Losing Babies

Fort Worth leads the state in a sad statistic: infant mortality.
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Posted March 27, 2013 by BY SARAH ANGLE | Photos by Tony Robles in News

The county report showed that 61 percent of moms who had lost children to infant mortality were overweight or obese when they got pregnant. Extra weight adds risk to pregnancy — and like many of the other factors associated with infant deaths, obesity is linked to poverty.

“Obesity doesn’t cause one specific problem, but many,” Dr. Henderson explained. Extra weight can increase a woman’s chances of developing gestational diabetes, decrease oxygen delivery to the  fetus, and increase the risk of pre-eclampsia, a potentially fatal condition that causes high blood pressure and a build-up of protein in the urine. (For fans of Downton Abbey, that’s what caused Lady Sibyl’s death last season.)

There’s also a correlation between obesity in the mother and stillbirth, Henderson said, but doctors aren’t exactly sure why. “Correlation doesn’t mean causation,” she warned.

Wilder: “We’re trying to make people healthy for nine months, but it starts way before we’re pregnant.”

Wilder: “We’re trying to make people healthy for nine months, but it starts way before we’re pregnant.”

According to the state health department, African-Americans and Hispanics have higher obesity rates than whites. Henderson said African-American women also have a higher chance of delivering their babies prematurely, although the reasons aren’t clear. Both factors increase the risks of infant mortality for blacks and Hispanics: In the county study, 37 percent of the mothers whose babies died were African-American — twice their representation in Fort Worth’s population.

Gracie Stearns, a bilingual health education specialist with Healthy Start, said that immigrants to Texas from Latin America have higher rates of infant mortality once they get here. “They start eating fast foods, and they no longer go to the market and eat fresh foods or exercise,” she said. The longer such immigrants stay in the United States, the higher their risk of infant mortality, Stearns said.

The Healthy Start program focuses on 11 Tarrant County zip codes with the highest rates of infant mortality; many of the areas have a majority-minority population.  The zip code with the single highest infant mortality rate is in southeast Fort Worth, which also has some of the highest poverty rates in the area.

“Our program targets African- Americans and Hispanic moms, because those two races have the highest rates of infant mortality,” said Misty Wilder, outreach program manager. The women she works with have various obstacles to healthy pregnancies — and healthy lives —  including lack of transportation, a weak support system, and poor access to care.

The dangers to babies of sexually transmitted diseases are another important reason for women to get prenatal care during their first trimesters.

In Tarrant County’s study, such diseases were the most common form of medical problems reported by women who lost their babies, said Micky Moerbe, biostatistician at Tarrant County Public Health and one of the study’s authors.

STDs can be passed from mother to child during pregnancy and birth. According to the Centers for Disease Control, STDs can bring on early labor and are a contributing factor in stillbirths, low birth weight, and other serious complications. If STDs aren’t caught and treated early in a pregnancy, the diseases can affect a baby’s development.

“It makes a big difference getting treated for a sexually transmitted infection before delivery,” said Massingill. If a woman is trying to get pregnant, she and her partner should get tested, he said.

Between 2004 and 2009, the rate of sexually transmitted diseases in pregnant women increased by 191 percent in Tarrant County, although those numbers have since declined somewhat. African-American mothers had far higher rates of STDs than other ethnic groups.

“Sexually transmitted infections are more prevalent because we don’t do a good job at sex education,” Massingill said. “Condoms, even in the worst-case scenario, prevent 70 percent of sexually transmitted infections.”

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Although obesity, sexually transmitted diseases, and poverty in general are significant factors in infant deaths, they don’t do much to explain Tarrant County’s dubious honor of having the worst infant mortality rates in the state.

The county’s poverty rate isn’t far off the state average, and local rates of obesity and STDs aren’t much different than elsewhere in the state. Teen pregnancy isn’t considered a strong indicator for infant mortality, and while Fort Worth and Tarrant County are near the top of an undesirable heap in terms of teen pregnancy statistics, so are all the other major Texas cities.

