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Nancy Mccarthy of The Skanner
Published: 13 September 2006

When it comes to birthing a healthy baby, 15-year-old Darkeesha Rasheed is discovering that it takes a whole lot of help. She's receiving that help from all the women in her Healthy Birth Initiative Class.
Even Rasheed's mother, Anna Polk, who has eight children of her own and is accompanying her daughter to the monthly Healthy Birth Initiative meetings, is learning a few things.
"These classes cover everything and anything," said Polk, who has appreciated classes that covered drug use and women's health care.
"Women don't know everything," she added.
Sponsored by the Multnomah County Health Department, the Healthy Birth Initiative seeks to improve the health of pregnant African American women and their children. African Americans have a higher infant mortality rate than any other race in the United States; even Blacks from other countries who settle in the United States have lower infant mortality and low-birthweight rates than African Americans do, said Sharon Smith, a registered dietician and director of the county's Healthy Birth Initiative.
The numbers are borne out in the 2006 World Mothers Study conducted by the Save the Children Foundation. The foundation, which researched the newborn mortality rate in countries throughout the world, listed the United States as the 32nd of 33 industrialized countries in terms of newborn mortality. With 4.7 newborn deaths per 1,000 live births, the U.S. rate is the same as that of Hungary, Malta, Poland and Slovakia. Only Latvia, with six deaths per 1,000, ranks lower. Japan heads the list, with about 2.8 deaths.
But with an infant mortality rate of 9.3 deaths per 1,000 live births, African Americans double the national average, according to the study.
African American babies are "twice as likely as White infants to be born with low birthweight, to be born pre-term and to die at birth," the study said.
While only 17 percent of all births in the United States are to African Americans, 33 percent of all low-birthweight babies and 38 percent of very low-birthweight babies are African American, the study noted.
"There are a lot of theories about why it occurs," Smith said. "We are finding out that even women in a higher socio-economic status have low-birthweight babies. It may be just the stress of being African American; we just don't know. There's no one answer."
The county's Healthy Birth Initiative works with women in North and Northeast Portland, who live in zip codes 97203, 97211, 97212, 97213, 97217, 97218, 97220 and 97227. They must be pregnant to receive the services and have no health insurance or access to medical care, or they may be suffering from undue stress, homelessness, lack of social support, be involved in gangs or have a medical risk. There are no age limits.
Those in the program attend monthly classes, which feature topics such as preparing for an early child, first aid and staying drug-free to keep the baby. On Sept. 27, the class will be about childhood immunization; on Oct. 25, participants will discuss child safety in vehicles; and on Nov. 22, the subject will be about maintaining health before, during and after pregnancy. The classes are held from 6 to 8 p.m. at 5325 N.E. Martin Luther King Jr. Blvd.
In addition to the classes, family support and mental health groups also are available. Because the program looks at the whole family, young fathers also attend classes sometimes, and a young men's health project also began this month.
A consortium of health professionals, Head Start directors and other community health organizations serves as an advisory group for the program, Smith said.
Community health nurses also make home visits and work with young mothers. Rasheed, whose baby girl, Zyarra, is not even 1 month old, has already asked advice about breastfeeding and the bumps on her baby's tongue. The nurse also weighs the baby and measures her to determine how fast she is growing.
"She (the nurse) gives me a lot of information," said Rasheed, who also noted that the 12 to 15 women in her class have helped her during the six months she has been in the program.
Rasheed learned about the Healthy Birth Initiative through the county's Northeast Health Center. Although she was, at first, reluctant to go because she thought the classes would be "boring," her mother encouraged her and offered to go along, too.
"There's always a meal for the women," said Anna Polk. "They don't make it boring; it's always exciting."
Other participants learn about the program through local hospitals and doctors; the Women, Infants and Children nutrition program; from other participants; and through outreach fairs involving the county health department. More than 120 families have participated, and at least 60 percent of the women stay in the program for at least three years, Smith said. Child care is available, as well as transportation.
"Most of our clients are happy to be in the program," Smith said. "We get a lot of first-time moms, and they are grateful for the education. They go to a doctor for 10 or 15 minutes, but they don't have time to ask a lot of questions. These classes tell them exactly what to expect.
There are 97 Healthy Birth Initiative programs offering services to target low-birthweight problems in all populations in the United States and Puerto Rico. In Oregon, another Healthy Birth Initiative program serves pregnant teens in Medford and Roseburg.
The program seems to be working, Smith noted.
"Infant mortality has gone down significantly since we started in 1997," she said. "We haven't had any infant deaths in our group."
Between 1995 and 1997, there were 15.7 deaths per 1,000 live births for African Americans in Oregon; 12 for Hispanics; and 6.5 for Caucasians, according to the Oregon Health Division.
However, between 2000 and 2002 (the last year available for comparison), the rate for African Americans dropped to 13.84; for Hispanics, 11.3 and 4.2 for Caucasians.

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