Although our nation’s infant mortality rate has gone down in the last 10 years, Ohio’s has remained the same. Tragically, Stark County’s death rate for infants is not only higher than Ohio’s, it also shows a disparity between white infants and African American infants. At Mercy, we are very concerned about this problem.
Guest post by Daphne Stevenson
One marker that helps monitor the health of any given community is that of infant mortality, which is defined as the death of a baby prior to his first birthday. Although our nation’s infant mortality rate has gone down in the last 10 years, Ohio’s has been the same over those 10 years. The infant mortality rate in Ohio in 2012 was 7.56/1,000 live births compared to the national rate of 6.05/1,000.
Tragically, Stark County’s death rate for infants is not only much higher than that of the state, but also shows a disparity in the number of white infants at 8.8 and African American infants at 19.7.
This problem has not gone unnoticed.
Partnering with Stark County Health Department on Safe Sleep
In partnership with the Stark County Health Department, Mercy Medical Center and other local organizations have implemented initiatives to address infant mortality in our community, especially the disparity that exists culturally among the African-American community. One key initiative is safe sleep.
“Each week in Ohio three babies die due to unsafe sleep environments,” says Stacy M. Kovacs, RN, MSN, director of Mercy Maternity Services. “Mercy intends to help reduce this number by modeling the American Academy of Pediatrics’ (AAP) recommendations for safe sleep: the infant sleeps ALONE, on his BACK, and in a CRIB or other safe sleep environment.”
She adds, “We soundly stress the importance of the AAP guideline that the infant sleep alone. Babies die while sharing an adult bed, chair, or sofa. Room-sharing is acceptable. Have the infant close for feeding, comforting, and monitoring, but parents should place the baby back in his crib before falling asleep.”
Situations when bed-sharing should NEVER happen:
- If the infant is younger than three months
- If the parent is excessively tired
- If the adult is using meds, alcohol, or drugs
- If the infant is with anyone other than a parent
- If the infant is with multiple persons
- If the infant is on a soft surface such as a waterbed or old mattress
- If soft bedding such as comforters are used
“Safe sleep is the message we are practicing at Mercy and that we are teaching new mothers prior to taking a newborn home,” Kovacs says. “For example, as of the last quarter of 2014, we began using Sleep Sacks. Newborns are placed in Sleep Sacks and placed on their backs after delivery. Also, each mom receives a new Sleep Sack to take home with her newborn.”
The sack keeps the newborn warm with no risk of being unable to breathe. The AAP does endorse the garment, and it’s to be used with no other covering to reduce risk of suffocation and overheating.
The Importance of Sleep Position, Proper Furniture and Bedding
The second aspect of safe sleep requires the infant to sleep on his back, even during a nap, until one year of age. The AAP does not advise side sleeping either. Once the infant is able to roll over from back to belly and belly to back, he can be allowed to his preferred sleep position. In addition, when the baby is awake and being supervised, she can be placed on her tummy to help strengthen the head, neck, and shoulder muscles and prevent flat spots on the head. Supervision is the key.
The last part of the safe sleep initiative insists upon the provision of sleep furniture that meets the safety standards of the Consumer Product Safety Commission: no missing crib hardware; a firm mattress designed for the specific product; and no gap between the mattress and the sides of the crib. The crib should be free of blankets, bumper pads, soft objects, toys, etc.
The hospital is required by law to ask the parent if a safe sleep environment exists at home. If the answer is no, the parent is given a DVD to watch concerning safe sleep. A safe-sleep questionnaire is given before and after counseling on the topic. If satisfactory, and if the parent qualifies, she can be given a Pack and Play (portable crib) to help ensure safe sleep for the infant.
Mercy has four nurses trained to be safe sleep advocates. They work with each new mother explaining that the safe sleep practiced at Mercy during the infant’s stay should be practiced at home.
However, upon arriving at home, often the care for a newborn may be undertaken by individuals in addition to the mother. “Our challenge is getting the message of safe sleep out to the older women who may help with the care of an infant,” Kovacs says.
Sharing Wisdom to Bridge the Gap
With the goal of getting the message further into the African American community, Kovacs and others have spoken to groups at St. Paul’s and Peoples’ Baptist Church. Kovacs feels the message has been well received.
In addressing the disparity issue, there is much to consider. Pregnant women of every race, ethnicity, religion, and age will pass through Mercy’s doors to give birth. Such diversity requires wisdom in the teaching or re-education of caring for an infant so that he or she may grow and thrive.
A passage in Ecclesiastes comments, “Wisdom is better than weapons of war.” Wisdom is the weapon the medical staff at Mercy has to combat the disparity that may exist in infant mortality. The challenge may be cultural, it may be fear, or it may be distrust, but as respect for one’s culture and background are offered, perhaps those challenges will ebb.
About Daphne Stevenson
Daphne Stevenson taught English and writing to middle and high school students in the Fairless and Tusky Valley school districts, and for a private school in Stark County before retiring with 38 years of service. She has been a volunteer at the Main Lobby Desk for Mercy for over six years, greeting visitors, providing way finding, and answering phone calls. Daphne is a quilter and animal lover and enjoys spending time with her Australian shepherd dog, Sophie. Daphne is also a frequent writer for Tapestry, Mercy’s diversity newsletter.