.
Eliminating “OB deserts,” or areas where there is no obstetric care available, is a key way to make sure that pregnant women aren’t being made unsafe by a lack of care in their area. (Nationwide, the March of Dimes reports that more than a third of counties in the U.S. lack maternity care, with no hospitals, birthing centers, or doctors offering obstetric care.)
The MSDH plans to activate an OB System of Care to standardize care across the state’s regions and improve transfer processes for various levels of care. This will help ensure that women with high-risk pregnancies can make it to facilities that provide the needed services.
A program called Healthy Moms, Healthy Babies already exists, and a proposed expansion would make home health visits more accessible for pregnant women and at-risk infants. This helps ensure that families in need are connected to available resources.
The department also hopes to increase community health worker programs that help connect families to resources.
Increasing education about Sudden Infant Death Syndrome, or SIDS, and the safe sleep practices that decrease the risk, is another key part of the plan. Breastfeeding, avoiding exposure to tobacco smoke, and following safe sleep practices are all recommended by the MSDH (and other health entities) to make babies safer.
Finally, the state hopes to partner with hospitals, birthing centers, and obstetricians to reinforce the importance of prenatal care and to fill gaps in accessibility.
The Rise In Infant Mortality Isn’t Just In Mississippi
While Mississippi’s Department of Health is working to address the problem before national statistics are released later this year, the issue isn’t limited to one state.
In Texas, for instance, Johns Hopkins University reports that infant deaths rose by almost 13% after the passage of strict laws preventing abortions. Specifically, deaths due to congenital abnormalities, including health problems discovered later in pregnancy, increased drastically.
“In an analysis of cause of death using all 2021 and 2022 death certificate data, the researchers found that Texas had atypical increases in infant deaths due to congenital anomalies, the leading cause of infant death. Infant deaths attributable to congenital anomalies increased 22.9 percent in Texas between 2021 and 2022 versus a decrease of 3.1 percent in the rest of the U.S. during the same period.”
Mississippi has also passed new, stricter laws limiting access to abortion care. A study released in JAMA earlier this year found that, on the whole, states that passed strict abortion limits saw rises in infant mortality. In contrast, the overall infant mortality levels in the U.S. continue to fall, according to the CDC’s statistics.
One factor in this is that some obstetricians have left areas where they fear prosecution if they recommend termination of a pregnancy due to fetal defects, and fear neglecting patients’ needs if they don’t recommend one where they see it as the best option.
A separate concern is that vaccines have contributed significantly to the fall in infant mortality over the past 125 years. Antivax sentiments on the rise may also be a contributing factor to the increase in infant mortality in some areas.
What Should Parents & Communities Do?
Pregnant women should seek comprehensive prenatal care, and families and communities should continue fighting for better access to necessary care.
We should all work to improve access to care in our families, communities, and states, and acknowledge with compassion that there are areas and individuals with limited or no access to care.
We should all be fighting to increase health education around topics regarding healthy pregnancies, infant safety, and vaccination, and to combat disinformation.
There will only be a solution if we work for one together.