ST. LOUIS — The United States has the worst maternal and infant mortality rates among wealthy nations. Missouri has among in the country. And within Missouri, mothers and babies in the city of ºüÀêÊÓƵ face the worst outcomes.
And even within the city, there are big differences between ZIP codes.
That’s why on Thursday the city of ºüÀêÊÓƵ Department of Health, in conjunction with the — the largest national organization representing Black physicians — hosted the first-of-its-kind regional discussion on maternal and infant health.
“This maternal health situation is not just an OBGYN problem, right?†said Dr. Yolanda Lawson, president of NMA. “Many people interface with pregnant women … everyone has a stake in the ground. Everyone has some work to do around it, and everyone has a role.â€
People are also reading…
More than 100 people attended the discussion, held at the offices of the philanthropic , to learn about the data and efforts to improve the health of moms and babies.
In the city, the infant mortality rate — the number of babies who die before their first birthday — is nearly 10 per 1,000 live births, compared to nearly six per 1,000 live births for the entire state, Lawson said. The infant mortality rate among Black babies is about three times that of white babies, driven by factors such as a high rate of preterm births and lack of early prenatal care, she said.
Between 2020 and 2022 in Missouri, nearly 81% of white women received adequate prenatal care, compared to nearly 62% of Black women. In ºüÀêÊÓƵ, those numbers are nearly 78% of white women, and 54% of Black women.
Across the state, the preterm birth rate between 2020 and 2022 was just over 10% for white women and nearly 16% for Black women. While in the city, the rate for white women was also 10%, but for Black women the rate climbed to 18%.
The maternal mortality rate in the city for those years was 53 deaths per 100,000 live births, Lawson’s data showed. That is compared to 32 deaths per 100,000 live births statewide between 2018 and 2020, the latest data for Missouri.
“In Missouri, the leading cause of maternal mortality is mental health issues,†Lawson said. “This calls for immediate action around substance use disorder training, depression screening and ensuring we are doing that for moms.â€
While the problems can be overwhelming and have complex causes, Lawson said the city can cut the numbers by increasing access to early prenatal care, improving “culturally competent†care and increasing public education about how to have a healthy pregnancy.
This can be done, she said, by training and educating health providers, forming collaborations, universal mental health screening, reducing stigma around seeking help and linking patients to support services.
With $4.3 million committed by the Missouri General Assembly to improving maternal mortality rates across Missouri, the Missouri Department of Health, Missouri Hospital Association and University of Missouri are leading a statewide improvement plan.
The plan centers on five areas: developing quality care protocols, training providers, standardizing screening and referrals during the postpartum period, creating a collaborative of mental health experts that primary care providers can call on for help, and improving data quality and accessibility.
Okunsola Amadou, director of J midwifery clinic in Ferguson, suggested integrating more midwives into hospitals, birth centers and home births. Midwives are trained in low-risk pregnancies and “keeping pregnant people low-risk and healthy.â€
Many advocates talked of the importance of increasing access to doulas, professionals who support women through pregnancy to postpartum, and community health workers who help coordinate a person’s health and social needs.
Kendra Copanas, executive director of , which advocates for health equity among women and children, said it’s difficult for a person overwhelmed with the journey to motherhood to also manage complex health and social systems.
“I think we need to have more high-touch community health workers paired up with pregnant women, and I think the combination of doula and community health worker is a powerful combination,†Copanas said.
Many echoed the importance of all mothers being able to feel the joy of giving birth and knowing that they received best care possible.
Dr. Kanika Cunningham, director of the ºüÀêÊÓƵ County Department of Public Health, recently returned to work after having a baby.
She remembers being fearful going into labor, but she had the support and encouragement of those around her, she said.
“I want that same experience for every single labor and delivering mom,†Cunningham said. “It doesn’t have to be because I’m the county director. It should be because this is the standard care, that we have stated all moms deserve that type of treatment and care.â€