NOTE: This column appeared in the April 1 edition of The Commercial Appeal.
Several weeks ago, a dozen babies gathered in our living room to celebrate my daughter's first birthday. It was a joyful afternoon of bubbles and balloons, singing and snacks -- the kinds of things all 1-year-olds should enjoy. Yet I know that in the Mid-South, many infants -- children who could have been my daughter's peers -- never make it to their first birthday.
What makes this sad fact more distressing is that we know what it takes to give children the best opportunity to survive -- proper vitamins and diet for the mother during pregnancy, prenatal health care, regular pediatric visits after birth, and careful attention to the tiny details through which babies send us signals about their health, hunger and happiness. Yet we do not do an adequate job of delivering the necessary information and services to the pregnant women whose children are most at risk.
The tragically high infant mortality rate in and around Memphis has been well documented. In 2005, Memphis had the highest infant mortality rate among the 60 largest American cities, a rate of 14 infant deaths per 1,000 births, twice the national average. In some of the poorest pockets of our community, the infant mortality rates are on par with those of several Third World countries. Statewide, Tennessee ranks 48th and the rates in Hardeman, Shelby, Tipton and Haywood counties are the worst in the state. Last month, this newspaper reported that the infant mortality rate in Mississippi, already the worst in the country, is rising, particularly in the Delta communities along U.S. 61. In the Mid-South, more human beings die each year before their first birthday than from homicides, even though we know the tools necessary to bring infant mortality rates down.
As a result of the notoriety born of such intolerable statistics, local and state leaders have pushed to make reducing infant mortality a top priority. Last spring, Tennessee Gov. Phil Bredesen and Shelby County Mayor A C Wharton convened a workshop aimed at decreasing infant mortality. The Tennessee Department of Health has set a goal of bringing the state infant mortality rate down to the national average by 2010. In addition, local and national organizations with experience in infant health are converging on Memphis. In March, the founder of the Birthing Project, a program that matches pregnant black teenagers with women trained to guide them through pregnancy and a child's first year, was in Memphis meeting with potential volunteers.
These initiatives are a start, but more must be done. Too many women do not see a doctor during their pregnancy until they enter the hospital for labor. They neglect to visit the doctor because they do not have health insurance or because they cannot get time off from work or because they do not know that regular doctor visits during pregnancy drastically reduce the risk of infant mortality.
Among pregnant women in Tennessee who received no prenatal care, the infant mortality rate is astronomical -- 46 infant deaths per 1,000 births. In 2005, infants born to mothers who first received prenatal care in the seventh month of pregnancy or later were twice as likely to die as those born to mothers who received care during the first trimester.
To give our community's most vulnerable the chance to survive their first year, we must remove all barriers to pregnant women receiving prenatal care early and often. This means providing health care coverage to all pregnant women and infants, a goal addressed by Bredesen's CoverKids program, slated to take effect today.
But coverage is only the first step -- all efforts must be made to ensure that covered individuals actually enroll in the new program and that sufficient numbers of doctors and health care facilities serve those in the highest-risk areas.
We know not only that these steps can lower the risk of infant mortality, but also which women need attention the most. In addition to behavioral activities like smoking or drinking while pregnant, increased risk of infant mortality is highly correlated to a pregnant mother's social traits, including poverty and lack of education. Unfortunately, infant mortality breaks along racial lines as well. In Tennessee in 2004, the infant mortality rate for African-American mothers was more than two and a half times higher than that of white mothers.
So we know the mothers whose babies are most at risk for infant mortality and we know what it takes to lower that risk. It is a matter of delivering the proper information and care to the right women at the right time. As a community, we must embrace maternal health and work to ensure that the information and services necessary to give women the best opportunity to give birth to a healthy child reach those women most at risk early in their pregnancies. We will not eliminate the tragedy of infant mortality, but we must do better at protecting our most vulnerable.
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