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Episode #01

Premature Parenthood - 1

Air date 05/14/12
Host: Dr. Rick deShazo
Guest(s): Ashton Jenkins, Natalie Taylor, Ethel Chapman, Irma Welch

Nineteen year-old Ashton Jenkins credits her one-month-old son, Karson, with saving her life.  Before she found out she was pregnant she was living with her boyfriend and was virtually estranged from her mother. Ashton’s lifestyle has changed since having her son.  The nights that she once spent at parties are now spent caring for Karson. 

At the age of 21, Natalie Taylor has already had five children.  Sadly, only her daughter has survived infancy.  Natalie’s story could be the stereotype for the teen mom.  She was practically abandoned by her parents and abused by her boyfriend. Her story departs from that of the typical teen mother because of her involvement in the Interpregnancy Care Project of Mississippi (IPC) at the University of Mississippi Medical Center.

 

 

Offering specialized medical treatment for extremely premature babies, the Neonatal Intensive Care Unit at UMC treats babies from all across the state. For more information on the services and care provided by the NICU team, visit their website.

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In the United States, Low Birth Weight (LBW < 2500 grams) delivery is the leading cause of infant mortality for African Americans. In addition, Very Low Birth Weight (VLBW < 1500 grams) deliveries frequently result in severe chronic health problems and lifelong disability in the surviving children.  Recent research has focused on fetal origins of adult chronic diseases such as diabetes and hypertension. These findings confirm that poor pregnancy outcomes such as VLBW infants are often trans-generational problems. They are more common among women in poor health who lack access to comprehensive primary health care. In Mississippi, Medicaid coverage is available to many women during their pregnancies. However, most of these women lose Medicaid coverage on the 61st day following delivery. Ironically, they become eligible for these services again only when they become pregnant. 

The best clinical predictor of a woman’s delivery of a VLBW infant is her history of a previous VLBW delivery. The base line rate of very low birth weight for the general population is 1.5 % of live births. After the first VLBW delivery, African American women have a 13.4% chance of another VLBW delivery.  These figures are doubled in the case of teen pregnancies and progressively rise with each additional VLBW delivery. Since Mississippi has a higher percentage of infants born to African Americans than any other state in the country, the impact on Mississippi is dramatic. Mississippi has approximately 42,000 births per year; VLBW deliveries only constitute 2.3% of these births but cause 53% of all infant deaths.

Based on experience in Georgia, a state with demographics similar to those in Mississippi, it appears that the strategy that offers the greatest potential for increasing a high risk woman’s chance of having a full term healthy baby is preconceptual and inter-conceptual care.

The Interpregnancy Care Project of Mississippi identifies and enrolls eligible African American participants at the mother’s discharge from the hospital following the delivery of a VLBW infant. The project establishes a reproductive plan with the participant with the goal of delaying subsequent pregnancies for a minimum of 18-24 months. The IPC program provides 24 months of primary, continuous health care, routine dental care, enhanced nurse case management, and community outreach via a resource mother. Primary health care addresses key areas epidemiologically linked to a VLBW delivery, including: 1) poorly-controlled chronic diseases; 2) substance abuse; 3) reproductive tract infections; 4) nutritional disorders and obesity; 5) depression and domestic violence; 6) periodontal disease and dental caries; and 7) short interpregnancy intervals. Peer group meetings are integrated with IPC health care visits. Resource mothers and resource workers focus on parenthood preparedness, safe housing, job skills training, and education in the form of home visits and telephone contact.

  • For more information about the Interpregnancy Care Project of Mississippi, please contact Lauren Ryan at (601) 984-5269, or at lelee@umc.edu.
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