If the District of Columbia wants to lower its infamously high infant mortality rate immediately, hospitals must improve their ability to resuscitate newborn babies with breathing problems, a special city study group announced yesterday.
The Mayor's Blue Ribbon Commission on Infant Mortality also called for increased use of specially trained nurses to provide pediatric and obstetrical care, and said the city must improve its system for gathering mortality data if it is ever to understand why the infant mortality rate here is so high.
These and other recommendations were included in the commission's first interim report on the city's problem, which has seen it ranked number one or two in infant deaths among large cities for the last decade.
At the same time he released the report, Mayor Marion Barry announced that the 10 hospitals in the city that deliver babies "have volunteered to improve the . . . resuscitation in their hospitals."
Barry released figures yesterday showing that the city had an infant mortality rate last year of 25.8 deaths per 1,000 live births, compared to 27.3 in 1977.
The statisticians who compiled the data, however, said the change was statistically meaningless because it was primarily based upon the annual fluctuation represented in the small number of white births here and in the always small number of deaths among white babies.
The black infant mortality rate here last year was 28.6 per 1,000 births, compared to 29.5 the year before. Last year's white rate was 9.5 deaths per 1,000 births, compared to 13.9 the year before.
Barry told reporters, "I expect to see a substantial drop in the infant mortality rate by the end of 1980."
Among the things the blue ribbon commission has initially recommended to achieve that goal are:
Licensing laws should be amended to require that any physician or nurse caring for infants be required to show proficiency in the cardiopulmonary resuscitation of the newborn, just as such physicians and nurses are now required to master adult CPR.
The city should adopt the national Model State Vital Statistics Act in order to require the more timely, uniform reporting of information by hospitals.
A Resuscitation Education Action Program (REAP) must be established to insure that each hospital in the city has a 24 hour-a-day capacity for resuscitation and stabilization of asphyxiated infants, since asphyxiation is a leading cause of infant death.
A system should be created so that sick newborn infants are transported to hospitals with the newborn intensive-care units.
Each hospital delivering babies should have a perinatal liaison coordinator who would coordinate record keeping and follow-up care for babies born in the hospital and their mothers.
The report also urged that "high quality prenatal care (be) available and accessible to every pregnant woman in the District of Columbia," and that "all expectant parents know why, when, where, and how to get quality prenatal care."
In addition, a system must also be established to insure that mothers who are at risk of delivering a sick newborn do so in a hospital equipped to care for such babies, the report said.
There is still a serious question about where the city is going to get the money to finance the actions recommended by the commission, none of which carry a firm price tag.
The one item on which the commission placed any figure is the plan to train resuscitation teams in the 10 hospitals. That, say committee members, could be done for about $90,000.
Barry said the city will attempt to find federal grants to finance the programs, and said the city has received some indications that money may be available.