Printed on: April 27, 2013

Saving the Babies

Hispanic infant mortality prompts outreach

By MELISSA DAVLIN
Twin Falls Times-News

TWIN FALLS -- As soon as Janell Cortez found out she was pregnant, she immediately made her first prenatal appointment.

It's the same thing the 25-year-old Jerome woman has done for her past three pregnancies, and it's exactly what Family Health Services is hoping women do.

But the message might not be getting out in the Idaho Hispanic community, which has a higher infant mortality rate than non-Hispanics.

According the Idaho Department of Health and Welfare, from 2008-2010, the infant death rate for Hispanics was 7.0 per 1,000 live births compared to 5.0 per 1,000 live births for non-Hispanics.

"It is statistically significant," said Tom Shanahan, public information manager at the Idaho Department of Health and Welfare. "... We don't know what the story is exactly."

No easy answer

Why do Hispanic infants die at a higher rate? There's no easy answer, but there are clues.

Dr. Camille Smith, of Family Health Services in Buhl, said women who receive inadequate prenatal care are more likely to have complications with pregnancy, such as low birth weight or taking medications that cause birth defects.

According to The Hispanic Profile Data Book for Idaho, pregnant Hispanic women are more likely to receive inadequate prenatal care and wait until the second or third trimester to get prenatal care.

Hispanic infants are more likely to die from maternal complications of pregnancy, short gestation or low birth weight.

One Hispanic woman, who was 20 weeks pregnant, recently came to the clinic for the first time while Smith was on call.

"She'd never had any prenatal care," Smith said.

The fetus died, and doctors don't know if the death could have been prevented had the woman's pregnancy been monitored.

Cortez was shocked when she found out some women in the Hispanic community wait for prenatal care.

With this pregnancy, Cortez said she's even more vigilant about appointments because she's concerned about how prior drug use might affect the fetus.

Her vigilance proved to be a good thing.

During a Tuesday appointment at Family Health Services in Jerome, Cortez found out she's at risk for complications from placenta previa, where the placenta is especially close to the cervix.

Dr. Matthew Duersch told her while she shouldn't be worried, they should schedule a follow-up ultrasound.

Once women do come in, Smith said, most follow through with care.

"It seems like if they're willing to come in and get established, they follow the guidelines," she said.

Reaching the uninsured

There are other factors in women not seeking prenatal care.

Hispanic women are more likely to be uninsured, said Lauren Necochea, director of Idaho Kids Count.

"In Idaho, non-Hispanic mothers are more than twice as likely to have private health insurance prior to getting pregnant, compared to Hispanic mothers," she said in an email to the Times-News.

But the news isn't all bad, Necochea said.

"Idaho's Hispanic mothers have at least one health advantage, which is that they are less likely to smoke during pregnancy," Necochea said.

Ethnicity, age and race also play into infant mortality rates nationwide, according to the Centers for Disease Control and Prevention.

The infant death rate for Hispanics varies in neighboring states.

For example, the infant mortality rate for Hispanic children in Wyoming -- 7.9 deaths per 1,000 live births, according to the Henry J. Kaiser Family Foundation -- is slightly higher than Idaho.

The same research found the Hispanic infant death rate for Utah is 5.0 per 1,000 live births, only slightly above the non-Hispanic infant death rate of 4.7 per 1,000.

Outreach works

So what's being done for Hispanic women in Idaho?

In eastern Idaho, the Community Council of Idaho runs health clinics in both Idaho Falls and Blackfoot for comprehensive care, including prenatal checks.

Arnold Cantu, Community Family Clinic director for the Community Council of Idaho, said bilingual nurses and clinic workers visit Head Start centers to talk to parents about the importance of wellness checks, including prenatal care.

That outreach works.

"We try to educate as many people as we can," Cantu said.

More needs to be done, said JJ Saldana of the Idaho Commission on Hispanic Affairs. The commission's board is meeting in Burley next month to discuss outreach for health in the Hispanic community, including prenatal care.

"Our big focus for the longest time had been education and other issues, but health has become one of our other top priorities as well," Saldana said.

On the Internet

For information on the Community Council of Idaho go to www.commu nitycouncilofidaho.org.