By Pam Dankins
Mississippi continues to rank first in the nation in fetal deaths, according to 2021 data released by the Centers for Disease Control and Prevention last month.
The report examined deaths of fetuses in utero that occurred after 20 weeks’ gestation, also known as stillbirths, in the United States. Mississippi led the nation with a rate of 10 deaths per 1,000 live births, almost twice the national rate of 5.73.
Mississippi has also long led the nation in infant mortality, or the death of babies up to one year of age.
State Health Officer Dr. Daniel Edney said “the time for study and evaluation has passed,” and it is time for action.
“We’ve been working for the past year to implement the Healthy Moms, Healthy Babies program for high-risk moms and babies on Medicaid,” Edney continued. “We’ve also just been given the endorsement of the state Board of Health to develop the best OB system of care that we possibly can, following the models of national organizations and the other 10 states that have mandatory maternal levels of care for hospitals.”
Healthy Moms, Healthy Babies is a partnership between the state’s Health Department and the state Division of Medicaid that places registered nurse case managers in the homes of mothers undergoing high-risk pregnancies and who have recently given birth.
Similar to the Mississippi State Department of Health’s trauma, ST-Elevation Myocardial Infarction, and stroke systems of care, the OB system will facilitate transferring high-risk pregnant women and their babies to the right level of care at the right time. The system of care is not yet in place — the state Board of Health just authorized staff to start working on it at its board meeting earlier this month.
Nationally, more than 21,000 stillbirths occurred in 2021, or about six for every 1,000 live births.
For Black women nationally, the fetal mortality rate declined by 4% from 10.34 (2020) to 9.89 (2021). However, Black women still had the highest fetal mortality rate compared to other racial and ethnic groups in the U.S – nearly double the national rate of 5.74 per 1,000 live births.
According to the report, most fetal deaths were associated with an “unspecified cause.” Other common causes were complications of the placenta, cord and membranes; maternal conditions unrelated to pregnancy; maternal complications of pregnancy and congenital malformations.
The fetal mortality rate for women who smoked during pregnancy was almost twice that of nonsmokers – 9.62 compared to 5.08, respectively.
“The latest data from the National Center for Health Statistics confirms what we currently know, stillbirth prevention needs to remain a priority. While the stillbirth rate from 2020 to 2021 essentially remained unchanged, any fetal deaths that could have been prevented are unacceptable,” Dr. Christopher Zahn, interim CEO and chief of clinical practice and health equity and quality for the American College of Obstetricians and Gynecologists, told Mississippi Today.
Samantha Banerjee, executive director of PUSH for Empowered Pregnancy and a mom whose daughter Alana was born still in 2013, said the “numbers are shameful” but “not shocking to those of us in the stillbirth community.”
“We have fallen far behind our international peers when it comes to ending preventable stillbirth, and averting these tragedies has never been made a priority in the U.S. It is beyond time for change, and we hope that the recent CDC report serves as a wake-up call to our medical and public health leaders,” Banerjee told Mississippi Today.
PUSH for Empowered Pregnancy, a national nonprofit dedicated to reducing the rate of stillbirth in the U.S., empowers pregnant women and their providers to recognize warning signs of stillbirth. PUSH also closely coordinates with Black maternal health and maternal mortality communities on patient-centered solutions addressing stillbirth.
Ana Lepe Vick, co-director of communications at PUSH and the mother of Owen, who was stillborn in 2015, told Mississippi Today that it is critical that the organization raise awareness about stillbirth and share known preventive methods.
“Unacceptably, the rate of stillbirth remains stagnant because there has been no national sense of urgency or investment in addressing the failures of our healthcare system which allows even healthy, ‘low risk’ pregnancies to end is this catastrophic outcome,” Vick said.