An Orangeburg-based family wellness program that has worked for more than 20 years to address infant and maternal health is looking to expand doula services and other resources following alarming trends seen in South Carolina’s 2023 Infant Mortality Report.
The S.C. Department of Health and Environmental Control’s 2023 Infant Mortality Report is released annually by the agency’s Bureau of Maternal and Child Health.
The report released earlier this year showed that the overall state infant mortality rate rose 12% from 6.5% in 2020 to 7.3% in 2021, when the most recent data is available, and has grown by almost 40% overall since 2017 for infants born to non-Hispanic Black mothers.
Black infants continued to suffer disproportionately, dying at a rate of nearly 2.5 times that of white infants.
Family Solutions Director Lamikka Samuel said she is not surprised.
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“It’s extremely alarming. I’m not surprised that the disparity still remains, but I am surprised at the drastic increase in numbers. Coming from the world of home visiting, what this says to me is there still needs to be more education provided. It needs to be education that comes from more just one group of people,” Samuel said.
She said education must not come just from the obstetrical community or perinatal home visitors, but “I think that we need to start looking at how we can equip others with this same sort of education that they can provide to the community,” including churches and school districts.
“Outside of education, the other thing that comes to mind is that there needs to be more focused attention on the population at risk. … The non-Hispanic Black population is being affected the most. So whenever we start looking at strategies, we can’t just use that one-size-fits-all approach because that obviously does not work,” Samuel said.
She said cultural sensitivity must be coupled with cultural competence when it comes to providing care for women of color.
“That would include not just knowing and being aware that differences are present among cultures, but it’s also the behaviors and actually changing how you interact with different cultures as a result of your awareness of what their needs may be,” Samuel said.
She said Family Solutions has doulas to help provide some of that care. A doula is a trained professional who provides continuous physical, emotional and information support to their client before, during and shortly after childbirth to help them achieve the healthiest experience possible.
“Doulas are not clinical professionals. Doulas are there to provide that holistic, continual support starting at five months’ gestation. … It’s not any competition for any clinical professionals. It’s just an added layer of support and education,” Samuel said.
“We are making sure that our staff is culturally competent, that we are aware that those differences are present and adapt our behaviors, education and conversations and tailor them to the needs of the diverse cultures that we may be encountering,” she said.
Samuel said Family Solutions, which serves clients in Orangeburg, Bamberg, Allendale, Hampton and Barnwell counties, has four doulas on staff who were trained by a certified doula to be a community-based doula.
“They were able to go through the community-based doula training because they are already certified as community health workers. Then we have one who is completing her certification now through the Childbirth and Postpartum Professional Association. We offer those services to all of the women who are in our program free of charge,” she said.
Samuel said Family Solutions’ focus will be on the promotion of their doula services.
“We’re going to ensure that all of the women who enroll in our program know about them and connect them with a doula during the initial enrollment. So we see expanding our doula support services. We are also looking at other opportunities to expand our resources in our community and making utilization of those resources a lot easier,” she said.
Samuel continued, “With what’s called a Family Resource Center model, the goal is to co-locate some commonly-used community resources so that people aren’t having to bounce around from one office to the next to get some of the things they need.”
While the state’s infant mortality rate rose by 12% from 2020 to 2021, it rose more than 120% during that time in Orangeburg County from a rate of 9.4% in 2020 to a rate of 20.8% in 2021.
There was either no or miniscule change between those years in Bamberg County, which had less than five infant deaths reported in both 2020 and 2021. Calhoun County had zero deaths reported in 2020 and less than five reported in 2021.
Samuel said the sharp increase in Orangeburg County’s rate could be caused by a combination of things.
“That includes those maternal complications, some of the things that mom may have already been experiencing prior to becoming pregnant, or becoming pregnant and getting sick and not necessarily being treated for what that illness is while being pregnant,” Samuel said.
She continued, “The stress of the pandemic caused a lot of people to deliver early. … What a lot of people don’t understand is that stress can impact your health because that can affect your blood pressure and how a lot of the systems within our body function.
“When you’re pregnant, that can lead to a short gestational period, that preterm delivery of those low birthweight infants who may be born much too soon to have a chance of survival.”
Causes related to maternal complications of pregnancy were one of three leading causes of infant death in the state in 2021, along with congenital malformations, or birth defects, and disorders related to short gestation and low birthweight.
In terms of local disparities seen in the tri-county area in 2021, Orangeburg saw the greatest disparity between Black and white mothers with Black babies dying at a rate of 29.1% compared to less than five white babies dying.
The disparity was not as great in Bamberg and Calhoun counties, which both had zero white baby deaths compared to less than five deaths of Black babies in 2021.
“It’s not OK for any baby to die, it’s not OK for any mother to die, but when you have where you’re seeing just astronomical numbers among one population, then it’s time to really focus your efforts on addressing the needs within that population,” Samuel said.
She said “maternity deserts” have also contributed to racial disparities in the infant mortality rate.
“We’re here in Orangeburg County, and we’ve gone from having several practicing OB/GYNs in our area to now our community is limited to where they can go for care,” Samuel said.
She continued, “Then not just Orangeburg County residents are coming to see those OB providers. So we’ve got to look at the need for more family practitioners in the area who also provide prenatal care, and who are also able to diagnose some of those health concerns the pregnant women have. We don’t see a lot of that. I think that could help, as well.”
Family Solutions, a program of the South Carolina Office of Rural Health, is the name for an umbrella of services that includes Healthy Start, an infant and maternal wellness program; Opportunity Knocks, a male-involvement program; and Nurse-Family Partnership, a home visitation program for first-time mothers.
For more information on the program, call 803-531-8008.
Contact the writer: dgleaton@timesanddemocrat.com or 803-533-5534. Follow “Good News with Gleaton” on Twitter at @DionneTandD
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