Local rate for infant deaths above state average

Maliaka English is hoping to bring her infant daughter, Isabella, home from the hospital for Christmas, still several weeks earlier than her expected due date.

Isabella is one of hundreds of babies born prematurely each year in Ohio, where a disproportionate number die before there first birthday, ranking Ohio among the Top 10 states with the highest infant mortality rates in the country.

RELATED: AREA HOSPITAL RANK WELL IN STATE RANKING

The number of infant deaths in Ohio increased from 955 in 2014 to 1,005 last year, or a mortality rate of 7.2 deaths per 1,000 live births, according to the most recent data from the Ohio Department of Health. By comparison, the U.S. infant mortality rate is 6.1 deaths per 1,000 live births.

The infant mortality rate is even higher in Montgomery County, where there were 50 infant deaths in 2015, or a death rate of 7.5 per 1,000 live births.

English, a 34-year-old social worker at Miami Valley Hospital, where she delivered her baby in September about 10 weeks early, said she was shocked to learn that she would be joining the list of mothers contributing to the sobering statistics in Ohio.

“Knowing the risk, it’s always in the forefront of your mind,” she said. “But I didn’t have any of the signs that would indicate an early delivery. I had an abrupted placenta, so my situation was kind of a freak accident.”

While English’s baby survived, she is among the group of women whose children are at the greatest risk of infant death. Nationally and locally, African-American women experience worse birth outcomes than any other major ethnic group.

RANKING: DOCTOR SCREENINGS INTENSIFY IN WAKE OF SEX ABUSE CASES

In Ohio, the infant mortality rate for black women — 15.1 deaths per 1,000 live births — has continued to climb over the past several years, and is nearly three times higher than the rate for white women, which was 5.5 deaths per 1,000 live births in 2015.

Health officials point to higher rates of poverty, less access to health care and higher rates of chronic diseases, such as obesity and diabetes, as reasons for higher infant death rates among black mothers.

But Dr. David McKenna — medical director of the perinatal care center at Miami Valley Hospital — said perhaps the most under-appreciated social determinant leading to premature births and infant deaths among black women is real and perceived racism.

“A lot of these women have stress throughout their entire life, and a lot of the stress is brought on by racism,” McKenna said. “That’s the reason why we see this big disparity between black woman and white women.”

English agrees, noting that perhaps the most prevalent byproduct of racism, segregated communities, is one of the biggest contributors to premature births and infant deaths among black women.

“There is research that shows women in impoverished, segregated communities did not have access to prenatal care before the Affordable Care Act,” English said, referring the federal health care law that President-elect Donald Trump has pledged to abolish. “So these women did not have the support or knowledge about prenatal care, and if you’re not getting prenatal care, then you’re open to all the risks associated with not having that care.”

RELATED: SEE HOW AREA HOSPITALS RANK

Despite the challenges, Ohio has made some progress in decreasing the overall number of pre-term births — or births before 37 weeks — which is the No. 1 contributor to infant deaths, McKenna said.

“We have made some improvements in decreasing the number of pre-term births in the state of Ohio by about a percentage point over the past 10 years,” he said. “If a woman has a baby that’s born premature, even if it makes it out of the intensive care unit at the time of delivery, it is at high risk of infant death”

Among the other proactive measures Miami Valley and other hospitals have taken to decrease premature births is to refrain from voluntary early induction at the mother’s request before babies reach full term.

“We used to be a lot more liberal in allowing them to deliver early, but we’ve found that that’s not really appropriate, and those babies do have problems,” McKenna said.

More doctors also are now using the hormone progesterone in early pregnancy, which has been shown to slightly reduce miscarriages and pre-term births.

And one of the newest strategies to address infant deaths is as old as child-birth itself — switching mothers from baby formula to breastfeeding, which has been shown to cut the risk of infant death in half, according to Maria Greene, a breastfeeding specialist at Miami Valley Hospital, where about 60 percent of mothers exclusively breastfeed their infants in the days following delivery.

“What we’re trying to do is encourage exclusive breastfeeding because we know that that sets up a baby, actually a person, for being healthy for the rest of their lives,” Greene said.

About the Author