Pregnancy is typically a joyous occasion with celebrations and planning. But without the proper care, both mom and the baby may become one of the 4.5 million who die every year during pregnancy, childbirth, or the first weeks after birth. “Maternal death is defined as the death of a woman while pregnant or within 42 days of the end of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by pregnancy or its management but not from accidental or incidental causes.” Some experts believe 42 days only captures a percentage of women whose bodies return to normal post-pregnancy. For those who do not recover in that six-week window, additional health concerns contributing to maternal mortality rates are still present or may develop within the first year postpartum. Still, they don’t qualify for the calculation of maternal mortality.
Maternal and infant mortality are a harsh reality that many women and families face due to a lack of healthcare, prenatal care, transportation to appointments, a high rate of cesarean section surgeries, poverty, and education on the proper care of the mother and baby. “Almost 95% of all maternal deaths occurred in low and lower-middle-income countries in 2020, and most could have been prevented.”
Why Maternal and Infant Mortality Matters
No one wants to experience losing a baby or the mother of a new baby, especially due to preventable reasons. However, maternal and infant mortality rates matter because they are an essential marker of the overall health of a society. Maternal and infant mortality rates show a disparity in human rights issues, especially for African-American women.
A 2018 report concluded that around 50% of all pregnancy-related deaths were caused by hemorrhage, cardiovascular/coronary conditions, cardiomyopathy, or infection. For non-Hispanic black women, the most common causes of death were preeclampsia, eclampsia, and embolism. Mental health conditions were the leading cause of death for non-Hispanic white women. African-American women account for 69.9 deaths per 100,000 live births, 2.6 times more than White non-Hispanic women. At the same time, African Americans are more prone to cardiovascular diseases, high blood pressure and less likely to take control of their health.
Understanding the Numbers of Maternal and Infant Mortality Rates
In Hardee and DeSoto Counties, there is a significant disparity between those who are insured and uninsured, those who make an income above the poverty line and below it, and those who are uneducated and those who are aware of the resources available to them to maintain a healthy pregnancy and birth. Florida CHARTS reported that the percentage of births in Hardee County to uninsured women from 2015-2017 was more than twice that of those within the state. The poverty rate is almost twice as high in DeSoto County compared to the state average (20.8% DeSoto vs. 12.4% Florida).
Additionally, one of the misfortunes of those living in rural counties, such as Hardee and DeSoto Counties, is that the obstacles to receiving proper health care have additional challenges due to the distance of medical centers, hospitals, and doctor’s offices. A lack of transportation is a significant obstacle most rural populations face. However, for pregnant mothers and those who have recently given birth, a lack of transportation adds another layer to the already high material and infant mortality rates.
These alarming statistics are a huge concern, which is why programs such as The Healthy Start Coalition of Highlands, Hardee and Polk Counties, Healthy Families Florida, and Hardee DeSoto Community Health Workers Programs are such an invaluable resource to help mitigate the rising numbers of those who require more assistance.
Causes of Maternal Mortality
To paint a picture of how Hardee and DeSoto Counties rank in maternal mortality rates, we looked at the global, state, and county statistics to see for ourselves. In 2020, almost 95% of all maternal deaths occurred in low and lower-middle-income countries. Today, compared to other states in America, Florida ranks number 17 in maternal mortality rates. That equates to 21.7 per 100,000. Within Florida, Hardee and DeSoto Counties rank some of the highest maternal mortality rates in the state.
The leading causes of maternal mortality include
severe bleeding (mostly bleeding after childbirth);
infections (usually after childbirth);
high blood pressure during pregnancy (pre-eclampsia and eclampsia);
complications from delivery and
unsafe abortion
Pre-eclampsia and Eclampsia
While severe bleeding, infections, delivery complications, and unsafe abortions are well-known, you may not be as familiar with pre-eclampsia and eclampsia. Pre-eclampsia can show up in pregnancy at 20 weeks to delivery day. Unfortunately, it is unknown why it shows up, but when it does, several symptoms indicate that the mother is at risk.
Eclampsia is a severe complication of preeclampsia characterized by one or more seizures during pregnancy or postpartum. In the developed world, eclampsia is rare and usually treatable if appropriate intervention is promptly sought. When left untreated, eclamptic seizures can result in coma, brain damage, and possibly maternal or infant death.
Causes of Infant Mortality
Infant mortality in Florida accounts for 5.8 deaths per 1,000 babies born, making the state #20 in the country. The number of births in 2020 in Hardee and DeSoto Counties was relatively low compared to other counties. However, infant deaths were still higher than in 47 other counties in the state. While those numbers have seen a downward trend, there are still leading preventable causes.
Leading causes of infant death include birth defects, preterm birth, low birth weight, maternal complications, and sudden infant death syndrome (SIDS). The most preventable causes of infant mortality, such as preterm birth, low birth weight, and maternal complications, rely heavily on the mother to take preventative measures. Those measures include regular doctor visits, educational information to improve their prenatal care, and the proper nutrition and exercise appropriate for their body and age.
Sudden Infant Death Syndrom (SIDS)
Sudden Infant Death Syndrom (SIDS) is the cause of death for roughly 2,300 babies per year in the United States. While that number may seem low, an infant death's impact is exponentially higher. It affects not only the infant's parents but also family members, community members, and those involved in the child's care. The cause of SIDS remains unknown; however, “Researchers have found problems in the brains of babies who died from SIDS. In some cases, the problem was found in a network of nerve cells in a part of the brain that controls breathing, heart rate, blood pressure, temperature, and waking from sleep. Other research suggests that changes in the baby’s genes may cause problems with how the body functions, including breathing and waking from sleep. Researchers also found that babies who died from SIDS had high serotonin levels in their blood.2 This finding could suggest a problem with how the body uses serotonin, which carries messages between nerves. Out-of-balance serotonin levels could affect how the baby’s body handles regular functions or everyday processes, like waking from sleep and breathing. There is currently no way to detect these problems when a baby is alive. Scientists also believe that these issues alone may not be enough to cause death.”
Is There Anything We Can Do To Lower Maternal and Infant Mortality Rates?
It may seem simple, but the answer is more nuanced and complicated for rural communities. The most effective way to decrease the number of maternal and infant mortality rates is through pre-pregnancy and prenatal care, creating a safe infant sleeping environment, using newborn screening tests to detect hidden defects, and addressing pre-term birth, low birth weights, and their outcomes. Additionally, learning to detect symptoms of common health concerns such as pre-eclampsia may be life-saving.
The safety of our community relies heavily on the ability to communicate with programs such as ours when there are barriers to healthcare, such as a lack of insurance, lower incomes, transportation obstacles, and language. If you are pregnant or think you may be pregnant, we encourage you to contact your local provider, our program, or other nonprofit organizations who can help ensure you and your baby are safe and healthy.
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