But health practitioners and others see high STD rates and high teen pregnancy rates as part of the same larger problem.

“We don’t just have a teen pregnancy epidemic in the state, we have a huge problem with sexually transmitted infections,” said Dan Quinn, communications director at Texas Freedom Network, an advocacy group that promotes civil liberties.

Massingill said teen pregnancies are more likely to be unplanned, teen mothers are more likely to be unmarried, and they are more likely to delay getting prenatal care until late in their pregnancies — and those factors do affect infant mortality. According to the United Way, Tarrant County ranks ninth-highest in Texas for teen pregnancies, behind other major metropolitan counties.

Wilder, with Healthy Start, and Ann Salyer-Caldwell, with the county health agency, both emphasized that women who want to become mothers really should think about getting and staying healthy long before they get pregnant.

“We’re trying to make people healthy for nine months,” said Wilder. “But it starts way before we’re pregnant. I don’t think a lot of people realize it — I didn’t. It’s a full life course perspective.”

“One healthy life equals another healthy life,” Salyer-Caldwell said.

A pregnant woman’s health is also affected by her environment and her culture, by what she eats and how much she exercises, Massingill said — and a doctor may not be able to have much effect on those things. For poor women, eating cheap is a lot easier and more convenient than eating healthy.

Massingill said he thinks Tarrant County does a great job in caring for women during pregnancy and delivery but falls short on providing care between the baby’s first six weeks and its first birthday. “A lot of the problems … can’t be addressed through better medical care,” he said.

Salyer-Caldwell said she thinks the topic of infant mortality is so depressing that many people will tune it out.

“People want to hear about healthy babies,” she said. “We want to talk about solutions now.”

 

Jodie held a small memorial service for her son.

“Everyone prayed over the family. It was really nice,” she said, remembering the funeral at Baylor Hospital in Dallas six years ago.

She said she knows now that her son’s death wasn’t her fault. “I’m at peace with it inside,” she said.

 

Fort Worth freelancer Sarah Angle writes for national and regional publications.


7 Comments


  1.  
    John Stoutimore

    “Losing Babies” began with Jodie’s plight. She was pregnant, poor, and in her second pregnancy. But she lost the baby because she couldn’t afford a doctor and didn’t know how to apply for Medicaid. By her third pregnancy, her problems were solved. Oh, she was still poor, but now she had taxpayer-provided prenatal care and everything turned out peachy.

    It’s fair to ask whether women who can’t afford prenatal care will be able to afford postnatal care. Will they be able to feed, house, and clothe their children? Or will taxpayers take care of that too by way of T.A.N.F., W.I.C., and Section 8?

    We as a nation cannot afford this any longer. The best solution is for Jodie to keep her pants on. She can’t procreate her way out of poverty.




    •  
      Heather

      You are a disgusting individual. Your comments are ignorant at best, and chauvinistic at worst.




    •  
      P

      I lost my daughter. And had insurance. Paid all my medical bills. Had trained professionals helping me. Nothing could save my daughter.
      Thinking that you would actually cover something worthwhile I picked this issue up. It’s all about uninsured infant deaths…..my sweet angel would have had ANY monitary care needed. And sure as hell had every bit of medical care. Yet still, she is gone.

      I go see her every night. Losing my daughter has shattered my world. Not only do I thank you for your poorly written article, but I thank you for;

      -not researching the actual issues.
      -picking only the side of a poor uninsured woman.
      -FOR YOUR COVER THAT DEPICTS OUR CHILDREN’S RESTING PLACE AS A VAMPIRE COFFIN.

      Women around the world are upset about the cover image. Mothers who have lost their children all the way in Kenya are nauseated by your choice of illustration.

      How about foot prints? An angel teddy bear? No no no a vampire coffin.

