Getting Past Age One

The infant mortality rate, or the death of an infant before its first birthday, continues to remain high among Black families. Efforts in Cincinnati and beyond have made some progress to lower it, including recognizing the importance of doulas and educating both healthcare providers and moms. How effective is this strategy and can more be done? 

Interview guests: Dr. Elizabeth Kelly, co-founder Cradle Cincinnati; Dr. James Greenberg, co-founder Cradle Cincinnati; Meredith Smith, executive director Cradle Cincinnati; Corinn Taylor, PhD, founder of The Empowerment Foundation; Sharon Hawkins, director, The Doula Initiative; Jill Miller, president & CEO bi3; Jeremiah Kirkland, senior vice president TriHealth; Kanako Kashima, director of community health Mercy Health; Marcus Romanello, chief medical officer The Christ Hospital; Evelyn Agbomi, clinical nurse manager UC Health; Brenda Logan, health integration manager UC Health; Sarah Huber, senior epidemiologist Hamilton County Public Health; mothers Jamira Holt, Agol Aloak, O’Landrea Joi Barnes and Adrienne Jacobson; Alaysia Ponder, Nurture Your Nature Doula Services.

Please give us your feedback: https://forms.gle/16YosVHyL7mE3Up9A 

Brick by Brick Website

• Feedback Survey

Transcript

Ann Thompson:

Infant mortality or the death of a baby before its first birthday remains high in the US, including Ohio.

Dr. James Greenberg:

Underneath it all, if we look at the Black infant mortality rate in Hamilton County, it's really high. And it's as high as it was when we started. So what's changed actually is that the white infant mortality rate has gotten a lot better. The black infant mortality rate, not so much.

Ann Thompson:

The causes are many, including SIDS, pregnancy complications, and preterm birth. Cincinnati mother Jamira Holt and her now one-year-old twins are doing fine, but when it came time for delivery, she says nobody listened to her. Failure to listen is a preventable contributor to infant mortality.

Jamira Holt:

I think the anesthesia was underestimated in my case, and it was negated. My feelings were negated at the time, and I just did not appreciate that.

Ann Thompson:

With a model that brings together parents, caregivers, healthcare professionals, and community members to support moms and babies, for years, the organization Cradle Cincinnati has been trying to keep infant mortality numbers in check.

Meredith Smith:

What makes a thriving community is a complex reality? But I like to go back to the African proverb that says the measure of how we treat our babies is the measure of a society.

Ann Thompson:

It's working so well that Ohio is expanding it statewide. Researchers like Dr. Corinn Taylor are encouraged.

Corinn Taylor:

I think it's just hopeful across the landscape. There's so many great things going on, so many feet on the street, being able to change kind of how this looks like and feels like.

Ann Thompson:

For Ohio counties have priority because of high infant mortality rates, including Montgomery. Today on the pod, infant mortality, why it's still such a big problem in the US and Ohio. Disparities between Black and White infants and how we can decrease their deaths. Let's get into it. This is Brick by Brick, solutions for a thriving community.

Ame Clase:

Brick by Brick is made possible thanks to leading support from Greater Cincinnati Foundation, AES Foundation and George and Margaret McLane Foundation, with additional major support from Laurie    Johnston, The Robert & Adelle Schiff Family Foundation, Murray and Agnes Seasongood Good Government Foundation and more. Thank you

Ann Thompson:

Hello, and welcome to Brick by Brick, where we're highlighting solutions for a thriving community in Southwest Ohio. I'm your host, Ann Thompson. It's hard to imagine that the US with some of the best minds in medicine in the world has one of the highest rates of infant mortality when compared to other wealthy nations. How many babies die before their first birthday? More than 20,000. Preliminary 2024 data finds 5.5 deaths for every 1,000 live births. The national percentage is much higher for Black infants, nearly 11%. When it comes to states, Ohio ranks 45th in the nation for infant mortality. In 2023, Montgomery County had 9.8 deaths per 1,000 live births. That's higher than both the state and the national average. For Hamilton County, the number was lower. Sarah Huber is senior epidemiologist for Hamilton County Public Health.

