When Timantha Lawson was pregnant with her first child, she was 21, jobless and looking for a permanent place to live without the support of her baby's father, she said.
"I was really scared. I didn't think I would be a good mother to her," she recalled. "I went from being by myself to having to worry about this little baby that couldn't fend for herself."
In search of prenatal care, Lawson was referred to the Healthy Babies Project, a nonprofit organization based in Northeast Washington. It offers support and resources to families in an effort to reduce infant mortality and illnesses.
Lawson's fears eased checkup by checkup. She got help finding a job and a crib, and got plenty of advice in parenting classes. She had a healthy daughter, Timea, now 4. Lawson is now in school and studying computer technology.
With the support of private organizations and city funds, programs like the Healthy Babies Project have offered help to thousands of women in the District trying to balance the demands of motherhood and making a living.
Yet the District's infant mortality rate has been among the highest in the nation. In 2002, the most recent year for which D.C. statistics were available, the overall death rate for babies less than a year old was 12 per 1,000 live births. The death rate for blacks less than a year old was 14 per 1,000 live births; it was 9 for Latinos and 7 for whites.
While the District's rate has declined overall from a peak of 23 in 1988, a time of widespread drug use, it remains comparatively high. In Baltimore the infant mortality rate in 2002 was 13 for African Americans and 5 for whites, and 11 overall. Nationwide, the rate was 7 per 1,000 live births.
Infant mortality data for 2003 is to be released later this month.
For health officials, infant mortality rates are a telling social barometer, linked to poverty, education, crime and access to housing and health care. Studies show that infants born to unwed mothers who do not have a high school diploma, for instance, have a higher mortality rate. For organizations such as the Healthy Babies Project, addressing infant mortality goes beyond making sure pregnant women get regular checkups. Living standards also must be addressed, officials said.
"There are so many things that contribute to infant mortality: the stress of being a parent, maybe a parent doesn't know how to hold the baby and the baby was dropped on its head," said Rhonda Waller, the executive director of Healthy Babies Project. "Maybe the mother isn't eating right because she's living in a house with other family members that are eating all her food."
Waller said women might get dated or conflicting advice from parents and grandparents. Older people might still believe that putting babies on their stomachs is ideal, yet more recent studies have shown that babies should lie in cribs on their backs, Waller said.
"There has to be continuous education when it comes to child development and prenatal development," she said. "We are getting new information all the time."
The Healthy Babies Project plans to start parenting classes this month for grandparents, who are often primary caregivers. The program, which is part of the Developing Families Center, offers courses about effective black parenting, breastfeeding and fatherhood, among others.
After Timea was born, Lawson began dating a new boyfriend, Aaron Lawson; he took parenting classes, too, and the couple later married. They live in Northeast D.C. with Timea and their sons, Timon, 2, and Taron, just eight weeks old.
Now 26, Aaron Lawson said that the group in his fatherhood class helped him get over his fear of commitment and being a parent.
"The group helped build me up to where I was ready to get married," he said. "It helps young guys become men."
Timantha Lawson, now 25, offered her own endorsement.
"Now I know that I'm not the only one going through motherhood and life," she said. "Even though it feels overwhelming at times, I'm doing what I'm supposed to do."