Using Fetal and Infant Mortality Reviews to improve birth outcomes in an urban community

Abstract

Objective: To describe the implementation of a Fetal and Infant Mortality Review (FIMR) in a small urban community to improve perinatal birth outcomes.

Design: Descriptive study.

Setting: Urban community within a Wisconsin city, population 85,000.

Participants: Between January 1, 2007 and December 31, 2008, all women (N=82) in a targeted five zip-code area within an urban city were identified who experienced a fetal loss >14 weeks, neonatal or infant death (<1 year of age).

Methods: The National Fetal and Infant Mortality Review Manual: A Guide for Communities developed by the American College of Obstetricians and Gynecologists and the Maternal and Child Health Bureau (2008) provided the framework for the systematic review of available records for all fetal and infant deaths during a 2-year period. Based on these findings, targeted evidence-based interventions were implemented.

Results: The infant mortality rate was higher in two of the five targeted zip-code areas. The mean ages of women who experienced fetal and infant mortality were in their 20s as opposed to teenage mothers. A higher proportion of Black women experienced fetal/perinatal losses than other race/ethnicities, many of which were related to prematurity.

Conclusions: Many social, environmental, and maternal health issues such as poverty, racism, and perception of stress negatively contributed to the general health of women's subsequent birth outcomes. Nurses have the opportunity to promote and improve health to eliminate racial disparities in birth outcomes within their communities.