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Infant mortality, part 1: A personal tragedy, and a plan for the future

Oct 9, 2012

For every 1,000 babies born in Michigan, roughly seven won't make it to their first birthdays.
Credit user tamakisono / Flickr

Behind the statistics: A personal tragedy

We talked previously about Chantania Smith and her struggle with losing a child. 

Six months into her pregnancy, Smith’s doctors discovered she had a short cervix, which is a major cause of preterm birth and a leading indicator for infant mortality.

When she went into labor a month and a half later, the umbilical cord prolapsed and came out first, and Smith was rushed to the hospital for an emergency C-section.  

On January 14, 2010, she gave birth to a little baby boy named Jerome – JJ for short. 

"I actually just found out recently that when my son was first born they had to resuscitate him because he wasn’t breathing when he was born." JJ stayed in the hospital for another six weeks, then returned home with his mom.  But there, things took a turn for the worse. “He wasn’t doing good, so I took him back to the hospital,” Smith says. JJ stayed in the hospital for another week before he was released to Smith again.

Two weeks later, JJ passed away. 

JJ is among the 817 babies who passed away in 2010.

But thanks to research provided by the likes of Dr. Sonia Hassan, a new product called progesterone gel is helping reduce the rates of preterm birth.

A biomedical solution to reduce infant mortality

Dr. Sonia Hassan is the medical director at the Center for Advanced Obstetrical Care and Research at the Hutzel Hospital in Detroit. Dr. Hassan has been doing a lot of research involving babies and pregnant moms. One of the things she knows is that a short cervix in a pregnant woman can make a preterm delivery more likely.

Recently Dr. Hassan helped spearhead a worldwide study involving 460 pregnant women and a particular type of gel, a progesterone gel applied vaginally, as a possible treatment for this condition.

"We found that the women who got the progesterone had a reduction in the rate of preterm birth of about 45 percent," says Dr. Hassan.

That means almost half of the women who were given the progesterone gel carried their baby to full term. That type of result was completely unexpected. Even Dr. Hassan was stunned.

"I see infant mortality as a community disease, as well as a medical disorder," says Dr. Larry Young. "Too often we focus on the medical aspect, and not the community aspect."

The study opens up the possibility to save a lot of infants around the state, and save a lot of money. Dr. Hassan estimates that if health providers screened 100,000 women for short cervixes and administered the progesterone gel when needed, health care costs would decrease by $19 million a year.

Not all health insurances currently cover cervical screenings, but that's about to change. Within in the next year, cervical screening will become standard for all pregnant women in Michigan during their second trimester.

But the gel is just one piece of the puzzle.

A community approach to solving Michigan's infant mortality problem

Michigan’s infant mortality rate is such a big problem that Governor Rick Snyder even included it on his “dashboard” of things he wants to address in his first term.

And so this summer, the powers that be got together to a come up with a plan to reduce Michigan’s infant mortality rate.

Olga Dazzo, the director of the Michigan Department of Community Health, introduced the plan at a news conference in Flint. "We have an important goal ahead of us, and we’re going to need everyone’s help to change the environment in Michigan so that our babies survive."

The plan Dazzo presented took a year to put together, and the process involved groups from across the state. The plan has eight main strategies, including things like more progesterone treatments for high risk moms, promote safe sleep positions for babies, better sex education for teens. The eighth strategy on the list is to look at the impact of community, and the experience of racial minorities.

The news conference to announce the plan was held at Hurley Medical Center in Flint. The location was picked because Hurley is one hospital that’s already made some progress on reducing not only infant deaths, but also reducing the racial disparity in infant deaths.

Hurley doctor Larry Young said the efforts to reduce the racial disparity in birth outcomes goes beyond the hospital walls.

"I see infant mortality as a community disease, as well as a medical disorder," explains Young. "Too often we focus on the medical aspect, and not the community aspect."

So how does the community play a role in reducing infant mortality?

I have three words for you: The “social determinants of health." We’ll unpack the social determinants of health in the next section of our State of Opportunity documentary.