The month of October sheds light on issues related to infant mortality as we recognize National Pregnancy and Infant Loss Month. In Indiana, the infant mortality rate (IMR) is 20% higher than the national average, according to Indiana University School of Medicine. Factors that contribute to this are socioeconomic background, income, race, geographic location and many others. While rates have improved from past years, Indiana and the rest of the U.S. have work to do in order to get IMR rates down significantly.

Raising awareness

It is no question that infant mortality is an issue plaguing the health care system in the U.S. According to the Centers for Disease Control and Prevention (CDC), almost 20,000 babies died before their first birthday in 2020. The causes of this range from Sudden Infant Death Syndrome (SIDS) to prenatal risks and preterm birth, all of which Indiana University School of Medicine reports as the causes for half of infant mortalities in Indiana and nationally.

Not only are these statistics concerning, but how this disproportionately affects race shows a need for improvement within the health care system. For example, the Indiana Department of Health (IDOH) reports that the IMR for white infants was 5.5 per 1,000 live births in 2020, while the IMR for Black infants was 13.2 per 1,000 live births. 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.

Emphasis on prenatal care

According to the IDOH’s Maternal Mortality Review Committee (MMRC), for pregnancy-associated deaths in 2020 in Indiana, only 50% of the women accessed prenatal care starting in the first trimester of their pregnancy. This shows the significance of adequate prenatal care as it encourages pregnant women to monitor their health, become informed of steps they can take to protect both their infant and themselves and ultimately identify high-risk pregnancies that require more care early on. Barriers that may prevent women from receiving prenatal care are high health care costs, transportation, quality care availability, lack of child care and other social factors. The same IDOH committee and the Indiana Hospital Association (IHA) reported that in 2020, there were 34 counties in Indiana categorized as maternal care deserts, meaning they lack a hospital with inpatient delivery services.

As stated, there are many factors that prevent mothers from accessing proper prenatal care starting in their first trimester. However, placing an emphasis on quality care during pregnancy can save lives – these doctor visits have the ability to catch the signs and symptoms of high-risk pregnancies early on to prevent further complications. Talk with your health care provider about prenatal care options as well as appointment times to ensure a safe and healthy pregnancy for both infant and mother.

Looking ahead: Importance of advocating for health

These statistics reflect the realities of pregnancy and infant loss in Indiana and across the U.S. However, combating this with awareness of the issue and how it impacts a wide range of demographics differently within the health care system is one step towards change. Along with this, prenatal care plays an enormous role in catching the signs and symptoms of high-risk pregnancies early on before complications arise. These preventative measures, along with advocating for one’s health at all times, are a few ways to ensure healthy moms and babies during pregnancy and post-birth.

As Indiana and the U.S. push for change to lower the numbers relating to pregnancy and infant loss, there is hope in the fact that there are steps to take to prevent maternal mortality, just like infant mortality. The Indiana MMRC reports 79.3% of pregnancy-associated deaths were deemed preventable in 2020. Lowering the rates of both maternal and infant mortality are goals that are in reach.

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. Our Babies First Program provides incentives for obtaining recommended prenatal care, well-child care, immunizations and lead testing. We also recently partnered with the Indiana University Richard M. Fairbanks School of Public Health at IUPUI on a five-year grant to launch a housing equity initiative to work to reduce Indianapolis’ infant mortality rate by addressing housing, a key social determinant of poor infant health.

Additionally, we are partnering with the state of Indiana on the My Healthy Baby Program, which connects women early in pregnancy with an OB Navigator, who provides them with personalized support during pregnancy and post-partum. Along with this, we are supporting the Indiana Pregnancy Promise Program to promote recovery from opioid use by providing maternal and infant support. By taking preventative steps to ensure healthy pregnancies in Indiana and beyond as well as being a strong advocate for your health, CareSource believes we can all work together to keep moms and babies healthy this year and moving forward.

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