The Journal Gazette
Sunday, January 28, 2018 1:00 am

A healthy dose of intervention

Your role in reducing infant mortality can be as simple as helping to mentor a mother-to-be

Dr. Lora Overton

No woman wants to bury her infant. No man, woman or grandparent ever wants to attend the funeral of an infant whose potential is forever lost. Yet, in Allen County, too many families experience this loss. The infant mortality rate in Allen County is one of the highest in the state and specifically, two ZIP code areas rank as the state's worst for infant mortality.

Infant mortality is the death of an infant before its first birthday, and the rates are staggering. The Centers for Disease Control states: “In addition to giving us key information about maternal and infant health, the infant mortality rate is an important marker of the overall health of a society. In 2015, the infant mortality rate in the United States was 5.9 deaths per 1000 live births.” If infant mortality is a marker for the overall health of a society, what does that say about Indiana?

When I was first made aware of this awful trend, the number of infant deaths was placed alongside deaths of infants in Third World counties. In the land of plenty, this should not be so.

What does this mean in real terms? The overall infant mortality rate in the 46805 ZIP code is 11.3. This means that 11 babies out of every 1,000 born in this ZIP code die. The black infant mortality rate for this ZIP code is 26.5. The overall infant mortality rate for the 46806 ZIP code is 14.3. The Black infant mortality rate for 46806 is 21.9.

What are the causes of such a terrible trend? Looking at the data not only from the state but the Centers for Disease Control, the greatest cause is birth defects. Some of these are genetic and there is not much we can do to change these. However, some are not genetic and can be changed. Those activities that may increase the risk of birth defects include smoking, drinking alcohol and/or using street drugs during pregnancy. Also included in that list are certain prescription medications or having someone in your family with a birth defect.

The second cause of infant mortality is preterm births – those that occur before 37 completed weeks of pregnancy. The causes of preterm birth are multiple, and many are preventable. Some of the causes are the physical health of the mother such as anemia, urinary tract infections, diabetes, hypertension, obesity, infections, sexually transmitted diseases and mental health.

The greatest focus in our community is the preterm birth issue. Most of these can either be controlled or prevented with early prenatal care. You see, that's the problem. Most women who have a preterm birth are not getting prenatal care in the first trimester and are late in taking prenatal vitamins. Why the late prenatal care? Most women I have talked with say they were afraid, didn't know what to do, didn't have a doctor, didn't have the money to see a doctor or didn't want to be pregnant (so they thought if they ignored it, the pregnancy would go away). The reasons are many and varied depending on the age of the pregnant woman. Some teens are afraid to tell their parents or, believe it or not, don't understand how their bodies work and how they got pregnant.

So, what can you do as a productive member of our community? You can be a mentor to these women and their families. You can take them under your wing and walk them through some of the most difficult times in their life. You can show love, compassion and care toward the most vulnerable in our community. You can help change the overall health of our community.

Dr. Lora Overton is an obstetrician-gynecologist in Fort Wayne.

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