Ohio has the eighth highest (7.11 infant deaths per 100,000 live births) in the United States behind Mississippi (9.11), South Dakota, Arkansas, Delaware, Louisiana, West Virginia, and Indiana (7.16)
“Mothers and children are at risk for for poor health outcomes due to really a variety of interrelated factors,” said Requette Lindsay-Eloi, maternal and child health senior manager.
These factors may include social and economic factors, health literacy, health care access and the quality of the care that they receive, she said. Those factors can compound each other, leading to increased vulnerability for both mother and child.
“Unemployment and lack of insurance can limit mothers access to the necessary health care services, including the prenatal care and vaccinations,” Lindsay-Eloi said.
Inadequate prenatal and postnatal care, can lead to mothers facing complications like gestational hypertension, as well as preeclampsia, Lindsay-Eloi said. Preeclampsia is a more severe form of hypertension that includes increased protein showing up in urine, which is a potential indicator for organ damage.
Disparities persist in mortality rates
Montgomery County’s infant mortality rate was approximately 9.8 infant deaths per 1,000 live births in 2023, according to Public Health - Dayton and Montgomery County’s Community Health Assessment.
When taking race into account, the infant mortality rate for Black infants, 16.3 deaths per 1,000 live births, was more than twice as high as white infants, 6.5 deaths per 1,000 live births.
Access to health care, racism and historic biases within the health care industry all contribute to the higher rate of deaths among Black infants, Public Health said.
These are trends seen across Ohio, as well, according to Groundwork Ohio, a policy and advocacy organization focused on young children.
Overall, Ohio’s infant mortality rate in 2022 was 7.1 infant deaths per 1,000 live births, the eighth worst in the U.S., according to the Centers for Disease Control. For white infants, that rate was 5.7 deaths per 1,000 births while Black infants saw 13.4 deaths per 1,000 births.
Strong Foundations Act loses appropriations
The Strong Foundations Act originally had $35 million in appropriations to go toward programs supporting infant and maternal mortality rates and developmental outcomes before the Ohio Senate cut those appropriations.
Bill sponsor Rep. Andrea White, R-Kettering, previously told this outlet that she’s “disappointed that a lot of the great, move-the-needle policies are not in the final version” of House Bill 7, but noted that she’s optimistic her original spending requests will be included in Gov. Mike DeWine’s proposed budget in 2025.
The remaining provisions of House Bill 7 set to become law include a few procedural regulations, including one placing reporting requirements on the state’s efforts to modernize and spread the word about its food stamp program for women, infants and children (WIC), given that only 41% of Ohio moms and young children who qualify for WIC actually receive the benefits, White said.
Other aspects of House Bill 7 include:
- The Help Me Grow program will streamline its intake and referral system.
- Ohio Medicaid will be required to evaluate and update the its coverage of evidence-based mental health and family therapy services for young children and their caregivers. Ohio Medicaid will also develop policy and billing guidance for Medicaid providers regarding the coverage.
- Each licensed daycare operating a Head Start or Early Head Start program or a program accredited by the National Association for the Education of Young Children will be rated.
More aspects of the bill include developing strategies on promoting parenting classes and other information-gathering stipulations.
Ohio Medicaid updates
More than half, or 57%, of Ohio’s infant deaths in 2022 were to mothers reporting Medicaid as their source of insurance, according to Groundwork Ohio. Ohio Medicaid covers half of all births in Ohio.
More supports will be coming from Ohio Medicaid as this is the first year that Medicaid is covering doula services.
Ohio Medicaid spent the past year collaborating with the Board of Nursing, advocates, and professional organizations to fine tune the coverage criteria and support mothers here in Ohio, a spokesperson for Ohio Medicaid said.
Doulas have been shown to improve birth outcomes, support birth equity, positively impact the social determinants of health and reduce disparities in maternal and infant outcomes.
Ohio Medicaid is also working on developing new billing codes available for facilities like Brigid’s Path, which provides care for infants exposed to addictive substances and their mothers.
“In 2018, we worked at the federal level to amend the Social Security Act,” said Meghann Naveau, director of advancement at Brigid’s Path.
The center worked with then-Senators Rob Portman and Sherrod Brown, also getting help from U.S. Rep. Mike Turner, so state Medicaid departments could reimburse newborn recovery centers like Brigid’s Path, she said.
"There wasn’t a rule for that before," Naveau said.
Brigid’s Path started working with Ohio Medicaid in 2019 on how to build those rules and rates for a newborn recovery center. That work was put on pause during the pandemic and started up again in 2023.
“We’re hopeful that we’ll start to receive that reimbursement in early 2026,” Naveau said.
Both Ohio Medicaid and Brigid’s Path are hopeful that once facilities are able to bill Medicaid for services related to newborn recovery that more centers will be able to form throughout the state. Brigid’s Path accepts infants from anywhere in Ohio, but traveling to their facility can be difficult for families on the opposite end of the state.
Ohio Medicaid is also seeing continued progress with its Comprehensive Maternal Care program, which launched in 2023. The community-based, statewide program creates a framework for providers and community partners to work together to support women and families who have historically lacked ready access to high-quality responsive care before, during, and after pregnancy, an Ohio Medicaid spokesperson said.
Through this initiative, the state is not just providing prenatal clinical care, but also directing women to needed services, including funding for food, housing and transportation.
To date, the program has served approximately 36,000 moms and enrolled more than 75 providers statewide, according to the state.