Sarah Huber:

We did have a dip in 2023. That was like a highlight year for us. Our infant mortality rate was 5.48. Our 2024 and 2025 numbers have increased since then, but they're still preliminary. So we do expect that they will be roughly where they are right now until data is finalized, but we are looking into why.

Ann Thompson:

The preliminary numbers for 2025 put the infant mortality rate back above eight deaths for every thousand births. For white mothers, the rate is lower around three. But for black mothers, the rate has gone back to levels seen before Hamilton County officials started addressing the issue. 20. They're still digging into the reasons why that's happening. The causes of infant mortality, however, are many. Preterm birth, sudden infant death syndrome, and sleep-related deaths, birth defects, and more. Even though Sarah's a numbers person, she often goes behind the data, identifying overlook risks like nursing pillows. Between 2013 and 2023, there were 10 documented deaths where a nursing pillow was present.

Sarah Huber:

We like to be able to have those available when mom is feeding or when she needs to use it, but in terms of sleeping, they don't need to be in the space with the infant because they don't have the ability to turn their head when something soft covers their face.

Ann Thompson:

Huber says in 2024, four additional deaths occurred under similar circumstances, representing a 40% increase. Because there are so many causes of infant mortality, decreasing numbers is not easy. In 2011, Hamilton County used to have the second highest rate among counties in the nation. We'll get to how the county lowered it in just a few minutes. But first, some real life examples of how mothers had to fight to navigate their pregnancy journeys. Teacher Jamira Holt says her first and only pregnancy experience was one to remember. While in labor with twins, she says she was poked and it was painful because possibly she didn't have enough anesthesia. She communicated that, wasn't acknowledged, and then rushed into making a series of decisions.

Jamira Holt:

Maybe just listening more instead of thinking that they know what the anesthesia is going to do and always trust that things could be different when it comes to the human body.

Ann Thompson:

Jamira talked about the lack of listening in a survey with Dr. Corinn Taylor. Taylor, a nurse, researcher, and founder of the Empowerment Foundation noticed early on that pregnant women, especially Black women, weren't being listened to.

Corinn Taylor:

I feel like it's very disturbing because it ultimately impacts the care the patient receives. And when someone is telling you about the situation, their story, whatever that may be, I think is super important for that person to be heard because that's how care is going to be effective if we understand the things that patients are going through.

Ann Thompson:

Taylor partnered with United Way and other nonprofits for the study. Other requests she found, which have nothing to do with medical care, were also ignored.

Corinn Taylor:

So if the woman wanted music playing in the room, someone explained to me that they said that it would mess with the equipment, so they couldn't adhere to the birth plan that they created for the kind of birth that they wanted.

Ann Thompson:

Taylor's report gives recommendations to health systems, helping them better understand pregnant women and their prenatal and postpartum needs. Agol Aloak was another of the three dozen women participating in the study. She had a high paying job and felt belittled by a healthcare worker who wanted her to qualify for WIC.

Agol Aloak:

She goes, "Okay, well, this is your money range for the income." And I was looking at it and I'm like, "Oh, well, what if you make more?" And she gave me this really disgusted face like, "You make more. You don't make more." And I was like, "I do. " I'm like, "Yeah, I make this much amount." She goes, "Oh, well then you don't even qualify." She just kind of moved the paper out of my face. And that kind of made me feel like, hmm, all right. So you put me in this box already and you don't even know who I am.

Ann Thompson:

Agol wants to tell other mothers you don't have to lower yourself and put yourself in a box. There are other ways to get help. In the survey, she also explained she was forced to have a C-section when she didn't think it was necessary. Jamira and Agol’s stories ring true in studies cited by KFF News. One report said Black and Hispanic women reported the highest rates of mistreatment, like shouting and scolding, ignoring or refusing requests for help while pregnant. Another study found that Black women are more likely to receive a C-section compared to White women. Strongly tied to women's health is the infant mortality problem. In 2011, Hamilton County had the second highest rate in the country for counties, nearly 11 deaths for every 1,000 live births. Doctors Elizabeth Kelly and James Greenberg decided to do something about it, forming Cradle Cincinnati in 2013 with a goal that every child lives to see their first birthday.

