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In Mississippi, a Local Take on Curbing Infant Mortality

Mildred Thomas missed a period, but it wasn't second period Math, or fifth period Arts. She missed her biological period. She was pregnant. She was 13.

By Fia Curley

Mildred Thomas missed a period, but it wasn't second period Math, or fifth period Arts. She missed her biological period. She was pregnant. She was 13.

Thomas, an African American girl from Mississippi, said a lot of things went through her mind when she found out she was pregnant. How to tell her mother? How to do this? Can she do this?

Tanya Lee holding an infantAbout seven months later, when Thomas finally got around to telling her mom, her mother went out to Cary Christian Center Exit Disclaimer in Cary, Miss., and signed Thomas up for the same prenatal classes she had taken when she was pregnant with Thomas. But the seventh grader didn't mind.

"I wanted to learn more about what was going on with my body," Thomas said, "because you see on TV a lot of people having postpartum [depression] and I didn't want to be like that."

Through the Center's Parent Child Ministry, which began in 1978, a woman can take classes to help her become a better parent in all stages of her child's development and decrease the rates of infant mortality that were once higher than the national average.

Although Thomas was eager to learn, she admits that she was a little apprehensive about taking the classes.

"I thought they were just going to be boring; a lot of old women just staring at me because I'm a pregnant 13-year-old," said the avid reader of religious fiction and short story and poetry writer.

Instead Thomas said the atmosphere was serene and friendly, as the expecting mothers started class with Biblical devotionals and then played games to help them remember critical prenatal facts.

"Nobody judged me or tried to belittle me," she said. "Learning was fun."

The prenatal class is part of the Parent Child Ministry, one of seven of the Center's ministries, which focuses on building a solid foundation for the future of parents and their children with the prenatal, terrific toddler and parenting classes.

The Center, formerly known as Cary Christian Center Clinic, was started in 1971 by Dr. Peter Boelens, a pediatrician, who wanted to address the needs of the community by creating a clinic. Back then, a family was charged $10 for the year and received medical care, and eventually dental care, through the clinic, according to Carolyn Newhof, director of the center.

Decades later, the clinic portion is now closed and the in-house WIC office has been moved about eight miles north to Rolling Fork, causing the center to work with local hospitals. To this day, the Center relies on donations to help supply their program.

The ministry uses referral services, up-to-date information and the hands-on approach from a Christian perspective to lower the mortality rate in Sharkey and Issaquena, both cities in Sharkey County.

"We always encourage abstinence and encourage that your next wise choice to make is to be responsible and not have baby after baby," Newhof said. "We still will tell them about birth control, but you've got to meet mothers where they're at. What do you do with a pregnant 13-year-old? Put them down?"

In 1990, the infant mortality rate in Sharkey County was about 23 deaths per 1,000 live births, compared to about 13 and nine for Mississippi and the United States, respectively. That rate began to take a nose dive, falling below the state and national average, after home visitors were introduced into the program, according to Newhof.

"When dealing with mothers and babies, it really makes a difference," she said. "You just have to be there for them."

Pregnant women can be referred to the Center formally or informally, by anyone. The class is available to any expecting mother. Once they're referred, they will receive information in the mail about prenatal care, prepping them for the weekly class they can take during their seventh month of pregnancy.

However, if the mother is considered to be at-risk, trained community workers, called home visitors, will spring into action before the final trimester, visiting the mother in the home to ensure that she can carry to full term.

"We're just there as a support person," said Irma Johnson, the full-time ministry manager of a four-person team and part-time home visitor "We're available 24 hours a day, seven days a week, 365 days a year."

When mothers are not at higher risks for infant mortality, home visits normally begin after the prenatal class. Home visitors will help the mom prepare for any upcoming doctor visits – the mother has to call to schedule appointments – and ready the house for the newborn's arrival.

Home visitors also review topics, such as breastfeeding, choosing the right physician for the baby, monitoring physical changes and reminding mothers to put newborns on their backs when they sleep, maintain a healthy diet and keep up with their doctor visits.

The importance of a full-term pregnancy, and what to do to get there, is also stressed to young mothers especially, Johnson said, as they get closer to their due date and switch their prenatal care visits from clinics in Cary and Rolling Fork to the closest pediatric hospitals in either Vicksburg or Greenville, both 45 minutes away, where they will deliver.

Once newborns come home from the hospital, home visitors stop by twice a week, usually on Mondays and Thursdays, paying special attention to the baby's shriveling navel chord.

Last year 78 women came through the program, most of whom are bussed to the center because of lack of transportation. Each part-time home visitor, four in all, sees an average of 15 moms and babies a week.

"So many moms act afraid of the chord because the babies cry," said Johnson, "but their baby's going to cry when you put the alcohol on it because it's cold."

After the chord falls off, visits occur every two weeks and then once a month after the baby turns two-months-old.

Regardless of the frequency, the home visits make a big difference, according to Thomas.

"If I wouldn't have had my home visits, I would have messed up my baby," she said with a laugh.

Thomas, now 24 and married for five years, completed high school and an associate's degree in sociology and elementary education, before taking a position as a dental assistant at the Center. She has been through the prenatal class for all three of her children, ages 11, 4 and 7-months-old. She said she thinks she would have been lost if she hadn't taken the classes.

"I probably would have been sticking a Q-tip in my baby's ear and wiping my baby's navel with a blanket," Thomas said. "I would've been doing it backwards."

According to Johnson, a lot of the mothers in the prenatal class, the majority of which are young and single, get their information about caring for a baby from their grandmothers, who normally are not aware of recent recommendations. Johnson said the Center even sends out a pamphlet to grandmothers, specifically highlighting changes in newborn care.

"There are some that still believe what they believe," the 51-year-old said. "Even after you give them the information, there are still those that are going to do it their way."

Johnson said she has found other factors contributing to infant mortality in the community, namely issues of mothers unable to access Medicaid because of proper identification, such as a birth certificate, proof of income, picture ID and social security card, some of which can be replaced only by traveling 45 minutes to Vicksburg. Lower literacy levels may also play a role, Johnson said, as women are hesitant about the materials they receive and about asking the doctors questions.

"A lot of them need a lot of encouraging," she said, adding that she helps mothers write down questions to ask their doctors.

Johnson attributes part of the success of the ministry to the fact that everyone knows everyone in the small town and the home visitors are trusted because of their track record and approach to the situation.

"I learned a lot of things with my first baby. The baby doesn't come with a manual. It's really loving them - not judging them, just loving them."

--

Fia Curley is a writer for the OMHRC. Comments? Email: fcurley@minorityhealth.hhs.gov

Links

A Healthy Baby Begins with You
http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=117

Pregnancy Information: Before, During and After
http://www.cdc.gov/ncbddd/pregnancy_gateway/default.htm

Healthy Start, Grow Smart
http://www.ntis.gov/cms/index.aspx

Infant mortality facts
http://www.cdc.gov/omhd/AMH/factsheets/infant.htm

Infant Mortality organizations
http://www.healthfinder.gov/scripts/SearchContext.asp?topic=456&show=1

March of Dimes
http://www.marchofdimes.com/ Exit Disclaimer



Content Last Modified: 7/9/2007 11:43:00 AM
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