Kokomo Tribune; Kokomo, Indiana

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November 8, 2013

Letters to the Editor: Nov. 8, 2013



Mom’s health key to infant mortality rate

In response to Indiana’s infant mortality rank of 45 among 51 states, Gov. Pence and Indiana Commissioner of Health Dr. William Van Ness II convened the first annual Infant Mortality Summit.

All concur that poor infant morality is heartbreaking, costly and an indicator of a community’s poor health. Dr. Van Ness said Indiana’s infant mortality has been high for a long time. That phrasing obscures the trend. After decades of improvement, it’s been worsening the last three years. Unfortunately, the summit was more theater than substance.

Many possible solutions to high infant mortality were omitted. Indiana’s rejection of the Medicaid expansion denies health care to hundreds of thousands of low income men and women before pregnancy, early in pregnancy and long after. Unintended pregnancy and short intervals between pregnancy are big risk factors that weren’t mentioned, and better contraceptive access isn’t in the plan.

Exaggerated emphasis was placed on behavioral factors. Neonatologist Dr. Niceta Bradburn incorrectly reduced social determinants of health to obesity and smoking. The keynote speaker was the commissioner of health from Texas, not a beacon of health. Curiously, no obstetrician spoke. The blame was squarely on moms.

Dr. Virginia Caine stood alone in naming stress on pregnant women as a cause of toxic cortisol levels, premature rupture of membranes, low birth weight, prematurity and infant mortality. These Social Determinants of Health are factors outside of health care like unsafe neighborhoods, financial insecurity, lack of child care, relationship conflict, isolation, unhealthy food, unhealthy elders, racism and lack of power. Dr. Caine heads the Marion County Health Department, where infant mortality has improved.

The CDC, NIH and WHO all say stress on marginalized pregnant women must be relieved to improve infant mortality. How alarming that Attorney General Zoeller has both indicated and denied that he seeks forced opiate testing on all pregnant women. He insists it’s legal. This would further stress pregnant women and drive them away from health care.

Medical and public health professionals specifically oppose law enforcement and recommend more treatment facilities for misuse of prescription drugs during pregnancy.

Gov. Pence said there’s “treasure in Heaven” for saving babies. He should heed his own words. When a mother doesn’t thrive, her children don’t thrive. We need to support moms instead of threatening them. There is no holiness in putting ideology before infant mortality.

Sue Ellen Braunlin MD, Co-president of Indiana Religious Coalition for Reproductive Justice

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