Infant Mortality
Goal
By 2027, reduce the infant mortality rate in Virginia to below the Healthy People goal of 5.0 deaths per 1,000 live births.
Infant mortality is a hallmark of overall health status of a population, which is why it has remained an objective of Healthy People 2030 and the Title V Maternal and Child Health Block Grant.
In 2020, 542 infants died before their first birthday in Virginia, making the overall infant mortality rate across all races 5.7 per 1,000 live births. This is a decline from an infant mortality rate of 5.9 in 2019. Since 2011, the overall infant mortality numbers have remained relatively constant, with a slight downward trend in recent years. However, this rate varies by race and ethnicity. For example, in 2020 the infant mortality rate among the non-Hispanic White population was 4.4, while the rate among non-Hispanic Black infants was 10.6. This disparity in infant mortality rates shows that Black infants were 2.4 times more likely to experience mortality than their white counterparts. To eliminate this disparity, the disparity ratio must be reduced to 1.0.
Strategies
Assess availability and utilization of prenatal care across the Commonwealth.
Partner with health care providers, home visiting programs, doulas, and community organizations to encourage healthy behaviors in pregnancy.
Assess the impact of social determinants of health (e.g., neighborhood, environment) on birth outcomes.
Strategies
Assess the impact of environmental health on infant mortality.
Fetal and Infant Mortality Review (FIMR) is a community based, action-oriented process to examine confidential, de-identified cases of fetal and infant deaths with the goal of identifying ways to prevent these deaths for women, infants, and families.
Conduct listening sessions and focus groups to understand barriers to implementing Safe Sleep strategies (e.g., parenting styles, cultural barriers, transient lifestyles, and parental age).
Partner with home visiting programs, doulas, early childhood centers, childcare providers, lactation consultants, community organizations, and caregivers to promote Safe Sleep interventions.
Strategies
Develop a state strategy on perinatal substance use.
Neonatal Opioid Withdrawal Syndrome (NOWS) is included under the umbrella of Neonatal Abstinence Syndrome (NAS). Whereas NAS refers to withdrawal due to exposure of multiple substances, NOWS refers to withdrawal due to exposure to opioids (www.MarchofDimes.org)
Ensure prevention education is given to providers and the pregnant population about the benefits of human milk feeding to mitigate effects of infant withdrawal symptoms during the early postpartum period.
Project LINK is an interagency, community-based collaborative program designed to coordinate and enhance existing services to help meet the extensive and multiple needs of women and their children whose lives have been affected by substance use.
Strategies
Increase the number of breastfeeding-friendly workplaces, encouraging lactation accommodations in the workplace.
Develop a state strategic plan for breastfeeding.
Ensure the provision of education about breastfeeding to providers and patients, to increase rates of babies breastfed at hospital discharge.
The Baby-Friendly Hospital Initiative (BFHI), a global program that was launched by the World Health Organization and the United Nations Children’s Fund in 1991, recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding and mother-baby bonding.
Educate providers, parents, and families on the Academy of Breastfeeding Medicine’s guidance on safe sleep practices and breastfeeding.
Strategies
Recognize chronic disease as a factor in maternal mortality, and partner with existing organizations to develop and coordinate regional systems for risk-appropriate care that addresses chronic disease in the pregnant population.
Expand innovative delivery methods and telehealth options, especially in rural and underserved areas, to ensure that pregnant individuals receive care for chronic health conditions.
Increase utilization of early prenatal and postpartum care.
Strengthen coordinated care models between clinical and community-based systems.
Strengthen the doula workforce by increasing the number of doulas overall, and the number of certified doulas that can be reimbursed by Medicaid.
Develop a state mental health strategy for the pregnant and postpartum population.