January 31, 2018 / Tamara Thompson, MD. FACPG
Recently, Ohio released the new state budget, which allocates nearly $140 million to reducing infant mortality, defined as the death of an infant before his or her first birthday. This commitment is especially encouraging because Ohio’s sleep-related infant deaths have dropped since 2015—a reduction that corresponds with intensive state and local initiatives promoting safe sleep practices. In other words, we’ve seen that using our resources to educate parents about infant mortality is an effective way to address the issue.
Now the state is putting methods in place to help reduce rates of other measures that have an impact on infant mortality including preterm birth, too-short intervals between births, smoking during pregnancy and birth defects—as well as expanding safe sleep promotion.
The following measures are proving successful here in Ohio, and may help you save the lives of more babies in your state, as well.
Preventing premature birth
Progesterone is a hormone medication that can reduce the likelihood of pre-term delivery in at-risk women. In Ohio, we are working with a group or professionals comprised of perinatal clinicians, hospital personnel and government representatives to provide progesterone in high-risk communities. Specifically, managed care plan efforts, in partnership with Ohio Perinatal Quality Collaborative (OPQC) provider partner sites, resulted in an estimated average of 94 fewer births per year of infants born before 32 weeks of gestation in Ohio. Through this program, Molina also saw an average pregnancy gain of 4.5 weeks compared to patient’s most recent preterm delivery.
Longer birth intervals of at least 18 months between deliveries allow a women’s body to fully recover, and reduce the risk of preterm birth and low birth weight. To promote longer birth intervals, we’re working to provide greater access to family planning and long-acting reversible contraceptives.
Discouraging smoking—Because smoking increases the risk of preterm birth and low weight, the state is expanding publically-funded promotion of an evidence-based smoking cessation model, and awareness campaigns including “Baby and Me—Tobacco Free.”
Prenatal Care—Ohio is leveraging federal grants to expand local voluntary, evidence-based home visiting services in areas with the highest infant mortality rates, to educate pregnant women about maternity care and parents about baby care.
Recommending against medically unnecessary initiation of labor —the Ohio Perinatal Quality Collaborative works to ensure that initiation of labor and caesarian section are pursued only when medically indicated.
Safe Sleep Practices
Safe Sleep Screening—Ohio law requires birthing centers and maternity units to assess whether newborns will have a safe sleep environment before they are discharged to go home.
Cribs for Kids®—For families unable to afford a safe crib, the state funds a network of local partners that provide a Graco® Pack ‘N Play for their newborn.
ABC’s of safe sleep—The state is relaunching a public awareness campaign that reminds parents to place babies Alone, on their Back, in a Crib, because babies who sleep on couches, in bed with others, or on their stomachs are more likely to die from an unexpected sudden cause.
OB/GYN Toolkit—To insure patients get as much information as possible about keeping newborns safe, our Safe Sleep Subcommittee is putting together a toolkit for OBs, gynecologists, nurse midwives and lactation consultants to address safe sleep and educate their patients.
As part of the SFY 2016-17 biennial budget process, the Ohio Department of Medicaid (ODM) –in partnership with Managed Care plans – invested $26.8 million over two years to support community-driven proposals to combat infant mortality at the local level and enhance coordination among various agencies that provide care for women and infants at risk. Funding was awarded to community organizations located in areas of the state with the highest infant mortality rates. Initiatives included focused efforts on home-visiting, faith-based community support, fatherhood initiatives, centering, mental health and addiction, cultural competency training, and community health workers.
The same level of funding for these community efforts were also provided as part of the SFY 2018-19 biennial budget process.
Molina Healthcare is very invested in lowering the infant mortality rate and we are grateful for Ohio’s leadership in taking on this issue, and that these measures will make a difference. Here’s hoping every baby boy and girl gets a chance to celebrate their first birthday!