Babies die for many reasons, not all of them preventable. But health advocates say the leading factor in infant deaths is low birth weight: Too many babies are being born weeks or even months early, resulting in tiny babies weighing sometimes 1 to 2 pounds struggling for life in neonatal intensive care units.
If they survive, they often have debilitating developmental disabilities for life, said Rae Bond, executive director of the Chattanooga-Hamilton County Medical Society and chairwoman of the Core Leadership Group on infant mortality.
There’s a misconception that teen pregnancy is at the root of most cases of premature babies, said Ann Everson, regional perinatal coordinator at Erlanger.
“We want to blame it on teenagers, but that is not the case. The teenage pregnancy rate has actually improved lately,” she said.
Most moms she sees who have premature babies are often 18 to 23, smokers, low income with a low education level, she said.
Some go through their entire pregnancy without any prenatal care, she said.
“They think they’re young, they’re healthy. They don’t need to go to a doctor,” Ms. Everson said.
But mothers who do not receive prenatal care are three times more likely to give birth to a low-weight baby (less than 5.5 pounds) and those babies are five times more likely to die before their first birthday, according to the local health department.
In 2004-2007 in Hamilton County 262 residents did not get any prenatal care, according to Hamilton County’s 2010 Community Health Data Profile by the local health department.
Some babies face socioeconomic hardships from the moment they enter the world, born to mothers battling poverty, undiagnosed mental illness and abusive partners, advocates say.
Deeply entrenched cultural norms – such as a distrust of medical providers among minorities that hinders prenatal care, and a lack of awareness about the importance of breast feeding – are some of the most challenging to overcome, health advocates say.
“You’re looking at generations of issues – if this wasn’t important to Mama and Grandmama, it’s not important to me,” said Mildred Moreland, chairwoman of the health committee of the East Side Task Force.
But infant mortality rates are also so high in Tennessee simply because of the poor health of the general population.
A mother’s body is less likely to be prepared for a healthy pregnancy because of high rates of obesity, diabetes and high blood pressure, said Dr. Lisa Lowery-Smith, medical director of the neonatal intensive care unit at Parkridge East.
“It all seems to come back to the one common theme of people just don’t take care of themselves,” she said.
NICU BEDS
Preemies in the region often are treated in the neonatal intensive care units at T.C. Thompson Children’s Hospital at Erlanger and Parkridge East. Because of increasing levels of high-risk pregnancies in Chattanooga and the region, in 2007 T.C. Thompson added an eightbed pod to its neonatal intensive care unit, bringing the total beds to 58. Parkridge East has 22 beds in the NICU.
COSTLY CARE
The monetary cost of premature births is enormous. Care in the neonatal intensive care unit costs about $1,000 a day, and the average length of stay in the unit is 18 to 21 days, said Ann Everson, regional perinatal coordinator at Erlanger.