Infant mortality rates—measuring the deaths of live-born babies during the first year of life—are important markers of the overall health of a society and the quality of available health care. In the United States, about 20,000 babies die annually from birth defects, preterm birth, maternal complications of pregnancy, respiratory distress syndrome, sudden infant death syndrome, and more.
However, in Florida, there’s a disparity between the number of Black babies that die within their first year and the number of white babies that do. As of 2022, Black babies had an infant mortality rate nearly three times as high as that of white babies, according to the Florida Department of Health’s Bureau of Vital Statistics.
Statistics on Infant Mortality
Florida is spending over a hundred million annually on maternal and infant health, but its overall infant mortality rate has remained nearly stagnant for a decade. Meanwhile, the rate of births to mothers who received no prenatal care during their pregnancy has risen. State funding for these issues has stabilized, not increased, in recent years as the government has focused its attention elsewhere. The state funds many resources for babies after birth but doesn’t allocate much for prenatal care.
In 2022, Florida’s infant mortality rate per 1,000 live births was 6.0—down from 7.5 20 years earlier. However, while the rate for white babies was 4.3, the rate for Black babies was 11.2—and as high as 100 in one county.
In the same year, for births in which the prenatal care status was known, the percentage of births to mothers with no prenatal care was 3.2. That number has been steadily increasing for a decade. The Bureau of Vital Statistics reported that only 63 percent of pregnant women in Florida receive adequate prenatal care.
Factors Contributing to Higher Infant Mortality Rates in Black Babies
Unfortunately, race does play a role in infant mortality levels. Black babies are at a significantly higher risk of infant mortality than white babies. In addition, the risk of prematurity is far higher for babies of color.
“There is evidence that the prenatal care needs of many Black pregnant women are not being met,” a 2019 study by the University of South Florida reported. “Although not identified in our study, patient socio-cultural norms related to pregnancy and pregnancy outcomes should be taken into account when providing prenatal care.”
The racial disparity in infant mortality has to do with the mothers’ health conditions, socioeconomic factors, access to health care, and regional disparities. Rural communities, in particular, are at a higher risk due to lack of access to prenatal care—these areas are called maternal care deserts, where women have to travel at least an hour to receive prenatal care.
Accessible Prenatal Care in Florida
Florida’s Barriers
According to the March of Dimes’ 2023 Maternity Care Deserts Report, more than two million women of childbearing age live in maternity care deserts, defined as “areas without access to birthing facilities or maternity care providers.” The report also designated almost 20 percent of Florida counties as maternity care deserts. The nonprofit health advocacy group found that more than 10 percent of Florida women had no birthing hospital within 30 minutes of their home, and women living in maternal care deserts traveled almost four times farther to birthing hospitals than women living in areas with full access to maternal care.
The report found that over 20 percent of birthing mothers received inadequate prenatal care in Florida—higher than the U.S. rate of 14.8 percent. Historically, people of color have lower rates of adequate prenatal care due to environmental factors like crime rates, access to transportation, and housing conditions.
Hospital closures and a shortage of providers are driving changes in maternity care access—as is a general lack of trust in the health care system. Women often feel that their doctors aren’t listening to them when they believe something is wrong.
Improving Access to Prenatal Care
Several strategies have been suggested to increase access to prenatal care in underserved areas, including Medicaid expansion and extension, improved integration of the midwifery model of care, reimbursement for doula care, and increasing the availability of telehealth services.
Studies have shown that telehealth services also greatly benefit underserved women, those vulnerable to poor health outcomes, and those with limited access to high-risk care.
Doulas and midwives play important roles in bridging the gap between health care providers and pregnant women. Embracing workers like doulas and midwives can make patients more comfortable and willing to seek health care during pregnancy, helping them avoid complications.
Individual prenatal care could also be improved by modifying scheduling practices and reducing the number of scheduled visits in high-resource settings to the WHO-recommended eight visits, improving access to early, timely prenatal care. Providing positive, caring, and respectful health providers with good interpersonal communication may also influence timely prenatal care, as could health education throughout the prenatal and postpartum periods.