      Just so you know, my daughter along with everyone else’s child for the past 65 years have been buried in a rectangle casket. Just like everyone else. Smaller, but for the most part the same. Your choice to not think more about the fact, “if Fort Worth is one of the leaders in infant death, maybe all of these mothers and fathers would like to see a poorly drawn mock of their child’s casket…” makes me sick.

      You are obviously not a mother. Or your conscience would have stopped you from that cover.




    •  
      P

      I lost my daughter. And had insurance. Paid all my medical bills. Had trained professionals helping me. Nothing could save my daughter.
      Thinking that you would actually cover something worthwhile I picked this issue up. It’s all about uninsured infant deaths…..my sweet angel would have had ANY monitary care needed. And sure as hell had every bit of medical care. Yet still, she is gone.

      I go see her every night. Losing my daughter has shattered my world. Not only do I thank you for your poorly written article, but I thank you for;
      -not researching the actual issues.
      -picking only the side of a poor uninsured woman.
      -FOR YOUR COVER THAT DEPICTS OUR CHILDREN’S RESTING PLACE AS A VAMPIRE COFFIN.

      Women around the world are upset about the cover image. Mothers who have lost their children all the way in Kenya are nauseated by your choice of illustration.
      How about foot prints? An angel teddy bear? No no no a vampire coffin.
      Just so you know, my daughter along with everyone else’s child for the past 65 years have been buried in a rectangle casket. Just like everyone else. Smaller, but for the most part the same. Your choice to not think more about the fact, “if Fort Worth is one of the leaders in infant death, maybe all of these mothers and fathers would like to see a poorly drawn mock of their child’s casket…” makes me sick.
      You are obviously not a mother. Or your conscience would have stopped you from that cover.




  2.  
    John Stoutimore

    A classic liberal response. Heather deftly avoids the substance of her adversary’s argument by calling him names. She deserves a B-. Had she included more trendy terms such as ‘racist’ and ‘homophobe’ she would have rated an A.




    •  
      Skeptic

      I really dislaike it when the current media exploits a tragedy, throws a bunch of incongruent “facts/data” together and comes to an illogical erroneous conclusion (which conveniently conforms to their ideology). The young woman was a displaced person from the Katrina tradgedy 2005 (statistics show that a hurricane of that magnitude has occurred once in 80 years in N.O., the last being 1926- although other less significant hurricanes have occurred in the interval). The Tarrant county community- unfairly vilified in this “article” offered shelter and housing through (limited) federal assistance, and now has provided a tax funding base for many who are not supporting themsleves and choose to stay. There are of course too many unanswered questions here: The pregnancy occurred two years after the storm,-2007- so where was her family? Why didn’t she go back to more familiar surroundings? Why not contact the Feds who provided the initial monetary and other relief? Why not contact a religious or other charity organization and ask for help? Even assuming that she felt well and her aminiotic fluid was not leaking-where did she plan to give birth–at home? JPS? In order to stay here she must have been a participant in relief efforts, so why NOT familiarize yourself with Medicaid?
      Was there any planning going on? When she started to feel badly (or even suppected she was pregnant )why not just go to JPS or another ER-all hospitals treat the uninsured, which is one reason why standard helath insurance is so expensive. The Docs and their hospital facilities featured in the report have been around for many years. I do not know of anyone who has been turned away from JPS-even folks from other countries. If you want to be intellectually honest–you will see that Federal mortality data bases do not support the author’s conclusions regarding Tarrant county being the highest in infant mortality, although that sentiment has been used more than once in this publication to support FWW’s “guilt trip” agenda. You, John, are quite within your rights as a taxpayer or even as a normal citizen supporting the social compact, to ask: now what? The incessant urge to blame everyone else for one’s own problems is a road to nowhere…and the real crime against this young lady is that she is encouraged by the authors of this and similar pieces to futility waste her life blaming the community which reached out to help her.




  3.  
    Skeptic

    Sorry about the abundant typos, I hope that you get the point, however…





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