Infant Mortality In Butler County

By Ellen Kahle

Miami University journalism student

It would be hard to come across a person who would argue with the idea that infant mortality is heartbreaking and needs to be prevented at all costs.

According to the Butler County Partnership to Reduce Infant Mortality, the "infant mortality rate (IMR) is defined as the number of deaths among children less than one year of age per 1,000 live births."

Butler County's infant mortality rate is 8.47 per 1,000 live births, while Ohio's statewide infant mortality rate is 7.72 per 1,000 live births.

While infant mortality has been decreasing overall in Ohio since 1990, both Butler County's rate as well as Ohio's are above the Healthy People 2020 national goal of 6.0 infant deaths per 1,000 live births.

"For infants under 1 year of age, the most common cause of death seen in the coroner's office is Sudden Unexplained Infant Death -- most of these are sleep-related deaths with bed sharing and unconventional sleeping arrangement," says Butler County Coroner Dr. Lisa Mannix.

Butler County Health Commissioner Jennifer Bailer says babies born too early and babies with low birth weights are also a contributing factor to infant mortality in Butler County.

Babies As Bellwethers

A baby is considered preterm if it is born before 37 weeks of gestation. Because key development happens in the late stages of pregnancy, babies born prior to that suffer from a greater risk of disability and death.

Babies are considered underweight if they weigh less than 5.5 pounds or 2500 grams.

Some things that contribute to preterm and low birth weight babies in Butler County are short birth intervals, smoking during pregnancy, similar previous birth outcomes, delayed entry to prenatal care, and poor social support for expecting mothers.

Data gathered by the Butler County Health Department shows that African American mothers and mothers in a low income bracket struggle the most with bringing a healthy child into the world, compared to white, upperclass mothers.

"IM [infant mortality] matters not only because it is heartbreaking when a baby dies, but also because if our youngest and most vulnerable community members are not healthy that means the overall health of our community is not optimal," says Jennifer Bailer. "IM is a bellwether statistic, that is, it indicates that the rest of us are not as healthy as we could be too."

Programs have been launched at area hospitals and other organizations to prevent infant death as well as to provide support for mothers and families who have gone through such a loss.

Education And Information

Mothers in prenatal care are taught the ABC -- Alone, on Back, and in a Crib -- sleeping method for babies to help prevent Sudden Infant Death Syndrome, or SIDS.

The Butler County Partnership to Reduce Infant Mortality also has a long list of programs they offer to help reduce and prevent infant deaths including High Hopes for expecting African American mothers, Centering Pregnancy for group prenatal care, smoking cessation programs and Safe Sleep programs that offer families portable Pak-N-Play cribs.

In addition, research is being done by Butler County public health nurse epidemiologists through the Fetal Infant Mortality Review (FIMR). FIMR nurses collect information about things like income, prenatal care, and smoking from birth summaries and death certificates and then gather more information from hospital records.

They take all this data, erase any personal information in it, and present it to the Case Review Team (CRT). The CRT then looks at the social, economic, cultural, safety, and health system factors that effect maternal health and fetal/infant mortality.

From their analysis, the CRT then makes recommendations on what can be done to improve the lives of the babies, mothers, and families. Finally, the CRT brings their recommendations to a Community Action Team who can then implement the changes in the community.

"Though it can be hard, I find it very rewarding to listen to families tell their stories. I think some of the families I have spoken to find comfort in knowing that Butler County is helping with the fight against infant mortality," says Public Health Nurse Epidemiologist Karen Carr.

Finding Space To Grieve And HEAL

Mothers and families who have suffered the loss of an infant can find support in the community. Programs such as Help Enduring A Loss (HEAL) allow grieving mothers and families to work through the loss of their child.

HEAL Program Coordinator Sheree Young created it after losing her own son, Mark, in 1988 after he was born two weeks early.

"I felt strongly there should be an established and evidence-based approach to care and it should be available within a matter of hours following the death and continue as long as parents needed ongoing support," says Young. "I have had an amazing opportunity to meet hundreds of incredible families who experience the greatest tragedy in life but who always remind me how to love harder and to cherish every moment…because moments may be all we have."

HEAL provides support groups for families who have suffered a loss and can also liaison between families and doctors.

Safe Sleep Coordinator and Baby Me Tobacco Free Facilitator Michell Tubbs says infant mortality is such a difficult topic, that it's important everyone feel supported and heard.

"This work is very dear to my heart because I feel like the unborn and the infants need a voice. These mothers, educators, medical professionals sometimes lack the knowledge of the possible factors that lead to infant mortality. That's where I come in."

A number of events have been held in Butler County recently to raise awareness of infant loss in the community.

Michelle Tubbs, Sheree Young, and others working on the issue say the one way to combat infant death is to make people recognize that it's happening and then learn how to prevent it.

Photos by Ellen Kahle.

Editors note: An earlier version of this story incorrectly reported the infant mortality rate as a percentage of births when it is, instead, measured in the number of infant deaths per 1,000 live births.