Mississippi is taking new action on maternal and infant care after a rise in infant deaths. Plans from health officials call for expanding doula access for birthing people, increasing education on safe sleep practices and upping home visits.
Photo by FatCamera, courtesy iStockphoto
“Preterm birth really is the leading driver of infant mortality in this country. When we think about all of those causes, there are so many opportunities for prevention.”
— Michael Warren
Health officials in Mississippi took emergency action this summer in the wake of a sharp increase in infant deaths.
With infant deaths in the state reaching 9.7 deaths per 1,000 live births in 2024 — the highest rate in more than a decade — the Mississippi State Department of Health declared a public health emergency on Aug. 21. Over the past decade, more than 3,500 Mississippi infants have died before reaching their first birthday.
“This is not the way it has to be,” Daniel Edney, MD, Mississippi state health officer, told The Nation's Health. “This can change, this will change and we're working as a catalyst to help make it change.”
Mississippi's 2024 infant mortality rate was nearly 75% higher than the national average of 5.6 infant deaths per 1,000 live births. But the crisis in Mississippi falls disproportionately on Black infants, whose mortality rate was nearly three times that of white infants, at 15.2 deaths per 1,000 live births, compared with 5.8 per 1,000 for white infants, according to state health data.
The leading causes of infant mortality in Mississippi are preterm birth, congenital malformations, low birthweight and sudden infant death syndrome.
To address the problems, Mississippi plans to create standardized system for maternal and infant care, address maternity care deserts, expand access to resources for birthing people and infants through community health worker programs and home visits, and increase education on safe sleep practices. The health department also plans to partner with hospitals and clinicians to reinforce the importance of early prenatal visits.
Improving access to high-quality care is critical to preventing infant deaths. Medicaid provides coverage for prenatal care, labor and delivery, and postpartum care for eligible low-income pregnant people. But in Mississippi, more than 80% of infants who died were covered by Medicaid, according to Edney.
The state has made progress in expanding access to care. In 2024, it launched a program for low-income pregnant women that allows them to receive immediate prenatal services while their full Medicaid applications are reviewed.
But limited access to care remains a concern. In Mississippi, more than half of counties lack maternity health care services, according to the March of Dimes. Nearly 25% of women in the state live more than 30 minutes from a birthing hospital, more than double the national rate of less than 10%.
For Edney, the ultimate goal is not merely to move Mississippi off the bottom of the list in national rankings for infant mortality, but to eliminate the problem altogether.
“I'm extremely frustrated, disappointed in the 2024 numbers,” he said. “But I also know that our strongest programs really have the power to push (this in) the right direction.”
Mississippi's preterm birth rate has also been on the rise, accounting for 15% of births in 2023. The state also has higher rates of chronic conditions such as hypertension, diabetes and obesity, which raise the risk of preterm birth. Environmental factors, including extreme heat and poor air quality, can also increase the risk of poor maternal and infant health outcomes, including preterm birth.
“Preterm birth really is the leading driver of infant mortality in this country,” Michael Warren, MD, MPH, FAAP, chief medical officer at the March of Dimes, told The Nation's Health. “And so when we think about all of those causes, there are so many opportunities for prevention.”
For more information, visit www.msdh.ms.gov.
- Copyright The Nation’s Health, American Public Health Association
