Infant Mortality Toolkit

Perinatal morbidity is higher in infants delivered before 39 weeks' gestation.

• Why the Last Weeks of Pregnancy Count. Bilingual brochure for women explains why it is important not to schedule an induction or Cesarean section for non-medical reasons before 39 weeks' gestation. The brochure, which was developed by the March of Dimes (MOD), describes infant growth and development in the last few weeks of pregnancy and includes questions that women can ask their health professionals about scheduling delivery. Also see YouTube video.
• See the MCH Digital Library resource brief, Preconception and Pregnancy: Resources for Families, for information about care, services, and support before and during pregnancy and websites about preconception and pregnancy. A separate section lists websites for pregnant adolescents.
• Guttmacher A, Spong C, Lamp J, Murthy K, Moore A. 2012 .Raising Awareness: Late Preterm Birth and Non-Medically Indicated Deliveries Prior to 39 Weeks (transcript). Bethesda, MD: National Child and Maternal Health Education Program.
• Main E, Oshiro B, Chagolla B, Bingham D, Dang-Kilduff L, Kowalewski L. 2011. Elimination of Non-Medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age: A California Toolkit to Transform Maternity Care. Sacramento, CA: California Department of Public Health, Maternal, Child and Adolescent Health Program.
• Oshiro BT, Henry E, Wilson J, et al. 2009. Decreasing elective deliveries before 39 weeks of gestation in an integrated health care system. Obstetrics and Gynecology 113(4):804–811.

• Text4baby. Free weekly text messages in English and Spanish to help pregnant women and new parents through pregnancy and their infant's first year.
• Health Resources and Services Administration (HRSA): Find a Health Center. Directory of federally funded health centers that provide free or low-cost care, including prenatal care.
• Maternal and Child Health Bureau: Health Assistance Programs for Pregnant Women, Mothers, and Children. Hotline number to help pregnant women and mothers with newborns identify free or low-cost services for themselves and their infants. Telephone: (800) 311-BABY (311-2229). Also includes a list of other resources for healthy pregnancy.
• National Alliance for Hispanic Health: Su Familia: The National Hispanic Family Health Helpline. Call for bilingual information and assistance with navigating the health system. Telephone (866)-Su Familia (783-2645) (English or Spanish)
• American College of Obstetricians and Gynecologists (ACOG): FAQ. Fact sheets in a question-and-answer format about topics including contraception, pregnancy, labor, delivery, and postpartum care.
• Centers for Disease Control and Prevention (CDC): Pregnancy. Information in English and Spanish about healthy pregnancy and healthy pregnancy planning to prevent birth defects. Topics include before pregnancy, during pregnancy, after the baby arrives, trouble getting pregnant, avoiding pregnancy, polysubstance use pregnancy, opioid use during pregnancy, zika and pregnancy, surveillance for emerging threats, and CMV and pregnancy.
• See the MCH Digital Library resource brief, Early and Periodic Screening, Diagnostic and Treatment Services in Medicaid: Resources for Families, for information about care, services, and support before and during pregnancy and websites about preconception and pregnancy. A separate section lists websites for pregnant adolescents.
• Salganicoff J, An J. 2008. Making the Most of Medicaid: Promoting the Health of Women and Infants with Preconception Care. Women’s Health Issues 18S: S41–S46.

• Centers for Disease Control and Prevention (CDC). Smoking: How to Quit.
• National Cancer Institute (NCI). Free Help to Quit Smoking. Provides a toll-free quit line, online chat service, and links to smoking-cessation materials. Telephone: 1-877-44U-QUIT (448-7848)
• SmokeFree.Gov. The section titled SmokeFree Women includes guidelines for pregnant women. This site also provides
  • An online Quit Guide.
  • Information on SmokefreeTXT. a free, smoking-cessation text messaging service designed for adolescents and young adults across the United States.
  • Information on the free Smokefree Smartphone Applications: QuitGuide and quitSTART, each designed to help smokers manage their smoking habits and gain skills to help them quit.
  • Resources for health professionals. Includes the QuitNowTXT Message Library developed by NCI's Tobacco Control Research Branch to provide health departments, academic institutions, and government agencies with an algorithm and database of messages designed to serve as smoking-cessation intervention for individuals who are ready to quit smoking.
• SmokefreeMOM. Coordinated program focused on providing pregnant women who wish to quit smoking with personalized, interactive, and evidence-based health text messages. DHHS partners in the project include CDC, the Substance Abuse & Mental Health Services Administration, the National Institutes of Health (NIH), and the Food and Drug Administration.
• Tobacco and Nicotine Cessation During Pregnancy. (2020). American College of Obstetricians and Gynecologists.
• MCH Digital Library Resources: Resource brief | Bibliography | Reproductive health services

• National SUID/SIDS Consortium was a consortium of four partners to reduce infant deaths and to support families affected by infant mortality with a shared goal of reducing sudden infant deaths and assisting bereaved families.
  
