Arlington County has the lowest infant mortality rate in the state, despite the fact that expecting Arlington mothers receive early prenatal care at lower-than-average rates.
These were some of the findings of a recent study conducted by Voices for Virginia’s Children, a statewide child advocacy group.
According to the study, from 2001 to 2005, there were 3.6 deaths of children aged one year or younger in Arlington for every 1,000 live births. Statewide during this time period, there were 7.4 infant deaths per every 1,000 live births.
Arlington’s infant mortality rate was lower during this time period than the rates of any other jurisdiction in the state. The next lowest was Loudoun County at 4.4.
"We are proud to have that statistic," Reuben Varghese, director of the county’s public health department, said. "I think that we have a more educated population… [and] we have a healthier population in general."
But despite Arlington’s low rate of infant mortality, pregnant women in the county receive prenatal care at lower rates than the rest of the state.
The Voices for Virginia’s Children study showed that, in 2005, 76 percent of Arlington women received prenatal care beginning in their first trimester, compared with 85 percent for Virginia as a whole. It also showed that Arlington’s prenatal care rates have lagged behind the state average for the first half of this decade.
"If you have a lot of risk factors it’s important to go to a doctor early," said Cindy Hetzel, the research director for Voices for Virginia’s Children. "If you don’t see the doctor within the first 13 weeks than you have even less chance of modifying the risk factors."
BEATRIZ BURNS IS A nurse at the Arlington County Maternity Clinic, which provides pregnancy care for low-income women.
She said that when a woman in her first trimester comes into the clinic she receives a standard physical examination with several blood tests to see if any diseases are present that could be harmful to the child.
But Burns acknowledged that "Not everyone comes in the first trimester [because] not everyone knows they’re pregnant in the first trimester." She also added that "The majority of our clients are very poor… It takes them a long time to find information [about prenatal care]."
Varghese also acknowledged this but he said that the lower rate of prenatal care in Arlington may also be attributable to the county’s ethnic diversity.
"We have a higher percentage of women from different cultures," he said. "We’ve had clients report to us that this isn’t what they do normally [in their home countries]."
But Varghese said that the health department will continue to conduct outreach operations to pregnant women encouraging them to seek early prenatal care. He also said that the responsibility was not just up to the expecting mother herself.
"If someone knows a pregnant woman," Varghese said, "One of best things that they can ask them is if they’ve been seeking early first trimester care. They should talk to their loved ones and say ‘Have you gotten the care that you need?’"
THE DISPARITY BETWEEN Arlington’s infant mortality rate and its prenatal care rate can seem fairly incongruous.
According to the Voices for Virginia’s Children study, the U.S. infant mortality rate in 2004 for women who received late or no prenatal care was 37 percent higher than the rate for women who received care in their first trimester.
Sara Long, a health worker with the March of Dimes who works on premature births, said that she believes that, because prenatal care rates don’t always correspond with infant mortality, waiting until pregnancy to visit a doctor may be too late.
"[The study is] an example of why prenatal care can only do so much," Long said.
While she acknowledged that visiting a doctor in the first trimester is much more beneficial than waiting until later, Long said "Sometimes the first trimester is too late."
She said that there are many health interventions that should be done before becoming pregnant — such as taking folic acid, getting diabetes under control and quitting smoking — that can greatly improve the chances of giving birth to a healthy baby.
"A pregnancy is really 12 months [because] the four months prior are really critical," Long said, adding that, in many cases, "It’s too late for intervention once the pregnancy occurs."