ATLANTIC CITY — Nearly a year ago, Alyssa Spruill was at a prenatal visit with her doctor when she learned she would have to deliver her baby 16 weeks early after developing severe preeclampsia.
“I already thought I knew what the outcome would be,” said Alyssa, 30, of Atlantic City. “I really thought that she wasn’t going to make it.”
Preeclampsia is a rare disorder associated with high blood pressure and can be dangerous for both mother and baby. The best remedy is delivery.
Weighing under a pound, MaKenna was born via Cesarean section March 12, 2018, at AtlantiCare Regional Medical Center, the smallest baby ever cared for by the Galloway Township hospital. And after more than 100 days in the neonatal intensive care unit, “Mighty MaKenna,” as she was nicknamed by one nurse, was able to go home.
MaKenna and Alyssa avoided becoming an alarming statistic affecting residents of Atlantic City: Black babies born to mothers from Atlantic City are dying at a rate five times higher than the state average.
In particular, the rate of black infant mortality was cited as a major health issue affecting the city in a recent report to Gov. Phil Murphy released over the summer.
To improve outcomes, local health care providers and advocates are working to ensure women in Atlantic City have access to the necessary care and resources. Health professionals agree the best way to prevent infant mortality is to improve maternal health, but there is no one solution to the problem.
The infant mortality rate in Atlantic City is an indicator of overall poor public health, said Dr. Diane Timms, program director for Maternal Fetal Medicine and vice chairwoman of the Department of Obstetrics and Gynecology at AtlantiCare Regional Medical Center.
“I think that ensuring that our families are healthy is exceedingly important in making sure that as a city we grow in a healthy direction,” Timms said.
Pre-existing conditions among black women
The risk of infant mortality becomes higher for women with unmanaged diseases such as high blood pressure and diabetes, which can lead to preterm labor and preeclampsia. Smoking and obesity are also related.
“All the same things that are causes for poor health in patients who are not pregnant are the same for those who are,” Timms said. “There’s things on the surface that seem so very simple but are so complex.”
Melissah Drummond-Williams, 38, of Atlantic City, experienced four miscarriages and two stillbirths before becoming pregnant at 36 with daughter Blessyn, now 8 months old.
“I was very nervous the entire time,” she said. “I did have a few friends who were pregnant at the same time. All of them weren’t so lucky.”
Helen Hannigan of the Southern New Jersey Perinatal Cooperative said key factors in reducing infant mortality include quality hospitals and good prenatal care.
In her early pregnancies, Drummond-Williams was diagnosed by doctors with Luteal Phase Defect, which affects the body’s ability to carry a pregnancy to term. Her doctors recommended weight loss and healthy eating, among other things, to help her body keep the pregnancy, which she took to heart. She said her doctor’s advice and her faith helped her keep this pregnancy.
Hannigan said some women’s health issues could stem from poverty but are also tied to the availability of fresh food, jobs and safe living environments.
There is also something deeper that contributes, she said.
“We do believe there is an impact of bias and of lifelong stress for minority communities,” she said. “We also know that for our black mothers, the effect of bias is still seen even among our highest educated black women. They have the same infant mortality rates as high school educated white women.”
Access to care
While historically, women who are pregnant have access to health care, it is only recently that the insurance has become available for women in between pregnancies, said Hannigan. This access to care between pregnancies may prevent health issues, she said.
Other programs are also being developed to bridge the gap. Hannigan, director of MIS and administration at the cooperative, said the Healthy Women, Healthy Families initiative at SNJPC is designed to improve maternal and infant health and reduce racial disparities in birth outcomes.
The program, funded with a $1.1 million grant from the New Jersey Department of Health, is designed to address mortality among black infants and mothers by providing free outreach and support for the mother pre- and post-pregnancy. It is one of several programs in the city aimed at at-risk mothers and pregnant women, but publicizing the program has been difficult.
Because of this, AtlantiCare now offers several services in Atlantic City such as birthing classes, pediatric care, obstetrics and gynecological services.
“One of the things that we’ve tried to do is to bring the care to them,” Timms said. “We’ve opened a practice in the city so that people can walk to see us if they need to.”
Timms said providing access where it’s needed is also one of the goals of the new health care building proposed by AtlantiCare.
The Southern Jersey Family Medical Center has also been operating here for decades and has worked to lower the rate of black infant mortality. The Atlantic County Health Department also offers services for women and families.
Hannigan said it would be more helpful if Atlantic City could beef up its own Health Department to ensure the right services were available to city residents.
Drummond-Williams said she was also lucky to be connected with the right people in Atlantic City — a doctor from Southern Jersey Family Medical Center, a visiting nurse from Nurse-Family Partnership, consultants from the local Women Infants and Children office and a supportive family.
“You have to want to know, you have to ask questions,” she said. “People don’t know, but there are a lot of resources available here in the city. WIC is more than just formula and food. They have the lactation counselors, they are able to help you with information about SNAP and food stamps. Oceanside Family (Success) Center, uptown, they helped a lot.”
Spruill said despite the complications, the care she received for MaKenna was much better than with her other children. She considers herself lucky to be able to take MaKenna home alive, especially being born so early.
“My daughter was born 16 weeks early, and in some states they don’t believe in putting them on a ventilator,” she said. “A lot of people take things for granted.”
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