218639 Infant Mortality: Learning from African American mothers who have recently lost a baby

Tuesday, November 9, 2010

Emmanuel Ngui, DrPH, MSc , Department of Pediatrics, Medical College of Wisconsin, Center for the Advancement of Underserved Children, Milwaukee, WI
Alicia Cortright, MPH , Infection Prevention and Control, Red Deer Regional Hospital Centre, Red Deer, AB, Canada
Karen Michalski, MA, MSW , City of Milwaukee Health Department, Fetal Infant Mortality Review Coordinator, Milwaukee, WI
BACKGROUND: The City of Milwaukee, Wisconsin has one of the highest African American (AA) infant mortality (IM) rates in the nation. Underlying reasons for this disparity are unclear. Efforts to reduce IM rarely include perspectives of mothers who have lost a baby. OBJECTIVE: To examine perspectives of AA mothers who have recently lost a baby due to prematurity or low birthweight on IM. METHODS: Focus groups of AA women 15-40 years old who had recently lost a baby examined several domains (e.g., prenatal care, barriers to care, patient-physician relationship (PPR), stress, perceived racism, and male involvement). Thematic analysis of transcripts was used to identify key themes associated with IM. RESULTS: Stress and poor PPR were the most frequently mentioned themes, followed by barriers to care and management of maternal conditions (e.g. diabetes, hypertension). For PPR, many women frequently cited providers as callous, dismissive, uncaring, and not taking women′s concerns seriously until it was too late. Neighborhood deprivation was identified as a major stressor that limits access to care and healthy foods, and ability of AA males to support/provide for their families. Women felt they had more resources than AA men, which limited men′s ability to provide for the family or discouraged men from trying. CONCLUSIONS: Perspectives of mothers who have experienced an infant loss can inform community IM reduction programs. Findings suggest the need for concerted efforts to reduce stress, improve PPR, cultural competency, and quality of care including better screening and management/referral of maternal conditions before and during pregnancy.

Learning Areas:
Diversity and culture
Public health or related research

Learning Objectives:
1) Discuss perspectives of mothers who have lost a baby on infant mortality 2) Examine key themes associated with infant mortality that could inform infant mortality reduction programs

Keywords: Infant Mortality, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I helped design and oversee the collection and analysis of the data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.