No matter where you stand on the whole health-care debate, it’s tough to argue with the fact that our revamped system needs to address our appallingly high rate of infant mortality. Though the American economy is the largest in the OECD, our babies perish more frequently than the organization’s average. In fact, our national infant mortality rate is only slightly better than Lithuania’s, and it’s slightly worse than Slovakia’s. And as the chart above shows, no improvement has been made in nearly a decade—a fact in part ascribable to the paucity of pre-natal care available to the un- and under-insured.
What’s most tragic about this situation is that so little investment would be required to improve the rate. That’s because the key to reducing infant mortality at this point is merely to ratchet down the rate of exceedingly premature births—that is, births in which the infant gestated for less than 28 weeks. For a blueprint on how this might be achieved, check out this seventeen-year study of infant-mortality rates in Dane County, Wisconsin, where the longtime discrepancy between black and white infant-mortality rates vanished thanks to slightly better prenatal care:
The percentage of black women receiving adequate, adequate plus, and intermediate prenatal care (measured by expected number and timing of clinical visits using the Adequacy of Prenatal Care Utilization Index [the Kotelchuck Index]) increased from 81.6% to 85.3%. Improvement in quality of care received is suggested by an increase in maternal medical conditions recorded on the birth record from 48.9% to 59.4%, and a decrease in birth record reported obstetrical complications from 50.2% to 42.5%, coupled with substantial reductions in infant mortality for black women with reported medical conditions or obstetrical complications. The decrease in infant deaths per 1,000 live births for babies born to black mothers with previous child deaths (from 84.2 IMR [eight of 95] for 1990-2001 to zero IMR [none of 47] for 2002-2007) and to those with previous premature births (from 54.3 IMR for 1990-2001 to 8.1 IMR for 2002-2007) underscores major improvement in birth outcomes among highest-risk pregnancies.
Oh, and perhaps the most essential elements of that improved prenatal care? Getting moms to quit smoking.