After years of decline, infant mortality is on the rise in the state of Mississippi, alarming health workers, and, as CBS News correspondent Kelly Wallace reports, giving the state the dubious distinction of leading the nation in newborn deaths.
Jamekia Brown's home is next door to the cemetery in Hollandale, Mississippi. That makes it easy to visit her two children.
Her first child died at two months during an operation to correct a birth defect. Jamekia was 18 then. At 20, she lost a baby girl when she went into labor prematurely.
"When they did the emergency C-section on me, the baby came out dead," Brown said. "I just cried and questioned God."
Infant death rates have shot up in Mississippi.
In 2004 for every thousand babies born in the state, 9.7 died before their first birthday.
In 2005 the number of deaths jumped to 11.4 per thousand – an increase of nearly 18 percent. That means 65 more babies died.
In the heart of the Mississippi Delta – one of the poorest parts of the nation and overwhelmingly African American – infant death rates are even higher.
For whites in Mississippi, the 2005 infant death rate was 6.6 per thousand, around the national average.
Among blacks, the rate soared to 17 per thousand, similar to rates in Sri Lanka and Russia.
The Mississippi Department of Health told CBS News that Hurricane Katrina may have contributed to the increase in infant mortality rates, but its own Web site says no infant deaths were related to the hurricane.
Lynne Walker of the Department of Health does not have any other explanation for the sudden surge of infant deaths.
"Prematurity and low birth weight and SIDS and birth defects are a leading cause of infant mortality in Mississippi," said Lynne Walker, a pediatric clinician with the Mississippi Department of Health.
But the causes of those problems have been around for years: obesity, diabetes, hypertension and low education levels in mothers who are often teenagers.
Roy Mitchell heads a Christian health advocacy group in Jackson. He says what did change two years ago in Mississippi was access to health care.
"We've implemented some Medicaid eligibility guidelines that are highly restrictive," Mitchell said.
Mississippi's Governor, Haley Barbour, was elected in 2004 after promising to slash Medicaid costs. By the end of 2005 the number of people on Medicaid in Mississippi had been cut by 19 percent.
"Another slogan is that Mississippians need to pull themselves up by their bootstraps, but babies don't have bootstraps," Mitchell said.
The state mandated new eligibility requirements, including annual face-to-face meetings and added paperwork.
For young women like Jemeika Brown, transportation is another problem. Now five months pregnant, she hitches rides to Medicaid appointments in Greenville, over 30 miles away.
"I had to get a ride up there, and I had to take proof that I was pregnant ... and I need an ID, and it was hard to get all that stuff," Brown said. "Last time, I think, I ain't need all this."
Jamekia's cousin Krystal Allen has a baby buried in the Hollandale cemetery too. He died at four months after a visit to the emergency room when he was having trouble breathing.
"We went home and he was crying, constant crying," Allen said. "'Bout six or seven, he died in my arms."
Krystal was 17 years old then. Now she's 20, a mother of two, and seven months into a high risk pregnancy. She hasn't yet made it to Greenville to see a doctor. She can't afford the fare. She can't even afford a tombstone for her son.
"It gonna happen one day, one day it gonna happen. He gonna have one sit there proudly with his name and everything on there," she said.
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