They, along with the county and the community, started looking at infant mortality data and raising awareness. Kelly says it was important to reimagine care, joining both medical and social drivers, which is what Cradle Cincinnati has done.

Dr. Elizabeth Kelly:

Think of like someone coming in and somebody saying with a piece of paper, "Do you have a ride? Do you have a bed? Do you have a heat? Do you have this? " And you're like ...

Ann Thompson:

Dr. Kelly shrugs.

Dr. Elizabeth Kelly:

As opposed to, "How are you feeling today? What do you need? How can, maybe not explicitly saying this, but how can we work together?

Ann Thompson:

This personal approach provides a care manager who connects mothers with doctor's appointments, a doula, transportation, domestic violence help, and eviction prevention. Dr. Kelly says social stressors are a cause of preterm birth and Cradle Cincinnati is hoping to mitigate that in a way that is not demeaning.

Dr. Elizabeth Kelly:

One of the most important things around this area of this question you asked is to say, "This woman is strong. This woman has got it. " How can we partner with her to make her realize what she knows she needs to have a healthy pregnancy?

Ann Thompson:

Cradle Cincinnati Executive Director Meredith Smith says the organization has expanded since its inception, realizing self-care is also important with a group called Queens Village.

Meredith Smith:

It is a space for Black women to gather together to do two things. One, heal from the reality of living in a Black body in the United States. And so that is a lot of gathering and celebration and whatever they're asking for. So at times it's yoga and sometimes it's painting and sometimes it's just celebrating infant mortality when it's going down. And other times it's co-creating interventions when it's going up.

Ann Thompson:

Dr. James Greenberg keeps an eye on the data, and for more than a decade, Cradle Cincinnati and others have mostly kept infant mortality numbers down in Hamilton County. Greenberg realizes there are many factors that can help lower infant mortality like early prenatal care and help from the father and the rest of the family after the baby is born.

Dr. James Greenberg:

Whoever’s there has to be there in the way a father can be there. All the time, twenty four seven in a real sense, and that's really important. And there's some research that supports this. If you look at big epidemiologic studies, the availability, if you will, of a father seems to be associated with better pregnancy outcomes.

Ann Thompson:

Dr. Greenberg also says exhaustion is one reason for babies sleeping in their parents' bed, and that is a cause of infant mortality. Sudden infant death syndrome is the second leading cause of infant mortality. One of the main messages Cradle and other groups like to share out are the ABCs of Safe Sleep, which we should all learn. They recommend allowing your baby to sleep Alone, on their Back, and in a Crib. Hamilton County families are slowly making changes. Raising awareness about the causes and building support for birthing parents is important. It can be seen as the ground up aspect to Cradle's approach. There is also a top down side to it, which is focused on refining hospital practices and eliminating unconscious bias. As Brick by Bricks Hernz Laguerre Jr. reports, the partnership of hospitals is vital to better care for pregnant women.

Nat sound of a Mommy Meetup:

We're trying to get in touch with the best part of ourself, the things that bring us joy.

Hernz Laguerre Jr.:

Cradle Cincinnati's branch organization, Queens Village, has events called Mommy Meetups. The meetups are opportunities for Black mothers to rest, relax, and connect to resources during pregnancy and postpartum. This is a resource that organization member O’Landrea Joi Barnes wishes she knew about before her first pregnancy.

O'Landrea Joi Barnes:

I did not know of Queens Villages or Cradle Cincinnati until I was having my second child.

Hernz Laguerre Jr.:

Joi went through four pregnancies, and it was during her third one in 2023 that a life-changing experience made her aware of the infant mortality crisis affecting Black women.

O'Landrea Joi Barnes:

Before I lost my daughter to still birth, I actually went to the hospital three times for the same reason. I was not listened to. I was not taken seriously. Ultimately, I got sent home. 24 hours later, I went to my doctor's appointment and my child was right smack dab in the middle of labor, preparing to be born.

Hernz Laguerre Jr.:

Do you feel like if you were listened to the first time you went to the hospital, do you think that would have made a difference?

