The infant mortality rate is rising. How can we bring it back down?

After decades of decline, the United States’ infant mortality rate is on the rise. Turning trends back around may require a multifaceted effort to protect newborn babies – and their mothers.

Ilan Shapiro, MD, FAAP, FACHE, a pediatrician, chief health correspondent, and medical affairs officer at AltaMed Health Services, says that looking at the data should prompt “an important call for action to evaluate what we are doing to protect our kids and pregnant people,” which includes addressing environmental and societal issues.

Infant health “correlates with maternal health,” Dr. Shapiro adds.

Below, healthcare workers highlight some ways to support maternal and infant health.

Ensuring healthcare access

For mothers and babies, access to healthcare is key in disease prevention and recovery. Ensuring that pregnant people, new mothers, and newborns – all of whom can be more vulnerable to sickness – have access to healthcare support can be crucial in protecting their longevity and well-being.

“When we are taking care of the mother throughout their pregnancy, having access to health care can reduce complications for a child's first year of life,” Dr. Shapiro says. This can include access to regular check-ups and vaccinations, among other things, he adds.

US News and World Report’s rankings list Hawaii, Connecticut, and Massachusetts as the three states with the best access to healthcare and Florida, Oklahoma, and Alaska as the three states with the worst access.

Promoting prenatal care services

One major pillar of healthcare access is access to prenatal care. While many mothers in the US receive adequate access to prenatal care, sizable amounts receive inadequate or no care as well.

“Access to preventive health services and evaluations for pregnant people encourages regular health screenings throughout the pregnancy, which are key to maintaining the mother and infant’s' health and identifying issues that can be managed,” Dr. Shapiro says. 

He adds that community health centers also play a crucial role in promoting affordable healthcare access and protecting the livelihood of expectant mothers and their babies.

Honing in on prenatal disease prevention 

People can be more vulnerable to common infections while pregnant, and they can also be at risk for life-threatening diseases. One serious condition that doctors should be ready to diagnose and treat is preeclampsia, a condition related to high blood pressure in pregnancy.

Doctors should also educate patients on their risks for preeclampsia and act quickly to treat those who are diagnosed.

Preeclampsia

Preeclampsia is a rare but serious complication that is related to high blood pressure in pregnancy. If cases get severe, people with preeclampsia can be at risk for organ damage, seizures, or even death. It impacts about 4% of US pregnancies and is one of the leading causes of maternal deaths worldwide.^[][] 

Monitoring patients’ blood pressure and giving patients the tools to check their blood pressure at home when possible may also help reduce risks by making people aware of their blood pressure levels.

There is no foolproof cure for the condition, and inducing early labor can be necessary to protect the health of the mother. However, this can pose some risks for the baby as prematurely born infants may have organs that are not fully developed, like their lungs.

Maria Sophocles, MD, FACOG, NCMP, a board-certified OB-GYN at Women’s Healthcare of Princeton in Princeton, NJ, says that mothers who are going into early labor can be given steroids to help protect their baby’s lungs.

In cases of early labor, proper NICU and postnatal care can also be essential to protect the health of the child.

Strengthening the NICU

Sarah Jeffries, MsC, a mental health first aid trainer based in Scotland, says she would like to see more effort put into strengthening Neonatal Intensive Care Units (NICUs) to reduce infant mortality rates.

“Enhancing the capabilities and resources of NICUs can ensure that premature infants and those born with complications receive specialized medical attention promptly,” Jeffries says. She adds that “investing in state-of-the-art equipment, skilled healthcare professionals, and continuous medical research can significantly improve the survival rates and long-term outcomes for these vulnerable newborns.”

Supporting postnatal care

Supporting mothers after delivery is also crucial in fighting infant mortality rates. Healthy parents can more effectively support and care for their newborns.

“Providing education on infant care, breastfeeding support, and guidance on recognizing signs of illness or developmental issues can empower parents to provide a nurturing and safe environment for their newborns,” Jeffries says. “Postnatal home visits by healthcare professionals or community health workers can further reinforce this support, offering personalized guidance and addressing specific concerns that parents may have.”

Supporting mothers’ mental health

Postpartum depression rates have dramatically increased over the last decade, according to research by the American Journal of Obstetrics and Gynecology (AJOG). Postpartum depression can be severe and can impact a mother’s mental well-being and ability to care for their infant. Diagnosing and treating postpartum depression may help mothers navigate the condition and reduce risks for infants.^[]

“Healthcare providers can help mothers navigate the challenges of early motherhood, ensuring their emotional well-being and, consequently, the well-being of their infants,” Jeffries says.

More steps exist to help support healthy newborns. In addition to the above, the National Institute on Child Health and Human Development (NICHD) encourages doctors to work to prevent infant birth defects, address low birth weight, prioritize newborn health screenings, and create safe sleeping environments for babies.^[]