August 9, 2018Family medicine physicians trained in obstetrics can have a profound impact on infant mortality rates in rural areas, according to research conducted by College of Community Health Sciences physicians and faculty. Their research shows obstetrics services provided by family medicine physicians in rural Pickens County, Alabama, resulted in an improved infant mortality rate for the county, and that the availability of local prenatal care was also associated with a lower infant mortality rate. The results were published in The Journal of the American Board of Family Medicine, July-August 2018 issue. Drs. Jessica Powell, Catherine Skinner, Drake Lavender, Daniel Avery and James Leeper authored the article and conducted the research. The results are especially impactful for Alabama, a largely rural state. Despite a declining national infant mortality rate, the state’s rate has shown less improvement. In 2013, Alabama ranked 49th in the nation for infant mortality. The College, meanwhile, continues to work to reverse those numbers, particularly through its Obstetrics Fellowship, which trains family medicine physicians in obstetrics care. According to the journal article, Pickens County had no obstetrics services, including prenatal care, from 1986 to 1991, and the infant mortality rate was 17.9. The rate is defined as the number of deaths among infants less than one year of age per 1,000 live births. From 1993 to 2002, full obstetrics services, including prenatal care and delivery, were available in the county and the infant mortality rate dropped by 60 percent, resulting in a rate lower than both the state and national rates during that period. Unfortunately, Pickens County lost local labor delivery services in 2002 when the Pickens County Medical Center closed its labor and delivery unit, and from 2005 to 2013 only prenatal care was available – provided by one family medicine physician trained through an obstetrics fellowship. While the infant mortality rate increased during this period, the rate was less than the period when no obstetrics care – prenatal or delivery services – was available locally.