Reducing infant mortality starts with listening to women in this city

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• William Brangham:

  Even with advances in medical technology and living standards, the United States still ranks near the bottom of the world's wealthiest nations in infant mortality, which is children dying before their first birthday.

  John Yang reports on efforts to address the problem in Cincinnati, which has one of the highest rates in the nation.

• John Yang:

  In Cincinnati's Avondale neighborhood, it's a typical morning for Ashantti Davis, getting 4-year-old Royal ready for day care, while also tending to King Adam, who was born in October.

  Arriving to lend a hand and offer advice? Fellow Avondale resident Tina Brown.

• Tina Brown:

  You been keeping the baby in the crib? You haven't been sleeping with the baby?

• Ashantti Davis:

  No, because I don't want to roll over on him.

• Tina Brown:

  That's right. You have got it down pat.

• Ashantti Davis:

  Got to keep him safe.

• John Yang:

  And she has a tip on a hospital job for Davis, who currently works for the Cincinnati Parks Department.

• Ashantti Davis:

  A worker readiness program?

• John Yang:

  During both pregnancies, Davis had gestational diabetes. But with King Adam, she had Brown at her side, counseling her on diet, going with her to doctor's appointments, reminding her to take her medications.

• Tina Brown:

  Good job with your diabetes, though. You're doing great.

• Ashantti Davis:

  Thank you.

  With this pregnancy, it was easier, you know, me knowing that I had somebody to help me out and stuff like that. And every week, she came by with some type of resources.

• John Yang:

  Tina Brown is part of a broad effort shaped by mothers and focused on mothers to reduce rate of infant mortality across Cincinnati. As recently as 2011, this county had the second highest rate in the nation.

  And despite a 15 percent drop over the past five years, it still ranks in the top 10 percent. The arrival of King Adam didn't signal the departure of Brown from Davis' life. On this day, Brown went with her to get clothes for both children at a pantry run by Carmel Presbyterian Church.

• Tina Brown:

  I call her every day, she how she doing, just kind of see what kind of mood she's in. We have got a close bond. Me and Ashantti have got a real close bond.

• John Yang:

  A year ago, the women were total strangers. Brown was matched with Davis as her adviser and advocate, what's called a health champion, by the Community Builders, the nonprofit development company that owns the building where Davis lives.

  Brown is one of nine health champions the company employs. Altogether, they currently counsel 64 families with either a pregnant mother or a child 6 or younger.

• Jodi Cunningham:

  Through housing, we have a unique access point to reach our residents.

• John Yang:

  The developer is considering expanding the program to its affordable housing properties nationwide. Jodi Cunningham is the Avondale project manager.

• Jodi Cunningham:

  It's really great having actual neighbors leading this. It's a different connection that they can have with moms.

  It's easier to build trust with our residents. It's easier to know what will work. And they really are the experts on Avondale.

• John Yang:

  The predominantly African-American neighborhood has historically had one the city's highest rates of infant mortality. It's also home to Cincinnati Children's Hospital Medical Center, which houses Cradle Cincinnati, a campaign to reduce infant mortality countywide.

• Ryan Adcock:

  The most important part of our work has nothing at all to do with the doctor's office.

• John Yang:

  Cradle Cincinnati executive director Ryan Adcock says listening to women is essential.

• Ryan Adcock:

  These moms live and breathe in their neighborhoods. And, therefore, they're experts when it comes to the place that is influencing their health. And so it's almost daily when I talk with moms that they teach me something that's going to be instrumental for the change that we're trying to make.

• John Yang:

  And it's not just physical conditions that influence their health. In Cincinnati, and nationwide, high infant mortality is driven by the fact that black infants are more than twice as likely to die as white babies, regardless of the mother's income and education.

• Ryan Adcock:

  An African-American mother with a master's degree is more likely to lose her child than a white mom who never graduated from high school. And so it asks us it forces us to ask question like, what is different about the black experience in America that is leading to these poor outcomes?

  And we do think it has to do with bias. We do think it has to do with racism. We think these things lead to very real stress that does impact pregnancies and impacts the outcome.

• John Yang:

  Racism in day-to-day life, including, black women say, at doctor's offices.

• Meredith Shockley-Smith:

  Tell a story about when you realized how much race matters.

• John Yang:

  At a recent gathering of Cradle Cincinnati's moms advisory board, women prepared to share their experiences face-to-face with medical professionals.

  Lavenia Jones is a new mom.

• Lavenia Jones:

  You will hear doctors and nurses like, oh, they're just exaggerating, and is not really listening to them because it's a black person.

  But if it's like a white person, it's just like, oh, my God, like, this is serious.

  These preconceived notions like, if I give her this medication, they will sell it, you don't do that to our white counterparts.

• Meredith Shockley-Smith:

  Black women want to come and share.

• John Yang:

  Meredith Shockley-Smith, Cradle Cincinnati's director of inclusion and community strategies, says physicians and nurses welcome the feedback.

• Meredith Shockley-Smith:

  Surprised is very often a response. Why are you afraid of me? Why do you feel like this is not a safe place?

  I think there's just a need for education and training. And they are asking for that.

• John Yang:

  Advisory board member Jera Boyd, a singer-songwriter, lost a baby in 2013 after only four months of pregnancy.

• Jera Boyd:

  It was a very traumatic experience. I felt lost. I felt discouraged. And…

• John Yang:

  Had there been warning signs before?

• Jera Boyd:

  There were no warning signs, but I was under a great level of stress, which I feel like added to what ended up happening.

• John Yang:

  She says the stress came from an unhealthy relationship, which she didn't feel comfortable discussing with her obstetrician, who was white.

• Jera Boyd:

  I don't really feel like the environment was serene and comfortable for me to open up and express myself. I really felt like I was just another patient at that time. And that's not a good feeling when your life is at stake.

• John Yang:

  In September 2017, Boyd gave birth to her daughter, Symphony. She had sought out a different doctor, who is black.

• Jera Boyd:

  It was a totally different relationship from the one I experienced in the past. Ultimately, she came out a happy and healthy baby. And she's just full of life and excitement.

• John Yang:

  Boyd and the other moms on Cradle Cincinnati's advisory board share their stories, in the belief that interactions outside of doctor's offices will help produce more outcomes as happy and healthy as these.

  For the "PBS NewsHour," I'm John Yang in Cincinnati.