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'More Than A Count,' Infant Mortality Is Societal Struggle


There are a lot of indicators for a country's general health, like average lifespan or the incidence of a disease. One of the most closely watched indicators is infant mortality.


MARTIN: At Mary's Center, here in Washington, D.C., women come for prenatal care and general checkups.

MINDY GREENSIDE: I am Mindy Greenside. I am a nurse midwifery director here at Mary's Center.

MARTIN: A lot of the women here are immigrants from Latin America. Greenside says they accept all patients, whether or not they have insurance or the means to pay. And Greenside told us that Mary's Center sees maternal health as more than just a medical issue.

GREENSIDE: We have social work. We have psychiatry, psychology, day care training, as well as a full spectrum of medical services - pediatrics, midwifery, adult medicine.

MARTIN: This is far more than just providing prenatal health...


MARTIN: ...prenatal care.

GREENSIDE: Exactly, because anyone who walks in the door needs more than just a pregnant visit of a belly check and listening to the baby's heartbeat.

MARTIN: This broad approach might be responsible for some good news. The Centers for Disease Control and Prevention reported last month that the infant mortality rate in the U.S. has been getting better. The CDC says that between 2005 and 2011, the infant mortality rate dropped by 12 percent.

MICHAEL FRASER: Infant mortality is more than a count.

MARTIN: Michael Fraser is the CEO for the Association of Maternal and Child Health Programs. It's a nonprofit group that works on state health programs.

FRASER: It's an indicator of how a society is doing. It reflects both the health care system, but also how women are doing, how moms are doing.


MARTIN: He and I met at Mary's Center and he said that there are a lot of factors that contribute to the infant mentality rate. And nearly all of those issues have improved.

FRASER: Part of the reason why we're seeing this decrease is we're seeing a decrease in congenital malformation, so birth defects are going down. Those are things that happen in utero and present at delivery. But we're also seeing, in the first year of life, a reduction in unintentional injury, or if your baby experiences SIDS.

MARTIN: So that's just not a maternal health. That's a parental education.

FRASER: Exactly, and that's why we're talking about this as a bigger issue than just access to quality care.


MARTIN: So that leaves one big question: Why? Why have things gotten better?

FRASER: You know, I wish I could tell you it's one magic thing that we've done. But I really think it's been a coordinated and combined effect of a number of different things. And those include providing quality care but also women's health, improvements to women's health over time.

MARTIN: But even as doctors and public health officials have seen some improvement, the U.S. still has a very high rate of infant mortality compared to other developed countries. The rate in Sweden, for example, is less than half of what it is in the U.S. And America is still worse off than countries like Germany, France and Canada.

Generally speaking, infant mortality represents the number of young children that die, for any reason, before reaching their first birthday. But the group Save the Children recently put out its annual Mother's Day report.

CAROLYN MILES: Shockingly, about 11,000 moms lose their babies on the first day of life.

MARTIN: Carolyn Miles is the group's president and CEO. And she says the group found that the U.S. really struggles with keeping newborns healthy immediately after birth.

MILES: Particularly in this first day, the U.S. is actually worse than all the other industrialized countries put together.

MARTIN: What needs to change? What practically can change to improve that number?

MILES: Well, here in the United States, the thing that's actually going to improve that number the most is making sure that mothers get the prenatal care that they need. And that can be an issue of access to that prenatal care. Or it can be an issue of actually going and seeking that care. So getting to moms to seek that care is really important.

And the number is worse among poorer mothers. So making sure that we're reaching poor moms is very important.

MARTIN: But what concerns many health advocates is the recent round of federal budget cuts known as the sequester. Michael Fraser told us that the cuts to health programs could mean that any recent gains could be reversed. Transcript provided by NPR, Copyright NPR.