O'Landrea Joi Barnes:

Absolutely. Would it have changed the outcome? No one will ever know the answer, but it definitely would have made a difference.

Hernz Laguerre Jr.:

During her fourth pregnancy, she and her husband utilized an initiative from Queens Village called Mama Certified.

O'Landrea Joi Barnes:

Also, patient care was big for me as well. Coming off of a loss, so that was how I used Mama Certified.

Hernz Laguerre Jr.:

Mama Certified is a hospital certification program to help parents to be and families find a hospital that meets their needs. Hospitals can earn a certification by following guidelines that include sharing data with Queens Village to help create better maternal care. Jill Miller is the president and CEO of the nonprofit philanthropy, bi3. This organization helps support health equity efforts like Mama Certified. She said for this initiative to work as a viable resource, major hospitals needed to cooperate with each other and the community.

Jill Miller:

They all realize, look, we're better together and we all want to improve mom and baby health and let's work together to do that as a region.

Hernz Laguerre Jr.:

Brick by Brick spoke to all the major hospitals in the region to see some of the ways they're addressing the high infant mortality rates. Dr. James Greenberg, the co-director of the Perinatal Institute at Cincinnati Children's, says issues with housing stability, poor environment, and other socioeconomic outcomes need to be addressed.

Dr. James Greenberg:

If you are preoccupied with these really serious issues where your own safety is involved, then it becomes more difficult for a host of reasons to be able to access that prenatal care that you need.

Hernz Laguerre Jr.:

Senior Vice President at TriHealth, Jeremiah Kirkland agrees. He says addressing mental health can in turn help maternal and infant health.

Jeremiah Kirkland:

In some ways, I think deeper training for us as a health system, but for many health systems across the country to see that, address it, and then have the support and resources to take care of that individual.

Hernz Laguerre Jr.:

Mercy Health's Director of Community Health, Kanako Kashima, stresses the importance of sustenance.

Kanako Kashima:

We've partnered with a wonderful organization locally called Produce Parks Midwest to deliver infant vitality produce boxes to parents throughout pregnancy and postpartum.

Hernz Laguerre Jr.:

Sleep-related deaths account for nearly a quarter of the high infant mortality rates in Hamilton County. Dr. Marcus Romanello, chief medical officer at Christ Hospital, says some families don't have the resources for safe sleep.

Dr. Marcus Romanello:

We've made sure that we're addressing that need. Every single baby goes home with a sleep sack. The households that don't have a crib, we help provide that.

Hernz Laguerre Jr.:

And from UC Health, we have clinical nurse manager, Evelyn Agbomi and Health Integration Manager, Brenda Logan, who reminds us the warmth needed in healthcare.

Evelyn Agbomi:

How we deliver that high quality care and making sure the patient experience it in the same way we intend for them and experience it is another portion that we have to learn and grow.

Brenda Logan:

We have a hospitality team that reaches out to mothers that are welcomed into the village. Yesterday, we did facials and massages to over 42 women.

Hernz Laguerre Jr.:

These collective efforts create waves of positive change in the community, and it appears to be growing. Since 2024, 2,500 hospital staff completed mama certified training on racial equity and respectful maternity care. Miller says the only way we can improve care for mothers and decrease infant mortality is by communicating with all entities.

Jill Miller:

We want to listen to the experts, listen to our nonprofit partners, listen to the people that they serve to better understand the problems such as maternal and infant health, so that we collectively can co-create solutions that lead to better health outcomes.

Ann Thompson:

Thanks for that story, Hernz. I like the idea that there's buy-in from the hospitals. Are more medical centers becoming Mama Certified?

Hernz Laguerre Jr.:

Yeah, it's all due to the efforts of Queens Village. They're doing a lot to get more birthing hospitals to go through the mama certified process. And Cradle Cincinnati shared that one of the newest facilities getting their certification is TriHealth's McCullough Hyde Memorial Hospital. The official badging will take place during their third annual mama certified hospital badging event this spring.

Ann Thompson:

Thanks, Hearns. We'll talk to you later in the takeaways.

