ARI SHAPIRO, HOST:
The state of Mississippi recently declared a public health emergency on an issue that is tragic for many families - infant mortality. The state has some of the highest rates in the nation. NPR's Katia Riddle brings us this report on the fight to save Mississippi's babies.
KATIA RIDDLE, BYLINE: Things were not looking good from Dr. Daniel Edney's perspective, as last year's data collection was coming to an end. He's the public health officer in Mississippi. It's his job to closely track the infant mortality rate.
DANIEL EDNEY: It just kept climbing 'cause we'd get another death coming in, another death coming in.
RIDDLE: Edney remembers exactly where he was when he got the final figures - sitting at his desk chair in his office.
EDNEY: My vital records team came to me and just said, we just need to give you a heads up. It's not looking good.
RIDDLE: In fact, he said it was very bad. For context, the infant mortality rate across the U.S. is 5.6 for every 1,000 live births. That means for every 1,000 babies born, five or six die. In Mississippi in 2024, it was nearly 10. For Black babies, even worse - at 15.2.
EDNEY: If having babies dying at the rate that our babies are dying is not a public health emergency, I don't know what it is.
RIDDLE: That allowed him to expedite a strategy that he and his team were already building. A critical piece of it is here in a town called Hattiesburg at the NICU in Forrest General Hospital. Randy Henderson, a neonatologist, gives a tour.
RANDY HENDERSON: This is the intensive side over here, so these are the sicker babies and the smaller babies here.
RIDDLE: Complications from early birth is a significant reason that infants are dying here. Henderson reads from a sign on the door of a room in his hospital. Inside is one of his tiny patients.
R HENDERSON: Two pounds, 5 ounces, and the height was 12 inches.
RIDDLE: So 2 pounds, 5 ounces at birth. That's very small.
R HENDERSON: Yes. Yes. Yeah.
RIDDLE: Is that typical?
R HENDERSON: Oh, sure. Sure. I mean, we have a lot of babies this size. We get a lot smaller than 2 pounds.
RIDDLE: Wow. Really? How small? What's the smallest?
R HENDERSON: Less than a pound. Yeah, for sure.
(SOUNDBITE OF BUBBLING)
RIDDLE: This little baby boy is in an incubator. Two nurses are attending to him. He's hooked up to a lot of tubes.
R HENDERSON: This little one has a central line in the leg that we're using to give liquid nutrition.
RIDDLE: There are only a few facilities like this in the state. Henderson is part of a team of doctors and public health officials trying to improve access to places like this so that premature babies can get a high level of care from the moment they are born.
R HENDERSON: So this baby's on something called bubble CPAP, which just helps with the breathing.
RIDDLE: In recent decades, medicine has made huge strides in saving the lives of premature babies. One big advancement is the development of something called surfactant. That's a soapy substance that is produced in the lungs. It's critical to helping people breathe. Premature babies don't always make it on their own. Now doctors can give it to them. That's if they have it.
R HENDERSON: Some of the outside hospitals don't have surfactant, so it's not an option. And some of the doctors don't know how to put a breathing tube in if the baby needs it.
RIDDLE: By getting moms into these specialty facilities sooner, their babies have a better chance of surviving. But there's a bigger issue that this team is not able to address.
ANITA HENDERSON: If you can get a mom healthy before she's pregnant, that is your best opportunity to prevent a preterm birth.
RIDDLE: Anita Henderson is a pediatrician here. She's married to Randy Henderson, the neonatologist. Anita Henderson says that many of the conditions that contribute to premature birth are chronic, like diabetes or hypertension. Aside from saving lives, she says treating these conditions in advance of pregnancy would save money.
A HENDERSON: Investing in moms now will prevent long-term complications, prevent those million-dollar NICU babies.
RIDDLE: This is the root of the problem. More than half the counties in Mississippi are considered maternity healthcare deserts where mothers can't get comprehensive prenatal health care. Mississippi did not expand Medicaid under the Affordable Care Act, like many other states. And the recent budget passed by the Trump administration and Republicans in Congress is cutting Medicaid by almost a trillion dollars over the next decade.
A HENDERSON: In Mississippi, all across the nation, we're really just trying to keep what we have. We know that we have huge Medicaid cuts that are coming down the pike.
RIDDLE: Nationally, advocates worry that as people lose access to Medicaid over the next few years, infant mortality will get even worse, not just in Mississippi. Michael Warren is with the March of Dimes. The group advocates for improvements in maternal health care across the country. He calls the U.S. one of the most dangerous developed countries for giving birth, with more than 5 babies dying per 1,000 births.
MICHAEL WARREN: What that translates to is 20,000 deaths every year. That's the equivalent of a jumbo jet crashing once a week for an entire year and killing everyone on board.
RIDDLE: Twenty thousand people, he says, who had not reached their first birthday.
WARREN: And let's be realistic for a minute. If that happened in this country, we'd stop flying after a couple of weeks. There would be task forces. There would be investigations. We would say, we've got to get to the bottom of this.
RIDDLE: Warren says, while he applauds the work that Mississippi is doing, he insists we should be asking the same of every state in the country. Katia Riddle, NPR News, Hattiesburg, Mississippi. Transcript provided by NPR, Copyright NPR.
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