  The SUID/SIDS Resource Center’s resources are now available on the SUID/SIDS Gateway and retains materials for families and professionals on risk reduction, prevention, and bereavement related to infant mortality. Extensive electronic and print resources are available through the website. Materials include What Works: Changing Knowledge and Behavior to Reduce Sudden Unexpected Infant Death and Resources to Support AAP's Policy Statement on SIDS and Other Sleep-Related Infant Deaths.
  
  
• Building Integrated Systems to Address Sudden Unexpected Infant Death. (2007). National Center for Cultural Competence.
• First Candle provides education, training, and bereavement support services to families and trusted community partners including nurses, OB/GYNs, doulas, social service agencies, childcare providers and faith-based leaders, who work with new and expectant parents in their communities. First Candle operates a 24/7 grief line as well as online support groups. Telephone: 1-800-221-7437
• The Safe to Sleep Campaign—formerly known as the Back to Sleep campaign—aims to educate parents, caregivers, and health professionals about ways to reduce the risk for Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death. Developed by the NIH/ Eunice Kennedy Shriver National Institute of Child Health And Human Development.
• Cribs for Kids is a national organization that provides safe sleep education and products including a portable crib which are distributed to families through a network of over 325 partner organizations. Cribs for Kids also provides a Hospital Initiative Toolkit and the Safe Sleep Ambassador Education Outreach Program.
• Office of Minority Health: Minority Population Profiles. Includes statistics on infant health and mortality for the Black/African American, American Indian/Alaska Native ,  Asian American, Hispanic/Latino , and Native Hawaiian and Pacific Islander communities.

Regionalized perinatal systems ensure that high-risk deliveries occur in the hospitals best equipped to optimize outcomes.

• Health Resources and Services Administration (HRSA): Find a Health Center. Directory of federally funded health centers that provide free or low-cost care, including prenatal care.
• Maternal and Child Health Bureau (MCHB): Perinatal and Infant Health. A list of programs and services aimed at increasing access to healthcare and reducing infant illness and death. Also includes resources for healthy pregnancy and a hotline number to help pregnant women and mothers with newborns identify free or low-cost services for themselves and their infants. Telephone: (800) 311-BABY (311-2229); (800) 504-7081 (Spanish).
• Centers for Disease Control and Prevention (CDC): Preconception Care. General preconception overview for women and men, Tips for women who are planning a pregnancy
• First Candle. Information about having a healthy infant, breastfeeding, infant care, and ways to reduce the risk of SIDS.
• Barfield WD, Kroelinger CD, White VA 2010. Collaborative Efforts to Address the impact of Perinatal Regionalization on Infant Mortality. Association of Maternal and Child Health Programs (AMCHP): AMCHP Pulse. Also collected for AMCHP’s 2009 Perinatal Regionalization Meeting.
• Lasswell SM, Barfield WD, Rochat RW, et al. 2010. Perinatal regionalization for very low-birth-weight and very preterm infants: A meta-analysis. JAMA: The Journal of the American Medical Association 304(9):992–1000. Analyzes more than 30 years of published data on the key premise of perinatal regionalization: access to risk-appropriate perinatal care improves infant mortality outcomes in very-low-birthweight and very-preterm deliveries.

• U.S. Maternal and Child Health Bureau (MCHB). In its efforts to prevent infant mortality and decrease disparities, MCHB supports the following programs and activities:
  • Maternal, Infant, and Early Childhood Home Visiting Program (see the website for information on 14 approved model programs and also the MCH Digital Library's Home Visiting Resource Brief)
  • The Health Start Program to reduce infant mortality and improve perinatal outcomes (for more information on the history of the program and a collection of research articles from its grantees. (see the Healthy Start special issue of the Maternal and Child Health Journal).
  • Title V MCH Services Block Grant that includes support for children with special health care needs and The Collaborative Improvement & Innovation Network (CoIIN) to Reduce Infant Mortality.
• DHHS's Secretary’s Advisory Committee on Infant Mortality (SACIM). A public and private partnership to provide guidance and to focus attention on the policies and resources required to address the reduction of infant mortality. The committee provides advice on how best to coordinate the variety of federal, state, local, and private programs and efforts that are designed to deal with the health and social problems impacting infant mortality. Materials include Recommendations for a National Strategy to Reduce Infant Mortality (January 2013).
• What is CDC doing to reduce infant mortality?  In its efforts to better understand and reduce infant mortality, CDC is working to improve national reporting of SIDS; conduct research, and engage in science-to-practices activities aimed at understanding and reducing preterm births.

• Family Resource Brief. Information on care, services, and support; expectant and new parents; and pregnancy loss and grief. Also of use for families are prevention and intervention services for sudden and other unexpected infant death. Developed by the MCH Digital Library.
• Grief support offered by First Candle's Program Support Center.