Hernz Laguerre Jr.:

Sounds good.

Ann Thompson:

Cradle Cincinnati is now a state model called the Partner for Change Initiative. Four counties have priority because of their high-infant mortality rates. One of them is Montgomery County. Locally, it's called Roots to Rise Dayton, Nurturing Moms and Babies, and brings together hospitals, families, community care partners, and other stakeholders to drive the death rate down. Dayton Children's serves as the lead coordinator for the region. Coming up on Brick by Brick, another Dayton initiative focusing on doulas. 

Adrienne Jacobson:

It’s like a breath of fresh air in a sense to have a doula.

Ann Thompson:

And proven results for programs helping moms and babies nationwide. That's after the break.

Ame Clase:

Brick by Brick is made possible thanks to the generous support of so many, including Diane and Dave Moccia, P & G, The Camden Foundation,  The Stephen H. Wilder Foundation, TJ and Susie Ackermann, Patti and Fred Heldman, a donation in memory of Frank and Margaret Linhardt, and more. Thank you. We couldn't do this work without you.

Mark Lammers:

A brighter future for all of our neighbors starts with getting past age one. Hi, I'm Mark Lammers, executive producer for Brick by Brick, and I'm encouraged you're listening to our coverage about solutions for trends around infant mortality in our region and beyond. Like so many challenges we've looked at, this one has many factors that contribute and the response is just as multifaceted. Just like raising a child, it takes a village. Our show is the same way. It takes a village to identify the key challenges that are holding us back as well as help find the most impactful responses. What are you hearing and seeing in your own community? What are you experiencing personally? If you're willing, we'd love to hear about it. Just click on the link in the show notes for this episode to provide your thoughts or visit us online at cetconnect.org or thinktv.org, where you can find a big green button to sound off.

For now, let's dig back into this major issue with our Brick by Brick team. Thanks.

Ann Thompson:

Welcome back to Brick by Brick. Area mothers we spoke with credited doulas with helping them deliver a healthy baby. Doulas are trained professionals who support pregnant moms by offering both physical and emotional support. As Brick by Brick's Emiko Moore reports, the University of Dayton's Fit Center recognizes the importance and is offering scholarships to address Black, infant and maternal mortality in the neighborhoods impacted most.

Emiko Moore:

Adrian Jacobson, a former TV reporter who currently works at the nonprofit Pink Ribbon Good, has one toddler and is expecting another child.

Adrienne Jacobson:

I just entered my third trimester, so that's exciting. It's game time. We're at the finish line. It's a lot different this time, which is nice. It's a lot more peaceful.

Emiko Moore:

In her first pregnancy, Jacobson was working as a news anchor in North Dakota and continued to have painful symptoms.

Adrienne Jacobson:

My hands were itching. I was crying in Walmart because we just got here, but walking around my feet are burning. I cannot stand up and walk. What is going on? And I'm saying these things to my doctor and they're like, "Oh, that's normal. This is a normal part of pregnancy. Just make sure you're hydrated. Just make sure you're moisturized." But I'm like, "This is not normal."

Emiko Moore:

She even began to question her own judgment.

Adrienne Jacobson:

I mean, after being told something is normal so many times, it's just like, "Okay, well, I'm being a bother. Let me stop asking."

Emiko Moore:

But colleagues convinced her to see a specialist who immediately advised delivering within three days or risk a stillbirth. Stunned, Jacobson was frustrated at how the other doctor had dismissed her symptoms.

Adrienne Jacobson:

So I was like, "I trusted you as a healthcare provider."

Emiko Moore:

Jacobson delivered a healthy boy, now two years old, but his resolute this pregnancy be different. She hired Alaysia Ponder with Nurture Your Nature Doula Services in Dayton.

Alaysia Ponder:

So a doula is basically your support system throughout pregnancy, labor and birth, breastfeeding, and postpartum. Doctors and providers are intimidating, and I think a lot of people have blind trust in them, and there's not a safe space to ask the questions or to challenge the things that they say. And that's one of my jobs as a doula is to make sure that I'm opening a safe space for communication.

