JPS Health Network launches new initiatives to combat county’s high infant mortality rate

Posted Thursday, Sep. 05, 2013  comments  Print Reprints
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From free prenatal dental care to doulas, JPS Health Network is launching numerous initiatives this fall to help low-income Tarrant County women be healthier so they will have healthy babies.

JPS officials announced its new grant-funded programs Thursday morning at a memorial service at John Peter Smith Hospital Fort Worth for infants who died before their first birthday. Tarrant County has the highest infant mortality rate for counties of its size in Texas with 7.6 deaths per 1,000 live births — higher than the state and national average.

By working with its community partners, JPS say it aims to significantly reduce that rate by increasing public education and support and by improving access to healthcare before, during and after pregnancy.

“It’s not just about the medical care. You can take the best care of that mom, you can take the best care of that baby and sometimes things don’t work out the way we hope they would,” said Dr. Sealy Massingill, head of Obstetrics and Gynecology at JPS . “It’s more about the before-pregnancy and after-delivery life that we really struggle with in Tarrant County.”

“This is a problem we have to solve as a community,” he said.

Infant mortality is closely tied to a lack of prenatal care, research has shown. In Tarrant County, 48 percent of babies who died before their first birthday were born to mothers who receive prenatal care late or not at all. JPS officials say many times a low-income expectant mother’s first encounter with a healthcare provider is when she arrives at the emergency room with some kind of complication.

“We are working to improve the timeliness of prenatal care,” said Wendy Burkholder, JPS vice president of community health.

The hospital’s goal is to get more women attending prenatal doctor appointments by their 13th week of pregnancy. Currently, only about 11 percent of the mothers served by the facility do so for a variety of reasons, which could include a lack of medical insurance or the inability to get time off work, Burkholder said.

Enhancing services

The network’s Health Centers for Women in Fort Worth and Arlington will begin providing an initial prenatal appointment in concert with pregnancy testing. JPS also plans to hire and train additional community workers to work with schools, churches and nonprofit agencies in targeted neighborhoods to identify women eligible for assistance and help them connect with the medical care and social services they may need.

Other initiatives include providing enhanced services, such as access to certified lactation consultants and dietitians, to both individuals and organized groups of women who are in the same stage of pregnancy so they can attend doctor’s appointments together and share their questions and concerns.

JPS will also begin offering free prenatal dental care to qualified moms.

“Good oral health leads to good birth outcomes,” said Burkholder, who said expectant moms surveyed by the hospital said they had not been to a dentist in two to five years. “Women are making choices between putting food on the table or getting dental care.”

JPS Health Network also received a $1 million-a-year grant for five years from the state to provide services such as free cervical and breast cancer screenings as well as free contraception to uninsured women. Up to 53 percent of pregnancies in Texas are unintended, Burkholder said.

Better prenatal care

A review of the 1,175 fetal/infant deaths reported in Tarrant County between 2008 and 2010 found that 51 percent of mothers had evidence of significant medical problems, including sexually transmitted diseases, chronic hypertension and thyroid issues, before they became pregnant. Family planning can give a woman time to become healthy and make lifestyle changes before she decides to become a mother.

“If you are pregnant, you need to get prenatal care. But what causes us more concern is the mother’s health even before she becomes pregnant,” said Ann Salyer-Caldwell, chair of Tarrant County’s Infant Mortality Network. “We still have a lot of issues with chronic diseases and obesity and maternity risk factors that make it tough to have a healthy pregnancy and a good outcome.”

Sometimes a woman may not have the support of her family and friends during pregnancy, Burkholder said. JPS also plans to connect women in certain ZIP codes experiencing high infant mortality rates, such as Stop Six in southeast Fort Worth, with doulas, or labor coaches, to provide emotional support and information on topics ranging from birth plans to breastfeeding.

Additionally, the hospital said it is working harder to make sure new moms attend their postpartum doctor visits before their child turns a month old. Risk factors for infant mortality can include exposure to secondhand smoke, lack of access to healthcare and co-sleeping.

“The first 28 days is the most risky for the child,” said Burkholder, adding that 80 percent of infants who do not live to see their first birthday die within that first month.

For more information, visit www.jpshealthnet.org or call the general information line at 817-222-2JPS.

Susan Schrock, 817-390-7639 Twitter: @susanschrock

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