Last year in Allen County, 53 babies ages 12 months or younger died. Some of those deaths might have been preventable, according to health department officials.
Although there were no dramatic spikes in the numbers over the last five years – 38 deaths in 2012, 55 in 2011 and 65 in 2010 – the statistics are nonetheless troubling, said Dr. Deborah McMahan, Allen County health commissioner.
With annual deaths in the 50s and 60s the last few years, she had no reason for the drop in 2012.
We lose so many babies, she said.
While the leading cause of death – congenital birth defects – is not controllable, others are.
Pre-term labor, low birth weight and unsafe sleeping – parents sleeping with their infants and accidentally smothering or crushing them – are all top contributors in infant deaths, McMahan said.
The governor and state health commissioner have identified infant mortality as a winnable battle, McMahan said. Our goal is zero deaths, because it is unacceptable to have an acceptable number of deaths.
Several groups are working independently in the county to reduce the number of infant deaths, and a group of health care professionals is looking for collaborative efforts the community could engage in to reduce infant mortality, McMahan said.
Those initiatives could include educating parents on the dangers of unsafe sleeping practices, the effects of substance abuse and smoking while pregnant and the importance of prenatal care, especially in the first trimester.
There are too many pregnant women who get little or no prenatal care or who smoke, which can cause premature births, low birth weight or stillborn deaths, McMahan said.
According to the latest available statistics from the Indiana State Department of Health, more than 17 percent of women in the state and more than 12 percent in Allen County smoked while pregnant.
McMahan thinks the numbers are higher.
Health officials were at a loss as to why many expectant mothers do not seek prenatal care, especially in Indiana where the Presumptive Eligibility for Pregnant Women program offers temporary coverage of prenatal care services to women while their Medicaid applications are pending.
Only 58 percent of expectant mothers in Allen County seek prenatal care in the first trimester, McMahan said.
It’s easy to get Medicaid if you are pregnant, she said. We don’t understand why some choose not to take advantage of these tremendous resources.
Several agencies offer help for new parents including Healthier Moms and Babies, CANI’s Early Head Start program, the United Way’s Baby 211 and Healthy Families of Allen County, a home-based prevention program for parents of newborns.
Under the national umbrella of Healthy Families America, programs similar to Allen County’s are available in Adams, DeKalb, Kosciusko and Wells counties.
New parents are referred to Healthy Families through local hospitals, said Lori Rowe, program administrator for the Allen County agency.
Caseworkers use a model, mentor and monitor approach and provide parenting and child development education, home management, health and safety instruction and provide connections to medical care, immunizations and community resources. Caseworkers also educate parents on safe sleep habits and shaken baby syndrome.
Between 475 and 500 families are enrolled in the program, but only about 85 percent actively participate, Rowe said.
Parents must meet low-income guidelines and have other factors, such as unstable housing or financial concerns to be eligible for the program.
Dr. Todd Rumsey, an obstetrician and gynecologist at Women’s Health Advantage, would like to see a program similar to Healthy Families offered to all new mothers, regardless of socioeconomic status.
Rumsey also is vice president of the Fort Wane-Allen County Board of Health, chairman of the Dupont Hospital Board and is a board member of the Lutheran Health Network and the Foellinger Foundation.
Before moving to Fort Wayne in 1995, Rumsey and his wife lived in Ohio, where their children were born. A nurse from the hospital visited after the babies were born, he said.
Home visits are certainly not the key to reducing infant mortality, but they could be a prevention component, Rumsey said.
Doctors who deliver babies don’t see the mother again until four to five weeks later for a postpartum checkup, and that’s a long time for a woman who is suffering from postpartum depression, he said.
Depression and other concerns could be identified with home visits from a health care professional, Rumsey said.
Dr. James Cameron, a Fort Wayne doctor who specializes in neonatal and perinatal medicine – taking care of sick newborns – agrees.
A lot of the problems new parents encounter has nothing to do with whether or not they have a high school diploma or a graduate degree, Cameron said.
Having a baby is not something most people are prepared for, it involves practical knowledge not really known or available, he said.
Cameron cited a recent study by researchers at Duke University who found that when new parents received home visits from a nurse soon after taking their baby home from the hospital it resulted in better parenting behaviors and safer homes.
There were savings to health care providers and fewer visits to doctors and emergency rooms in states that included postpartum home visits, Cameron said.
Postpartum home visits would have to be initiated at the state level for the Department of Health, although hospitals could introduce their own home visiting service, Cameron said.
The program could be cost-prohibitive to many hospitals, with an estimated cost of $150 for two home visits, he said.
In order to implement such a program, Cameron said, they would probably need help in the way of grant money.