The average mortality rate for infants under 28 days old in the Virgin Islands in the past five years is around 9.52 per 1,000 live births.
That’s better than the worldwide rate of 19 and the Caribbean and Latin American rate of 16.1, according to Dr. June Samuel, chief of medical staff at the BVI Health Services Authority — and she thinks it’s high time people knew that.
“We still don’t tell our stories,” she said on May 2 during the opening of the territory’s first Perinatal Conference, a three-day event hosted by the Women and Children’s Health Division.
The perinatal period stretches from 22 completed weeks of pregnancy to seven days after birth, according to Dr. Samuel.
The event, she said, was an opportunity to begin celebrating the fact that the BVIHSA is “doing good things and having good clinical outcomes in spite of limited resources, stretched human resources and sometimes not enough public support.”
She noted that one of the United Nations Sustainable Development Goals for 2030 is reducing neonatal mortality to less than 12 per 1,000 live births, and mortality in children under 5 to less than 25 per 1,000 live births.
Another UN goal is to decrease the worldwide maternal mortality rate to less than 70 per 100,000 live births. The VI maternal mortality rate has remained at zero in recent years. By contrast, in 2015, the global maternal mortality ratio stood at 216 maternal deaths per 100,000 live births, according to the World Bank.
|New preemie support group launched
Cerine Dasent only got to hold her son for a few seconds when he was born about seven weeks early weighing just three pounds and eight ounces.
Then she had to hand him over to the staff at Peebles Hospital for the special care given to babies who arrive prematurely, which typically involves a stay in the Neonatal Intensive Care Unit.
“I got to have that bonding moment,” she explained. Although she said the experience was “a bit scary,” she praised the staff at Peebles for alleviating her fears.
“They were quite helpful, and they gave me that assurance that everything was okay when I had doubts, because it was the first time I experienced anything like that,” she added. “They were very supportive and professional.”
Today, Ms. Dasent’s son Jair George is a healthy 2-year-old, but she believes the support she received in the hospital should be an ongoing process.
“Prematurity is quite common, but I think it’s not as recognised,” she said. “Awareness would help, I think. You have the babies: They’re in the NICU for a period of time, and then they’re discharged and everyone forgets about them.”
That’s why she’s excited that she and her son will be able to lean on the support of other families of preemies, thanks to the Friday launch of Tiny Champs, the new support group for “graduates” of the NICU at Peebles.
Pediatrician Dr. Natasha Frett, the founder of the group, said she was inspired by the stories she heard from parents.
“It was very obvious that there was a need for a support group that would bring them together and help them realise they were not alone in this journey,” she said.
During the launch, she gave a photographic slideshow recounting the triumphs of the premature infants who have passed through the NICU in recent years.
“When I observed our NICU, I was fortunate to observe a lot of bonding occurring between the moms,” she said. “Sometimes it was quite interesting. [Parents] would call each other. They would give you updates. We appreciated that it was a bonding experience for the parents in the NICU.”
So far, she added, nine parents and eight children have joined Tiny Champs, and others have expressed interest. Many of them attended on Friday, where parents received official group t-shirts and shared stories while the children made friends.
Dr. Frett pointed out that children born prematurely face a higher risk of infections, language-learning delays, and vision and hearing loss. She said the support group will seek to encourage relationships between parents; provide access to specialists, social and financial networks; and advocate and educate medical professionals and the wider community about the challenges that occur in these children.
Ms. Dasent has high hopes, she said: “I like that doctors will able to liaise with the various school principals to see their progress and development, and see if there are any problems they can address.”
“It is good,” Dr. Samuel said of the VI’s record. “But maybe we need to dig deeper, and that is what this conference is about.”
In fact, the VI’s rate of neonatal mortality — the term used for deaths of infants under 28 days old — is still higher than England and Wales’, which was 3.8 per 1,000 live births in 2016, and the United States’, which was 5.6.
Dr. Samuel added that she wishes to encourage a “critical look” at the data, “so we know where we need to improve.”
When a baby comes early
BVIHSA CEO Paula Chester-Cumberbatch showed attendees photos of a baby named Marcellus, who was born at 28 weeks at a birth weight of just over 2.5 pounds. He went home with his family three weeks ago.
“The birth of a baby is usually a joyous event, but when a baby is born too early there are some complications that may occur, including serious health problems for the baby and steep medical bills for the family,” she said. “The role of the staff in such circumstances is usually questioned, and a label is usually placed on the health of a country and its population.”
The conference, she added, was an attempt to mitigate such difficulties and celebrate successes.
In the VI, Ms. Chester-Cumberbatch said, “We have an average of 265 deliveries a year with an average of one to two stillborn infants.”
That rate is “something that we need to applaud,” she added. “For the region, that is something that many countries are trying to achieve.”
Ms. Chester-Cumberbatch’s numbers put the VI’s stillborn rate between 3.8 and 7.6 per 1,000 births.
In 2015, the estimated average global rate was 18.4 per 1,000 births, and in Latin America it was 8.2. For every 1,000 pregnancies in England and Wales, about 4.4 infants were stillborn, and the rate in the US was nearly six.
Role of midwives
The conference coincided with International Midwifery Day on Saturday. Midwives “are key in family planning; safe pregnancy … and healthy newborns,” Ms. Chester-Cumberbatch said.
Gretchen Hodge-Penn, BVIHSA director of nursing, added, “We are going to be honouring [midwives] … and the myriad things they do every day to contribute to the well-being of mothers and children around the world.”
The 68 midwives licensed to practise in the territory, who include nurses and nursing assistants, deliver 44 percent of babies here, according to Jacinth Hannibal, the BVIHSA’s chief nursing officer.
“In nations where there is a dearth of midwives, babies die and mothers die in childbirth,” Ms. Hannibal said. “The impact of quality midwifery care is well documented. Therefore the call now for midwives to lead the call for quality care is timely and apt.”
Numbers ‘tell a story’
Second District Representative Mitch Turnbull spoke on behalf of Health and Social Development Minister Ronnie Skelton.
“The minister is proud that this team continues to grow and continues to perform at an excellent rate, delivering care to mothers and children in their early stages,” Mr. Turnbull said, adding, “While there are many initiatives under way to further improve maternity services in the BVI, there will always be more that we can do.”
Ms. Hannibal added, “It is said that we measure what we value and we value what we measure. …The numbers must tell a story.”
Therefore, some of the plans discussed at the conference included reducing perinatal trauma during birth; improving mother and infant bonding; and improving access to birth preparation classes.
“While we feel that we are doing great, we can always do better,” she said.