The infant mortality rate in South Carolina dropped remarkably in the latest statistics, and state infant health leaders hope initiatives begun in the past few years will turn that improvement into a long-term trend rather than a short-term blip.
The infant mortality rate in South Carolina dropped from 7.6 per 1,000 live births in 2012 to 6.9 percent in 2013, according to statistics released Wednesday by the S.C. Department of Health and Environmental Control. That’s the lowest rate since South Carolina has compiled the statistics several decades ago.
“One child death is obviously too many, but we’re cautiously optimistic and excited about the trend in this year’s numbers,” said DHEC director Catherine Templeton.
She was especially pleased with the significant reduction in infant mortality among African-American babies. While the rate for whites increased slightly, from 5.3 to 5.5, the rate for blacks dropped from 12.5 to 10. While the overall rates began to drop a decade ago, the rates among African-Americans always have been higher than among whites, and improvements have been harder to achieve among African-Americans.
The big drivers in the reduction are improvements in bed deaths (dropped from 39 in 2012 to 21 in 2013) and deaths from respiratory distress and placenta complication among the smallest of newborns (also from 39 to 21). The respiratory and placenta death reduction can be attributed mainly to technological advances at hospitals, according to Michael Smith, DHEC Maternal and Child Health epidemiologist.
Health care leaders think the bed death improvements can be linked directly to a statewide Safe Sleep initiative that preaches the importance of newborns sleeping alone, on their back and in an uncluttered crib. Some parents even are given pack-and-play cribs when they take their newborns home from the hospital.
“I really feel like this may be a blip, but something has changed in the way people are coming together around this issue in this state,” Smith said. “I’m really hopeful that we’ll be able to continue this good work.”
National numbers aren’t out yet for 2013. Two other states that have released their 2013 numbers have seen decreases, though not to the scale of South Carolina’s. Alabama’s rate dropped from 8.9 to 8.6, while North Carolina’s dropped from 7.4 to 7.0.
Some of the other initiatives that are moving the needle on this issue in South Carolina include:
• A Birth Outcomes Initiative that encourages pregnant women and their physicians not to have elective births before 39 weeks of pregnancy. That initiative also has encouraged Centering Pregnancy, a program that brings a group of pregnant women together for education and group support. Medicaid has given physician’s financial incentives to back these programs.
• A breastfeeding initiative that not only educates new mothers on the health benefits but provides training and breast pumps. Encouraging breastfeeding also is a major component for earning certification as a Baby Friendly Hospital. South Carolina now seven Baby Friendly Hospitals. About one-quarter of babies born in the state next year will be born in those hospitals.
• Clinical practice changes that encourage progesterone for women at high risk for pre-term births and recommend long-acting contraceptives for new moms to reduce multiple pregnancies close together.
State health departments, hospitals, obstetricians, pediatricians and many other health care groups increasingly have been working together on these initiatives in recent years. Many were disappointed when the infant mortality rate rose from 7.4 in 2011 to 7.6 in 2012. They hope that was the blip in a decade of mostly downward trends.
“There’s a lot of energy behind this, there’s a lot of optimism behind this,” said Dr. Amy Picklesimer, an obstetrician in Greenville who leads to Birth Outcomes Initiative. “Seeing positive feedback like this infant mortality rate, even if we can’t directly take credit for what is happening, I think this is a sign things are moving in the right direction. These are parents making good choices to take care of their babies.”