Emiko Moore:

In 2024, the doula initiative was created in Dayton to improve birth outcomes for Black women. Sharon Hawkins is the director of the program.

Sharon Hawkins:

I was hearing it from people on the ground that this was a solution, and then I did my own research for a year and a half, looking up how doulas have been effective in other cities, other areas.

Emiko Moore:

According to Hawkins, there's no shortage of doulas, just not as many willing to work in certain zip codes.

Sharon Hawkins:

It's vital in coming into our doula initiative as that women who are recruited are recruited specifically from the zip codes that have the highest rate of infant mortality, of preterm birth, and of low birth weight. And if you are grown up in an environment, you understand the stressors that are in that environment, and you have an understanding of what it's like to have disadvantages, and you can overcome those because you have overcome those.

Emiko Moore:

A stipend pays for the seven month doula program, which combines birth coaching and business training.

Sharon Hawkins:

Having a business foundation and the ability to start your business can open a whole wide range of opportunities for the women that are part of the doula initiative. That's what makes us different.

Emiko Moore:

State legislation, coupled with the state budget, made birth coaches accessible to mothers in Ohio.

Sharon Hawkins:

We were able to get this bill passed in October of 2024 for Medicaid to be able to pay for the doulas.

Emiko Moore:

The first cohort of doulas, which include Alaysia Ponder, is working to form a joint doula business called the Birthright Collective to share their varying strengths, such as nutrition and herbal knowledge. They recently met with a lawyer to discuss moving it forward.

Alaysia Ponder:

Luckily with the Birthright Doula Collective, we have a team of doulas. So if there was at any point that I needed to tap out, I could always tag somebody in. And in that case, you would know who that would be ahead of time, a backup doula, of course.

Adrienne Jacobson:

It's like a breath of fresh air in a sense to have a doula. My husband is really very helpful. Not put him to work, but put him to work in the way you're ready. Absolutely.

Alaysia Ponder:

As much as you work, he got to break a sweat too. He

Adrienne Jacobson:

Can help with some exercises on the ball and do some massages. So I'm excited to see how you help incorporate him into the labor process. And I just feel like it's just going to be a much more calming and peaceful experience.

Absolutely. I'm excited.

Ann Thompson:

Thanks, Amico. It seems like a program that could make a difference. How are the women picked for the doula program?

Emiko Moore:

Well, these women who are chosen for this initiative are ones from the zip codes in the area that have the highest rates of infant mortality. They better understand the life experiences of these mothers, their stressors, and how they try to communicate their own birth plans. These women receive scholarship or stipends to pay for the training, so it's not a cost to these trainees. And in Ohio, Medicaid now pays for doulas who have the specific certification that this initiative offers.

Ann Thompson:

Sounds interesting. Talk to you in the takeaways.

Emiko Moore:

Sounds good.

Ann Thompson:

Brick by Brick will be following the success of this program and the difference it's making in the community. Because infant mortality is such a big problem in the US, there are other programs designed to decrease the numbers. One of them is Family Connects in Durham, North Carolina. It started in 2008 and has been tried in communities across 20 states. NPR reports in New Orleans, it's run by the city health department. Moms get three visits where nurses weigh, measure, and examine the babies and check in on the mother's health and wellbeing. In 2025, Louisiana lawmakers passed a law requiring private insurance plans to cover the visits. NPR reports two years in Tulane University research shows families who got the visits were more likely to stick with the recommended schedule of pediatric and postpartum checkups. Moms and babies were also less likely to need hospitalization. And overall, healthcare spending was down among families covered by Medicaid.

Research in North Carolina where Family Connects started showed it reduced ER visits by 50% before the baby turned one. And for every $1 invested in the program, it saved $3.17 in healthcare billing before the child turned two. In a number of ways, the effort is similar to the Cradle Cincinnati approach, improving responsiveness of the healthcare system to the actual needs of birthing parents, but also through those covered checkups, reinforcing the need for proactive prenatal and postpartum care and working to remove barriers to it. Epidemiologist Sarah Huber summed it up best by saying, "The reason lowering the infant mortality rate is so hard is because there are multiple factors that go into it. " It's hard to identify just one thing that we can work on specifically and it can happen to anybody. So just prioritizing the fact that these are babies in our communities and they impact families and we just want everyone to have proper education like the right resources to provide their infants with safe sleep.

