Strategies for improving birth outcomes among high risk women in Mississippi: Financial challenges in implementation of interconception care

Background: Mississippi leads the nation in infant mortality, low birthweight, very low birthweight, and preterm birth. Mississippi's 2007 infant mortality rate of 10.1 per 1,000 live births greatly exceeds the Healthy People 2010 goal of only 4.5 per 1,000 live births.

Discussion: Maternal age and economics contribute to poor pregnancy outcomes. Mississippi has the highest percentage (nearly 53%) of births to unmarried mothers and highest rate of teen births (68.4 live births per 1,000 females aged 15-19). Teenage pregnancy, although not a leading contributor to infant mortality, contributes to the cycle of poverty within the state. Mississippi ranks as the poorest state with the largest percentage of residents living at 100% below the federal poverty level. Mississippi has historically maintained a large number of Medicaid-dependent residents. Rather than continuing to seek funding for high risk care, a more practical solution would be to reduce the number of high risk neonates, reducing costs for the public funding system.

Conclusions: Mississippi must overcome the financial hurdle to provide more comprehensive care for women of child-bearing age. These difficult economic times underscore the need for extensive action to improve both health and financial outcomes for the state.

Public Health Implications: Assisting women to set and achieve personal goals for reproductive health should be a priority consideration for public health professionals as we work together to improve health outcomes for infants and their families.