I

n the US, a rising number of babies are living to see their first birthday, according to a study released Tuesday by the Centers for Disease Control and Prevention.

The data show that infant mortality has declined by 15 percent over the last decade, with the biggest gains concentrated in the south and east of the country. That’s good news given that the US has persistently had a higher rate of infant deaths than other wealthy nations.

The new report doesn’t compare the US to other countries, but it does highlight states that have been particularly successful. Colorado, Connecticut, South Carolina, and Vermont all saw drops of more than 20 percent in infant death rates from 2005-2007 to 2012-2014. Washington, D.C., saw a drop of almost 50 percent, although it’s much smaller in population.

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Doctors across the United States credit a variety of initiatives for helping children survive.

In Vermont, for instance, clinicians at the state health department have tried to stem the number of women scheduling deliveries before 39 weeks of pregnancy, which can be risky for a baby’s health. Dr. Breena Holmes, director of maternal and child health at the state’s Department of Health, said Vermont’s small size made a one-on-one approach possible: Staff from her department regularly met with community hospital staff and explained why it was a bad idea for a woman to give birth before the baby came to term.

That intervention, along with a number of others — such as sending nurses into new mothers’ homes to help them care for their newborns, and teaching new mothers not to sleep with their babies — may help explain the decrease in Vermont’s infant mortality rate: It fell by 23 percent, from 5.74 to 4.42 infants per 1,000 live births over the years covered by CDC’s analysis.

In South Carolina, another state that saw a large decline, the state Department of Health and Environmental Control says that advances in care for babies born with a low birthweight may have played a role. “The largest contributor to this decrease in infant mortality has been that these very small infants have been more likely to survive,” said Robert Yanity, the department’s public information officer. In the years covered by the CDC report, Yanity said that the mortality rate for low birthweight infants fell by about 20 percent.

Other interventions have also played a role. For instance, in order to discourage women from scheduling early deliveries, the state Medicaid program decided that it would stop paying for the procedures in 2013, said Dr. Amy Crockett, the clinical lead for the South Carolina Birth Outcomes Initiative, a program of the state’s health and human services department.

Around the same time, Crockett said, the state made it easier for women to receive long-acting contraception, like an implant or intrauterine device, right after they gave birth, based on the idea that intended pregnancies lead to healthier children.

Previously, there was no “billing code” for receiving this contraception while staying at the hospital — meaning there was no easy way to get insurance to pay for it. The women would have to leave the hospital and then come back for follow-up appointments. And many missed those appointments.

So, Crockett said, the state needed a new billing code. Her hospital in South Carolina started using the billing code in 2013, and Crockett said that now, more women leave the hospital with some type of contraception after they give birth.

The CDC data doesn’t credit any of these particular programs with lowering the infant mortality rate — it simply points out that the rate is in decline. But doctors see this data as an affirmation that their initiatives are working. “We’re really proud of our work,” Holmes said.

But the US rate is still high by international standards, and clinicians’ efforts still continue. One of Vermont’s current projects is to try to reduce the number of women who smoke while pregnant. About 18 percent of pregnant women in the state smoke, a number that’s remained steady for the past two decades.

“We’re perfectionists up here,” Holmes said. “We still feel like we have a lot of work to do.”

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  • I’m wondering if anyone has an answer for my question.

    “Other interventions have also played a role. For instance, in order to discourage women from scheduling early deliveries, the state Medicaid program decided that it would stop paying for the procedures in 2013…”

    The question I have regarding this is that I wasn’t aware women can schedule early deliveries for non-medical reasons. Why was is allowed and covered for someone to induce an early labor (assuming health/medical issues weren’t the reason for it)? It seems odd that someone would do this unless it was medically necessary.

  • This is great news! As a resident of Washington, DC, I do, however, want to point out that DC has a population that is bigger than the state of Vermont – so if you are going to highlight what Vermont did in a small state to achieve their decline, I’m not sure why you diminish DC’s much bigger rate of decline by suggesting that a small population size makes this less impressive.

  • This is great news! We are so happy that Dr Crockett and her team are having such a great impact on this issue. We are grateful for all her CenteringPregnancy work!

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