Every region in Mississippi ranked higher in infant mortality than the national average of 5.4 deaths per 1,000 live births, according to the state’s 2021 Mississippi Infant Mortality Report released last week.

This report comes one month after the Centers for Disease Control and Prevention released data showing that Mississippi’s infant mortality rate reached a five-year high while the national rate remained relatively stable from 2020 to 2021. That report also showed that the state continues to lead the nation in babies who die before their first birthday.

In 2021, 327 Mississippi babies died before the age of one, according to the state’s report. 

The leading causes of infant death in Mississippi are prematurity, low birthweight, birth defects and Sudden Infant Death Syndrome (SIDS). Babies whose deaths were caused by SIDS also reached a 10-year high in Mississippi in 2021, the report said. 

“Mississippi also has the highest premature birth rate in the nation, and this drives our high infant mortality rate,” said Dr. Anita Henderson, a pediatrician and past president of the Mississippi chapter of the American Academy of Pediatrics. “We encourage all moms to get in to see their OBs in their first trimester for optimal prenatal care.” 

While deliveries of babies with very low birthweight (defined as less than 3.3 pounds) decreased from 2020 to 2021, most infant deaths in the state still occurred in infants born with very low birthweight, according to the report. The statistic is more dire for Black babies, who saw three times as many deaths due to prematurity and very low birthweight than their white counterparts in 2021. 

Henderson said lack of access to health care in Mississippi is contributing to high rates of prematurity and infant mortality. 

“Presumptive eligibility for moms on Medicaid would facilitate timely access to prenatal care for that critical, first trimester OB visit. Over half of the counties in Mississippi do not have an OB or a delivering hospital,” she said.

Pregnancy presumptive eligibility, which Mississippi does not have, allows women to receive care during pregnancy, even if they’re not on Medicaid. Providers can enroll their pregnant patients and start billing Medicaid, which reimburses them without delays or questions.

The new report also detailed each county’s average infant mortality rate over a 10-year period, showing that only two counties – Rankin and Smith – met the national recommendation of no more than five infant deaths per 1,000 live births. The other 80 counties were above that recommendation, with 31 counties seeing at least twice the recommended rate.

The three counties with the highest 10-year averages were rural counties in the Delta. Issaquena County had the highest rate in the state at 18.7 infant deaths per 1,000 births. Humphreys and Quitman counties were the other two, with rates of 16.9 and 15.8, respectively.

Following the closure of the only neonatal intensive care unit in the Delta, in addition to a labor and delivery unit at a Greenwood hospital, State Health Officer Dr. Dan Edney announced at a July Board of Health meeting a proposal for an “OB system of care,” which would model itself after other systems of care in Mississippi.

“We’re losing too many babies in transfer,” Edney recently said to a legislative committee. The proposed system would evacuate high-risk pregnant women in rural areas to either Children’s of Mississippi in Jackson or out of state. 

When asked for updates about how the system of care would work, including what states Mississippi would model its system on, officials with the Mississippi Department of Health did not respond by the time of publication.  

Edney was also not available to comment on the latest report, though he said in September the numbers are “extremely concerning.”  

Infant morbidity, which the report defines as “any condition that adversely impacts the ability of newborns to survive and thrive,” highlights numerous racial and socioeconomic disparities. 

Twice as many Black women as white women in Mississippi are diagnosed with preexisting hypertension, one of the leading causes of infant and maternal morbidity and mortality. 

The report referenced a study from the American College of Obstetricians and Gynecologists that found that pregnant women on Medicaid have an increased risk of complications and poor fetal outcomes when compared to women on private insurance. That is significant in Mississippi, where, according to the report, “an estimated 22,633 deliveries are from women who have Medicaid insurance” – nearly two-thirds of the 35,156 live births that occurred in the state in 2021.