Maternal/Infant Care Under Construction in Indiana
The death of an infant is devastating for parents, family members and the community as a whole and the rates of these incidents continue to rise for the State of Indiana. According to the Indiana University School of Medicine, Indiana ranks poorly at 40th out of 50 in the United States for infant mortality. According to the research, over the past 10 years, the United States infant mortality rate has improved from 6.5 to 5.9 deaths per 1,000 live births. Although Indiana’s infant mortality rate has decreased, it remains above the national average (6.75 per 1,000 live births) despite community efforts and targeted programs created to address this overwhelming issue. There is more work to be done at the policy and systems level to continue improving these rates.
Infant mortality is a complex issue with many different causes. The leading cause nationally and in Indiana is perinatal risks and premature births, which account for 48% of the infant deaths. The other causes of infant mortality are related to Sudden Unexplained Infant Death (SUID), congenital malformations, assaults and accidents, and other causes, including infections. There is also a significant difference that persists in infant mortality among different racial and ethnic groups, especially Black babies. Black infants are at greater risk of death than infants of other races, according to the United Health Foundation. In Indiana, the infant mortality rate for Black babies is higher than the state and national average at 13.2%. Additionally, disparities also exist based on geographic location. Out of the 92 Counties in Indiana, 32 Counties lack prenatal services for pregnant individuals. Furthermore, more than a quarter of all infant mortality cases in Indiana occur in 3% of the state’s zip codes, and half of these zip codes are in Marion County and in the underserved communities. For more specific information on a specific region of Indiana, visit the Indiana Department of Health: https://www.in.gov/health/mch/infant-and-maternal-health-data/data/.
As a response to this pressing issue, in 2018, Governor Eric Holcomb announced that his administration set a goal for Indiana to reduce its infant mortality rate to be the lowest in the Midwest states by 2024. In other words, Governor Holcomb would like for Indiana to become the “Best in the Midwest by 2024” improving our infant mortality rate. In response to this challenge, the Indiana University School of Medicine has partnered with key clinical teams, including Eskenazi Health and IU Health, to develop innovative approaches to address this crisis.
In addition, the Indiana Department of Health created the Safety PIN (Protecting Indiana’s Newborns) grant program, which has allowed Indiana Department of Health to develop and execute a statewide strategy to implement safe sleep practices programs in hospitals throughout the state and create the INspire Hospital of Distinction recognition program.
This program was developed to encourage hospitals to implement best practice care for our Hoosier mothers and babies and recognizes hospitals for their excellence in addressing the 6 key drivers of maternal and infant health: infant safe sleep, breastfeeding, tobacco prevention and cessation, perinatal substance use, obstetric hemorrhage and maternal hypertension (Alliance for Innovation on Maternal Health (AIM) Patient Safety Bundles).
Indiana has taken additional strides to address the problem of infant mortality, which includes implementing programs like the Indiana Pregnancy Promise Program and the Labor of Love program. The Labor of Love program provides support to all pregnant people in Indiana and focuses on breastfeeding, early and regular prenatal care, safe sleep practices, and avoiding tobacco, drugs and alcohol before, during and after birth. The Indiana Pregnancy Promise Program is a free, voluntary program for pregnant Medicaid members or Medicaid members within 90 days of giving birth, who use opioids or have used opioids in the past. The program connects individuals to prenatal and postpartum care, other physical and mental health care, and treatment for opioid use disorder.
There has been considerable progress in the United States and Indiana in the past 50 years to reduce infant mortality. But there are still more bridges to build to eliminate disparities and ensure continued progress. Needed steps include improving timely access to health care providers, reducing tobacco and alcohol consumption, improving sleep practices, improving the socioeconomic status of pregnant people, and ensuring adequate nutrition before and during pregnancy. Although Indiana has improved the infant mortality rate overall, the road to improving the rates for Black babies still needs work as the disparities persist among this population. There is significant evidence that a statewide coordinated perinatal system of care will improve infant mortality and morbidity. It is important for our communities to come together and bridge the gap to ensure all babies born in Indiana have the best start in life.
It takes a Village to build this bridge!
Dr. Cameual Wright, Vice President,
Market Chief Medical Officer, CareSource Indiana
%20the%20infant%20mortality%20rate,deaths%20per%201000%20live%20births https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm https://www.in.gov/health/mch/files/2020-Infant-Mortality-Morbidity.pdf https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/IMR_MCH/state/IN https://www.ihaconnect.org/patientsafety/Initiatives/Pages/Reducing-Infant-Mortality-.aspx https://www.in.gov/health/mch/infant-and-maternal-health-data/data/
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