North Texas medical students working to address rising infant mortality rates
Hospitals in both Tarrant and Dallas counties are taking at a growing problem: children who are dying before their first birthday. The infant mortality rate in both Texas and the U.S. has worsened in recent years.
Along with seasoned doctors and health care professionals working toward solutions, some medical students just getting started in their careers are also hoping to make a difference.
This is part two of three in our series about the work being done by local health experts to address rising infant mortality rates. See more from this series here.
Health outcomes for babies born in hospitals
A third-year medical student at the Anne Burnett Marion School of Medicine at TCU, Lucy Eletel is already tackling one of medicine's major mysteries: why, in a developed country like the U.S., some babies don't survive to see their first birthday.
It's a problem both both nationally and statewide. And in the same zip code where Eletel goes to medical school, 76104, a University of Texas study found the highest infant mortality rate in the state. Nearly two out of every 100 babies born to women living in the zip code don't make it to one year.
Eletel is one of several Burnett School of Medicine students who has chosen to make the survival of the area's smallest residents the focus of their thesis projects. She and her mentor Dr. Dave Riley have been focusing on infants treated in Cook Children's neonatal intensive care unit. They've found babies born outside of traditional hospital settings are more likely to end up in a NICU hours or even days later.
"We were getting in fairly routinely, babies that were brought in from home or from these birthing centers," said Riley, a practicing neonatologist and an assistant professor at the Burnett School of Medicine. "Some of the injuries they were suffering from, especially if you're talking about injury to the brain, actually turned out to be a lot worse because of the time delay."
Riley and Eletel found these babies had more neurological complications, more respiratory complications, longer stays in the NICU and had to be on antibiotics for longer.
Despite the risks, they found there's growing interest among women in giving birth outside of traditional hospital settings. And increasingly, it's white women from middle-class backgrounds making that choice.
"I do think it comes down to that potential mistrust in the health care community or that autonomy they want," Eletel said.
Eletel is now visiting locations where women have suffered complications in birth to learn more about them. She's hoping to gain a better understanding of what's going on in those communities and to cut down on delays when problems do arise.
"Even simple things like what is the equipment there? Do you have the ability to give babies oxygen? Do you have the ability to give babies IV fluid?" said Dr Riley.
We're hoping to achieve a little bit of a better understanding of what's going on in the community."
Ultimately, though, the goal is to find ways to cut down on any delay in care when problems do arise.
"I really think we can come up with some standardized approach in each of these birthing centers," Eletel said. "I genuinely believe that could help lower the infant mortality rates."
Racial disparities in maternal care
Coming from a multi-racial family, Eletel's classmate Amber Broderick is keenly aware of how women of color are at an increased risk of pregnancy complications. It's one of the reasons she's researching racial disparities in maternal care as part of her thesis project.
"There's a lot of times where Black women specifically have issues with their delivery experience of their pregnancy that can be prevented," Broderick said.
Broderick and her mentor, Dr. April Bleich, are surveying new mothers to find correlations between their perception of how they were treated, and their race.
"We're looking at, did they think their pain was controlled? When they asked about pain medication, did they get the answer that they needed? Did they have any complications that they weren't expecting?" said Broderick.
"Part of it is trust in the health care system," said Bleich. "The other thought is that there's some degree of implicit bias that happens within health care providers."
A better understanding of the problem, these students hope, could spur solutions.
