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

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.