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Fighting Alabama’s Infant Mortality Rate

Fighting Alabama’s Infant Mortality Rate

Alabama has one of the highest rates of infant mortality in the nation.

Alabama is one of the leading states for infant death and mortality within the first year of life. We sat down with Tana-kae Lewis, a Registered Nurse with the Alabama Department of Public Health (ADPH) who works in the State Perinatal Program as the Perinatal Coordinator for the North Alabama region.

Lewis reviews cases of infant death that then go before a group of individuals called the Regional Perinatal Advisory Committee to deliberate and discuss the case. The goal is to identify any gaps in services of care delivered to the mother or baby and make recommendations for improvements  in order to prevent future deaths.

Why it Matters

Alabama ranks 46th in the Nation in infant death (before his/her first birthday) per 1000 live births. To confront the State’s high infant mortality rate, the State Perinatal Program was established in 1980 by the Alabama Perinatal Health Act. The following facts were discovered from the Alabama Department of Public Health’s 2020 Infant Mortality Report:

  • Alabama had a rate of 7 deaths per 1,000 live births.
  • Alabama’s infant mortality rate ties for the lowest rate in more than five decades, but still remains higher than the U.S. rate which was 5.5 in 2020.
  • Alabama’s three-year infant mortality rate of 7.2 is one of the lowest on record.

The total infant deaths before reaching 1 year and mortality rates for each year are as follows:


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  • 2020: 404 infant deaths, 7.0 mortality rate
  • 2019: 449 infant deaths, 7.7 mortality rate
  • 2018: 405 infant deaths, 7.0 mortality rate
  • 2017: 435 infant deaths, 7.4 mortality rate

The health of a mother and the health of her infant are interwoven. Alabama, like the nation, continues to face an urgent maternal and infant health crisis. In order to help improve these statistics and prevent further tragedies, it’s important to address the factors that contribute to poor maternal and infant health outcomes.

The health of mom and baby are intertwined.

The Top Three Leading Causes of Infant Mortality

Infant mortality rates are an indication of our community’s overall health. According to the ADPH 2020 Infant Mortality report, the three leading causes of infant deaths in our state are:

  • Preterm birth/ low birth weight – Preterm births are defined as delivery before 37 weeks of pregnancy. Premature babies may have more health problems, which could require them to stay in hospitals longer than babies that are born full term. According to the 2021 March of Dimes report card, Alabama was graded F with a preterm rate of 12.9%.
    The March of Dimes Prematurity report for 2020 also found the following:- 1,127 babies on average are born in Alabama per week
    – Of those, 140 babies are born preterm (less than 37 weeks)
    – 101 are born late preterm (between 36 & 37 weeks)
    – 22 babies are born very preterm (less than 32 weeks)
    – In 2019 preterm births were 12.5% of all births
    – Babies born with low birth weight (less than 5lbs, 5 oz) accounted for 10.5% of all births
    – In total, preterm and low birth weight accounted for about 15% of all infant deaths in 2019According to the ADPH Infant Mortality report for 2020:
    – the number of preterm births increased from 7,309 in 2019 to 7,440 in 2020, which is statistically significant
    – the number of low weight births increased from 6,153 in 2019 to 6,228 in 2020.
  • Congenital birth defectsBirth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body.
  • Sudden Infant Death Syndrome (SIDS) – Unexplained death of a baby less than 1 year old. Most of these types of infant deaths occur while the baby is sleeping. Creating a safe sleep environment can prevent SIDS. The safest way for a baby to sleep is Alone on his/her Back in a Crib (ABC’s of Safe Sleep).Babies are the safest when they sleep alone in their beds on their backs in an uncluttered environment. ADPH has a safe sleep Cribs For Kids Program where mothers can get assistance in obtaining a crib.

Ways to Reduce Infant Mortality from the Three-Leading Causes

Knowledge is power. We can help to reduce the incidence of the three-leading causes of infant deaths in our state by:
–        educating moms and bringing awareness to the issues that cause infant deaths
–        avoiding alcohol while pregnant
–        smoking cessation
–        avoiding abuse of prescription drugs
–        avoiding abuse of street drugs
–        taking prenatal vitamins / folic acid if planning to get pregnant or once pregnancy is confirmed
–        providing a safe sleep environment for the baby.
–        entry into prenatal care within the first trimester or as soon as pregnancy is confirmed.

About the Author:

My name is Tana-kae Lewis, and I am a Registered Nurse with the Alabama Department of Public Health (ADPH) working in the State Perinatal Program as the Perinatal Coordinator for Region 1 (North Alabama). My primary responsibility entails Fetal and Infant Mortality Review (FIMR), which involves the review of an infant’s death that occurs before the first year of life.

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