Insurance and Medicaid Challenges in Florida for Pregnant Women
Insurance presents numerous challenges to underserved women seeking prenatal care. Medicaid coverage often doesn’t kick in until later in the pregnancy. Meanwhile, doctors get a lower reimbursement rate for Medicaid patients, so these patients are often denied care. In addition, the low number of health care providers in the state and the prevalence of maternal care deserts mean that many people face extreme delays in obtaining both prenatal care and Medicaid coverage.
Your local health department may be able to connect you with prenatal care services. The Florida Department of Health has several programs for eligible low-income pregnant people, including Presumptive Eligibility for Pregnant Women, a temporary insurance coverage that can keep you healthy before Medicaid kicks in. The Healthy Start program also offers services to pregnant women and children up to age three, including provider referral, care coordination, and support for childbirth, breastfeeding, and parenting.
Medical Malpractice and Negligence
Health care providers owe a duty of care to mothers during pregnancy and childbirth. If an obstetrician or other professional makes an error harming you or your baby, they may be liable for medical malpractice.
Birth injuries often occur from medical negligence during pregnancy, labor, birth, or shortly after birth. OB-GYN errors may lead to premature birth, stillbirth, physical and mental disabilities, physical injuries and malformations, abnormal brain development, maternal death, bleeding complications, placental issues, uterine rupture, and preeclampsia.
The medical malpractice legal team at FHVG in Florida have significant experience in handling cases involving both infant and maternal mortalities. We understand what it takes to get fair compensation for these terrible cases, and we will fight to get justice for the families we represent. Our birth injury lawyers continue to fight to shed light on this problem so that changes can be made to the system that continues to fail families in Florida and throughout the country.
Expectant Mothers’ Legal Options
Medical professionals owe a professional duty of care that includes listening to patients and considering their concerns. Medical gaslighting occurs when a health care provider dismisses a patient’s concerns. If you feel that your health care needs are being ignored or inadequately addressed, you have options, including the following:
- Changing doctors
- Getting a referral to a specialist
- Filing a complaint with the state medical board
- Pushing back against dismissive behavior
- Getting the provider’s refusal to treat or examine you in writing in anticipation of litigation
If an obstetrician or other medical professional fails to meet the accepted standard of care, harming you or your baby, you may have grounds for a medical malpractice claim. If you believe you or your baby has been a victim of medical malpractice, consult an experienced medical malpractice lawyer as soon as possible. They can analyze your case and determine if your health care provider breached the applicable duty of care.
Florida’s Policy and Legislative Changes in Prenatal Care
In March 2024, Florida Governor Ron DeSantis signed a $717 million package of bills into law that aims to improve access to health care and increase the number of doctors in the state. Dubbed the “Live Healthy” initiative by Florida Senate President Kathleen Passidomo, part of the legislation regards freestanding birth centers to reach people in maternal care deserts and increases funding for labor and delivery services. One bill includes allowing “advanced birth centers” that could provide cesarean-section deliveries for women with low-risk pregnancies. Some birth centers already exist, but they haven’t been allowed to provide C-sections.
Another measure, Senate Bill 7016, creates and expands training programs to help develop and retain Florida’s health care workforce. The bill also provides requirements for advanced birth centers regarding operating procedures, staffing, and equipment and requires them to enter written agreements with blood banks for emergency blood bank services. The package also reduces regulations for autonomous nurse midwives, expands telehealth maternity care, and creates a website to help expectant parents learn about available services.
Despite the new laws, Florida’s current 15-week abortion ban will likely make more babies vulnerable to infant mortality. A challenge against this ban is pending before the Florida Supreme Court, and if the justices uphold it, it would trigger a six-week ban that lawmakers passed last year, further endangering infants.
Moving Forward
Legal professionals, politicians, and health care providers must work together to improve Florida’s maternal and infant health outcomes. If you suspect medical malpractice from your obstetrician, advanced birthing center, or another health care provider, contact Freedland Harwin Valori Gander today for a free consultation.
