Infant Health: We Can Do Better

By Rev. Bethany Johnson-Javois

As we enter this spring season, which is the earth’s way of reminding us to hope and to be renewed, we do so under circumstances that make us have to catch our breath and square our shoulders. How infants thrive (or fail to do so) during their first year of life holds up a mirror to any society. It reflects the social, economic, environmental, and spiritual conditions that our most precious little ones face and have to endure to make it.

As we hold the mirror up to ourselves in the eight counties of Deaconess Foundation’s footprint in Missouri and Illinois, our reflection is distorted. Systems are historically designed to foster thriving for a narrow few while intentionally structured and fueled to discount and diminish the lives of the many. Out of all the numbers I could share and the life experiences I can personally point to, I’m choosing to boil it down to this: of all pregnancy-related deaths in the state of Missouri, the Pregnancy-Associated Mortality Review (PAMR) shows that 84% were determined to be PREVENTABLE.

In the Illinois Maternal Morbidity and Mortality Report showing what happened to 263 people who died while pregnant or within one year of giving birth from 2018 to 2020, 91% of pregnancy-related deaths might have been PREVENTABLE. Preventable. We cannot continue to look grieving families in their eyes to share the truth they’ve always known. Many of the reasons why their loved one is no longer with us, and they are left to figure out life without them is caused by something we could have and should have stopped from happening.

To each warrior seen and unseen at every level of community, institutions, and systems who never stops fighting and winning to get us closer to the best reflection of ourselves in the image of our Creator, thank you and we see you. More than one generation’s worth of philanthropic and federal funding flowed in Missouri to support innovative partnerships to curb the tide. For the sake of fueling hope, I draw attention to the possibility of what can happen when philanthropy, community health and public health infrastructure, and bold leaders galvanize to shape system response around the will and experiences of Black mothers and birthing people.

In direct response to the Ferguson Commission’s call to action to create opportunities to thrive through systemic changes, including increased access to care, the St. Louis Integrated Health Network (IHN) was activated. The IHN works with partners and community organizations to ensure accessible and affordable healthcare services for all residents of Metropolitan St. Louis. A multi-racial group of women physicians identified and are disrupting the stark inequities and unconscious biases pervasive within infant and maternal healthcare.

By intentionally listening to and amplifying the solutions brought forward through the wisdom and life experiences of Black mothers and birthing people, the IHN is perpetuating a model of well-being that can be tapped into by moms and medical professionals alike through the work of EleVATE (Elevating Voices, Addressing depression, Toxic stress and Equity). As a status quo disruptor, EleVATE provides prenatal care in a group setting for Black women and birthing people and their support system, engaging the patient as a partner, and offering the best clinical care and quality information sharing to elicit the best choices that moms make for themselves and their families. 

The results are generating improvements in infant and maternal vitality that include increased rates of breastfeeding, increased trust reported among and across care providers and patient partners, higher birth weights, and decreased stress levels. Dismantling the impacts of structural racism systemically and individually is centrally positioned as the collaborative’s ongoing work to stop the generational cycles of trauma before they start. 

In Southern Illinois, I desire my community to receive even more activation and transparency around the issues that surround maternal and infant health that squander the potential of generations of its people. What are accountable institutions, public servants, and leaders doing about it? For example, how do national statistics compare locally, disaggregated by race and socio-economic levels?

We know that only 5.7% of physicians in the U.S. identify as Black or African American, according to the Association of American Medical Colleges, compared to an estimated 12% of the U.S. population identifying as Black or African American. Of all OB-GYN physicians, only 10.7% identify as Black or African American across the U.S. I’m concerned about OB-GYN physician representation that reflects moms and birthing people in Southern Illinois. With fewer pregnancy-related deaths reported in 2023 among Black people as compared to the 2016-2017 Illinois Maternal Morbidity and Mortality Report, and more pregnancy-related deaths for Hispanic/Latinx and white Illinoisians, what is happening, and not happening, what exists, and does not exist in the Southern Illinois ecosystem that affects its people across the board in this way? What do we see when we look in the mirror given the lack of attention paid to this issue?

I offer my support to the open call letter written by our two health department directors Dr. Matifadza Hlatshwayo Davis and Dr. Kanika A. Cunningham for equity and reproductive justice. I lend my voice and purpose to join the cloud of witnesses around the world calling for women’s health justice before and beyond our reproductive years. Our power, value, and identity are sourced in so much more than what happens or doesn’t happen biologically within us. This is a call to be fully seen, unapologetically prioritized, and appropriately recognized for all that we bring to heal this nation and all of its people. We will not be silent, and we are far from dormant. What do you see when you look in the mirror?

Rev. Bethany Johnson-Javois, MSW is president & CEO of Deaconess Foundation and pastor of Monument of Faith Church.

This post was originally published on St. Louis American