In 2011, Indiana ranked 44th out of 50 states in infant mortality. Nearly eight infants died for every 1,000 live births in the Hoosier state, a statistic nearly 2 percent higher than the national average.
As a result of the state’s poor performance, the Indiana State Department of Health called for action in November of 2013, and Howard County was eager to meet the challenge.
Through a grant from the Community Foundation of Howard County, the Family Service Association in July created the Healthy Moms, Healthy Babies Program, and appointed Lisa Washington, a long-time local registered nurse, its program coordinator.
Washington has spent her first couple of months on the job examining the needs of the community and what it will take to turn the troubling trend in the right direction.
“I think for women, most of it has to do with education,” she said. “What we’ve found so far is there are lots of resources, but people just aren’t aware of them.”
Infant mortality coordinators have examined evidence-based medicine, looking at data and research studies over time to develop sufficient ways to improve the statistics, and have developed a list of four key areas to do so, including safe sleep, breastfeeding, prenatal care and smoking cessation.
“When moms find out they’re pregnant, the doctors ask them about these things,” Washington said. “But, the goal of this program will be following up with mom throughout her pregnancy, making sure that it hasn’t been brought up to her just one time, but multiple times.”
In terms of safe sleep, coordinators have developed what’s known as the ABCs of sleeping, an acronym which stands for Alone, on their Back, and in a safe Crib.
Officials have found that most homes have a proper crib, but several cases where an infant suffocated in their sleep, parents weren’t utilizing the crib for the baby’s sleep period.
“Sometimes they’re on an air mattress, but they aren’t inflated correctly and the baby slips in between,” Washington added.
In Indiana, roughly 24 percent of moms don’t breastfeed. In Howard County, it’s even worse, with about 34 percent choosing not to. Washington has reached out to women to find out why a larger percentage of women locally are opting to not breastfeed. She found their reasons vary, but most are centered around the facts that employers don’t always allot them time to breastfeed and it’s just not convenient for them to do so.
Washington explained breastfeeding has been made pretty convenient in the last 15 years. Both local hospitals, Community Howard Regional Health and St. Joseph, have lactation specialists to help struggling mothers. WIC also has local peer advisers to help.
“Right now what we want to do is make sure this program will be another layer, reinforcing all those things and making sure that moms have those support people,” Washington said. “We need to make sure we’re doing that, because we know there are lots of benefits to women breastfeeding. We’d like to see them do it for six months, and if we can get them [to do it] a year out, that’s wonderful. That 6-to-12 month is such an important timepiece for women to breastfeed if at all possible.”
In terms of prenatal care, 71 percent of women locally make and maintain their obstetrics doctor visits, which is higher than the state average of 68 percent.
Regular doctors’ visits during pregnancy are just as important for the mother as they are for the baby, where physicians can catch complications like high blood pressure or diabetic problems, Washington said.
“We want to make sure they’re hitting all those key visits, because sometimes we have women entering prenatal care late,” Washington added. “If you’re not entering prenatal care until 24 or 26 weeks, you’re hitting prenatal care really late. We need to make sure those moms are entering as soon as they find out they’re pregnant and establishing care.”
Right now, studies estimate that 20.6 percent of pregnant women smoke in Indiana, which is down from the 24 percent who reported smoking in 2010.
Studies have shown that babies born to women who smoke are born smaller, earlier and with life-long health problems as a result of their exposure to smoke. Getting women to stop smoking, at least during the prenatal period, is a mission of Washington’s.
“Smoking cessation, I’ve seen the aftereffects of it, and that’s why I’m passionate about it,” she said. “I recognize there are points where you can cut it off, and others where you can’t. When I was pregnant with my second child, I worked at a hospital, and the only way I could go into the hospital was through where the smokers smoked. That’s just an example of one, but we want to screen the women and see where they’re exposed to smoke, because those are important things for their doctor to know.”
Washington said the Healthy Moms, Healthy Babies program will work with community organizations such as WIC and Bona Vista to continue to attract expectant mothers to the program. Most local doctor’s offices have referral forms those mothers can fill out to start the process.
“That’s one of the goals of this program, to be out with the community partners and see what they’re doing so that we can coordinate and get some of those programs together for moms,” Washington said. “Even if they are entering prenatal care late, there still is a lot of support we can give people through these programs.”