Georgia Baby Death Lawsuit Shines Light on Infant Mortality Rates in the U.S.

A recent incident involving an alleged decapitation of a baby has sparked a conversation about the infant mortality rates in the U.S. Although rates have decreased over the last several decades, infants born to both Black and American Indian/Alaska Native mothers are dying at disproportionate rates.

Explore the details of the case and hear from two perinatal nurse clinicians on possible solutions to improve infant health outcomes.

Jessica Ross and her boyfriend, Treveon Isaish Taylor Sr., are suing Southern Regional Medical Center in Riverdale and obstetrician Dr. Tracey St. Julian — a physician not employed by the hospital — after alleging that excessive force was used to deliver their baby, according to a report by NBC News.

According to the lawsuit, shoulder dystocia was present — a condition in which a baby’s shoulders are stuck behind the mother’s pubic bone — and the baby did not properly descend, possibly due to this reason.

St. Julian used various methods to try to deliver the baby vaginally including traction, per the lawsuit. Ross pushed for three hours until a cesarean section was performed, resulting in the delivery of the baby’s decapitated body.

The couple alleged that the hospital tried to cover up the manner of death. They demanded to hold their baby but were told by hospital staff that they could only view him, according to a report by CNN.

“During this viewing, their baby was wrapped tightly in a blanket with his head propped on top of his body in a manner such that those viewing him could not identify that he had been decapitated,” said a family spokesperson in a statement.

According to the suit, they were also discouraged from getting an autopsy. In a statement, the hospital denied “the allegations of wrongdoing,” and is “cooperating with all investigations.”

Georgia is one of many U.S. states with an infant death rate greater than that of the national average.

Ross’ case sheds some light on U.S. infant mortality rates (IMR) — the number of infants per 1,000 live births who die before their first birthday. According to the latest statistics from the CDC, Georgia had an IMR of 6.28 in 2020 — the equivalent of 769 total infant deaths for the year. While rates in the state have declined in recent years, infant deaths continue to be a problem nationwide.

In 2020, 20,000 infants died in the U.S. — an IMR of 5.4. That same year, over half of all U.S. states had an IMR higher than the national average. Mississippi, Louisiana, Arkansas, and South Dakota were at the top of the list.

*Rate does not meet National Center for Health Statistics standards of reliability; based on fewer than 20 deaths in the numerator. The actual number of infant deaths in Vermont totaled 18 in 2020 and 15 in 2019.

Although IMRs in the U.S. are on the decline overall, deaths remain highest among Black, Indigenous, and people of color (BIPOC).

According to CDC data, infants born to Black mothers died at a rate of 10.1 per 1,000 live births compared to 4.5 among those born to white mothers — almost double the rate. The mortality rate of infants born to American Indian/Alaska Native mothers was 7.9 that year.

While statistics show an improvement in IMRs from 2018 to 2019 across all ethnic and racial groups, death rates among infants born to BIPOC mothers are still highest.

In the Georgia incident, a cause of death for Ross’ baby has not been released yet. Although the case may be considered a fetal demise or stillbirth rather than an infant death, there remains a need to address the causes of most infant deaths in the U.S.

The top three leading causes of infant mortality in 2020 were congenital malformations (birth defects) (21%), disorders related to short gestation or low birth weight (16%), and sudden infant death syndrome (7%). Infants born to both Black and American Indian/Native Alaskan mothers die at much higher rates from low birth weight and birth defects in particular.

*Rate does not meet National Center for Health Statistics standards of reliability; based on fewer than 20 deaths in the numerator.

The CDC defines low birth weight in infants as weighing less than 5 lbs. 8 oz. Low birth weight is a worldwide problem. Globally, more than 80% of newborns who die every year have a low birth weight, reports the World Health Organization (WHO). While birth defects may be a non-modifiable risk factor for infant mortality, low birth weight may be partially preventable.

According to the WHO, low birth weight is associated with poor maternal nutrition, hypertensive pregnancy disease (or preeclampsia), and inadequate maternal care.

Health disparities play a role in infant mortality as factors like access to quality care, affordability of healthcare, healthy food availability, and environmental safety can significantly impact infant health.

The solution to eliminating health disparities and improving the overall health of all infants requires a collaborative effort from nursing leaders, legislators, and communities. Two perinatal nurse clinicians discuss ways to bring about change in the workplace and community.

Lacey Miller, DNP, CNS, APRN, RNC-OB, C-EFM, is a perinatal clinical nurse specialist and legislative coordinator for the Washington State Section of the Association of Women’s Health. She references a 2020 study that suggests Black newborns are significantly less likely to die when cared for by Black physicians.

“We must find ways to eliminate infant mortality for all babies,” says Miller. “To do so, we need to eliminate systemic racist influences on the health of Black birthing people and infants, and on the ability to diversify the healthcare workforce.”

Megan Ludeña, MN, RNC-OB, NPD-BC, nursing expert in perinatal care, nursing workforce diversity, and nursing professional development, also believes that an ethnically and racially diverse workforce is necessary to improve patient outcomes.

Ludeña, who is also an expert in healthcare equity and workplace policy development, takes it a step further and recommends changing the workplace culture.

While workplace changes may be necessary, leaders working together with the community may be the final piece to the puzzle. Miller, who has worked in both the U.S. and Uganda, believes that community engagement is vital.

“I truly believe that engaging and funding the communities most affected will expose and solve the issues surrounding healthcare disparities, and that these solutions will help everyone,” she says. “Our society must invite, listen to, and give power to the communities who are most affected.”

Miller further addresses the necessity of change within communities.

“Optimal health of a birthing person begins with optimal health of the birthing people from generations before them,” she says. “We will continue to see benefits for generations to come if we invest in the health of our people today.”

Page last reviewed on September 26, 2023