Infant Mortality: There Are Still People Who Aren't Aware

By Eleanor Boudreau

Memphis, TN – Programs like Healthy Start and The Blues Project--which help the babies of Shelby County's most at-risk pregnant women survive with almost 100 percent success--probably haven't made a bigger dent in the infant mortality rate because they don't reach enough women. Healthy Start works with about 200 women at a time, The Blues Project has helped more than 800 women since 2005. But there are almost 16,000 births a year in Shelby County. Calondra Tibbs is the Program Coordinator for Healthy Start. "We cannot touch every high-risk woman," she admits.

Reaching out to more of those women is the work of Community Voice. Mia Earl is the Project Director. Earl says it takes more than doctors to teach women good prenatal care and good parenting. She likes to use this example:

"The doctor tells us to do something. The doctor has said, Okay, I want you to position this baby on the back to sleep,'" Earl says.

But after that the woman goes home.

"And the baby is fussing and crying," Earl continues. "And grandmother or aunt or whomever is there says, You know what, you should place that baby on the stomach to sleep.'"

Earl pauses for dramatic effect, as if to say, What do you think that woman does then?'

"They're going to listen to the person that is in there home," she concludes.

And the way a baby is put to sleep does seem to be a piece of the problem here in Shelby County. An early examination by the Fetal & Infant Mortality Review shows about seven percent of infant deaths in county are sleep-related. Nationwide it's less than two percent.

So Community Voice is trying to spread word to new moms by talking to the people the moms talk to.

"There are still some people that are not aware that this [infant mortality] is an issue. And it's a complex issue; it's not based on one factor. There are many, many factors that play a part." Earl said.

No one yet knows exactly what the mix of factors is that makes infant mortality higher in Shelby County than it is in most of the rest of the country. Figuring that out is the job of the county's Fetal & Infant Mortality Review. But we do have a long list of things that kill babies--that list includes prematurity and its complications, sleeping with loose bedding, and overheating.

So, Community Voice tries to educate its students about as many of those causes of infant death as possible, with a 10 hour course.

Earl is teaching in a room of a church on Frayser Boulevard.

"How many of y'all agree that parenting can be challenging?" she asks.

"All of us, all of us," her class replies.

Earl sits at the front of the room ringed by her fourteen students. Everyone in circle is black. The cover of Earl's curriculum book reads "Decreasing African-American Infant Death. Lay health guide." The curriculum was first used in Lynchburg Virginia, and Earl says Lynchburg did see a decrease in infant mortality.

This hour Earl talks about putting the baby to sleep properly. Earl also talks about not smoking while pregnant, or around a baby. According to the Fetal & Infant Mortality Review smoking is less of an issue here in Shelby County, and nationally black women are much less likely to smoke during pregnancy than white women.

Earl ends the hour by talking about shaken baby syndrome. Shaking a baby can cause brain damage, and even death.

Earl pulls out a life-size mechanical baby doll. The doll has a clear plastic head and you can see through to where an infant's brain would be.

Earl turns the doll on and it begins to cry.

"What do you all do?" Earl asks. "The baby is crying and crying?"

Earl passes the doll around the circle and her students take turns holding, rocking, and trying to comfort it. Unsuccessfully. Earl takes the doll back

"I'm glad to know that all y'all are gentle," she says.

Then she screams, "SHUT UUUUUUUP!!!!" And shakes the doll violently.

Red lights flicker inside its plastic brain, and the doll falls silent.

"That's what happens with shaken baby syndrome," Earl concludes.

The class murmurs.

"For real," one student says, "I have seen it done. And I have to get the baby, like, Girl give me this baby! What is wrong with you?'"

After students have completed the Community Voice course, they have to go out and share something they learned with at least five other people. Community Voice graduates fill out a form every time they tell someone else something they learned in the class. The Center for Research on Women at the University of Memphis keeps track of those forms.

It looks like infant mortality in Shelby County has decreased ever so slightly since 2006, but there is still a lot of room for improvement. Memphis has one of the most abysmal infant mortality rates of any city in the country. So when will Shelby County's rate drop somewhere near the national average?

"Of course we would like to say immediately," Earl says, "But we know education, awareness, and impacting behaviors. It takes time."

Community Voice has reached more than 8,000 people since it got its start in 2008. That number is about a quarter of the live births that happened in Shelby County during that time.

To sign up for a Community Voice class call (901) 381-2699.