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Recommendations from the Fetal Infant Mortality Review Program

Recommendations from the Fetal Infant Mortality Review Program. Central Commonwealth Perinatal Council Cheryl Bodamer RN, MPH. FIMR 2004 Case Reviews. FIMR 2004 Case Reviews.

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Recommendations from the Fetal Infant Mortality Review Program

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  1. Recommendations from the Fetal Infant Mortality Review Program Central Commonwealth Perinatal Council Cheryl Bodamer RN, MPH

  2. FIMR 2004 Case Reviews

  3. FIMR 2004 Case Reviews • Eighty-eight percent of the infants who died were black, 8% were white and 4% were Hispanic. Fifty-four percent were males, and 46% were females. • Fifty percent of the infants were of very low birth weight (< 1500g), but 38% were > 2500g. Of the SIDS, asphyxia and undetermined deaths seven out of nine (78%) were of normal birth weight. The undetermined deaths involved an unsafe sleeping environment of the infant . • Sixty-eight percent of mothers were 18-29 year-olds, 16% were women under 18, and 16% women over thirty.

  4. FIMR 2004 Case Reviews • Half the mothers were unemployed, only 12% had private insurance. 38% did not graduate from high school and only 12% had any post-high school education. • Only half the mothers sought prenatal care in the first trimester, but 90% did have prenatal care consisting of more than one prenatal visit. • Forty two percent of mothers admitted to smoking cigarettes, and 33% used some form of illegal drugs.

  5. Findings • Infection, preterm labor, previous fetal and infant loss, late entry to care, missed prenatal appointments, unsafe sleep surfaces for infants and poverty were identified as common issues in these deaths

  6. Fetal Infant Mortality Review: A Systems Approach to Recommendations • Community Based Education • Interagency Linkages • Internal Organizational Practices • Professional Training and Education

  7. FIMR Recommendations: Community Based Education • Importance of early prenatal and pediatric care • Prenatal education including Pre-term labor, Folic Acid supplementation • Educate women of childbearing age re family planning • Back to Sleep campaign and safe sleeping environment, hidden hazards of adult beds for babies

  8. FIMR Recommendations: Professional Education • Provide screening and referral for substance use, violence/abuse, perinatal depression • Review management of hypertension in pregnancy • Educate caregivers re: Back to Sleep, safe sleeping environment

  9. FIMR Recommendations:Internal Organizational Practices • Prenatal psychosocial assessments including screening for perinatal depression and violence/abuse • Referrals to nutrition services for obese clients

  10. FIMR Recommendations: Interagency Linkages • Agency Partnerships improved communication/follow-up • Increase teen pregnancy prevention support services • Increase resources for home visitation for high risk clients • Expand health insurance for low income working women up to 200% FPL

  11. Priority Recommendation #1 • Develop a culturally competent public health campaign on “Back to Sleep” emphasizing safe sleeping for infants based on recommendations by the American Academy of Pediatrics and the Consumer Safety Commission

  12. Implementation Status • FY 2006: Continue distribution of materials and offer educational trainings. Meet with Oliver Creative and the Hodges partnership regarding additional campaign materials

  13. Priority Recommendation #2 • Prenatal education for pregnant women on the signs and symptoms of preterm labor, high blood pressure during pregnancy, and perinatal depression

  14. Implementation Status • Training held in September 2005 @ CCPC quarterly meeting. Continue distribution of educational materials, continue to market the VDH perinatal depression training website

  15. Priority Recommendation #3 • Address the issues related to the lack of access to obstetric care in the region • Form a regional access to care group to develop a strategic plan • Work with local task groups and community agencies in rural areas

  16. Implementation Status Regional Access to Care group formed March 2005 Education and training plans: • Develop tools for improving emergent care of the pregnant women • Maternal Transfer Form • Obstetric guidelines for preeclampsia, vaginal bleeding, preterm labor

  17. Implementation Status Education and training plan • Develop EMS training video on Neonatal resuscitation in conjunction with the Office of EMS @ VDH (completed 8/05) • EMS tele satellite training with new NRP video (completed 9/05) • Conduct perinatal outreach education on OB/Neonatal programs to the three ER’s- Rappahannock, Tappahannock, Emporia

  18. Implementation Status • Participate in workgroup for statewide OB pilot project – HB2686 • Attend “How to Start a Birth Center Training” (completed November 2005) • Look at different models of birth centers • Assist with looking for funding support

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