We want to hear from you as Brick by Brick develops more episodes. Go to our website, cetconnect.org and thinktv.org, where you'll find a big green button to give feedback. That's where you'll also see related articles, a link to the podcast that Hernz and Emiko's video stories, as well as online extras. Hernz and Emiko are here right now for the takeaways.

Hernz Laguerre Jr.:

Hey, everyone.

Emiko Moore:

Hello

Ann Thompson:

So some disturbing information, some of which seems fixable.

Hernz Laguerre Jr.:

Yeah. One of the things that are fixable is sudden infant death syndrome. We attended an event, an online event from Creative Cincinnati before we even started recording this episode where there was conversation of people understanding why folks find themselves using unsafe sleep practices, whether it's being a first time parent, being sleepy, the baby's not sleeping. Plus on top of that, you have multiple families who upon generations upon generations who get away with it, for lack of better words. Even my father, he always tells stories about how I would not go to sleep unless he was laying down and I was laying on his chest. So because you have a lot of people who were fortunate like me and who "got away with it, " I think that's why you have people who try to implore the same practices and unfortunately aren't as fortunate. Critic Cincinnati stressed that they were going to use visual storytelling in order to emphasize the need for safe sleep.

Emiko Moore:

And it's really important to have a good support system that really understands safe practices like doulas do. The director of The Doula Initiative, Sharon Hawkins, she's also a registered nurse and she shed some light on the impact of stress levels for those in lower income areas on a pregnancy. She said, "If you think about it, like if you're working full-time, you've got children that need to be picked up, groceries, meals to be prepared, your car or transportation is an issue, your bills are piling up, you're on constant stress levels." And she used an example of someone trying to get across the street where cars are constantly coming and you want to avoid being hit, but the car's never slow down and there's not a stoplight, so you're constantly on hypervigilance. And she said, "That can harm an infant in the long run." We have this stress hormone cortisol that can spike during these times and it can actually slow down the birth of a child.

She said it also increases the glucose, which increases your chances of having preterm diabetes or an infant born with a compromised immune system. So I think having a good support system like a doula can help alleviate some of those stressors.

Ann Thompson:

And what's somewhat discouraging is the infant mortality numbers for Hamilton County for African Americans are back up to where they were before this effort started. And Cradle Cincinnati founders are continuing to drill down on things that could help, like a pilot program called Queens Village Corner. It connects women receiving prenatal care with resources in real time that it can address social determinants of health and optimize the trust and support between the patient and the provider. This is about clinic workflows. Here's how it works. It relies on a liaison who's not only in the waiting room to provide support and resources, but goes back with that mom when she's seen the providers so two people, that liaison can work with the provider with any concerns that come up.

Hernz Laguerre Jr.:

Yeah, shoot. And I think it'll be helpful just to having an extra set of hands to help families make it through this pregnancy journey safely.

Ann Thompson:

We're going to be following this effort and others to see if it makes a difference in the infant mortality numbers. Thanks for your thoughts, guys.

Hernz Laguerre Jr.:

No problem. 

Emiko Moore:

Thank you.

Ann Thompson:

Coming up on the next episode of Brick by Brick, a nonprofit Dayton developer continues to add affordable housing.

Adam Blake:

We knew that some of these apartment complexes that were destroyed were not going to be rebuilt. So it was important to create home ownership opportunities for some of those renters.

Ann Thompson:

How CountyCorp is creating generational wealth and spurring economic development in Montgomery County. That's next time on Brick by Brick. 

That's our show. If you like what you hear, please rate and review our podcast. It makes it easier to find. We hope you learned something, and if you did, please tell your friends and family about it. For Hernz Laguerre Jr. and Emiko Moore, I'm Ann Thompson. We'll be back soon with more solutions. Take care. 

Our show is produced, hosted an edited by me, Ann Thompson with reporting and story editing from Hernz Laguerre Jr. and Emiko Moore. Our Executive producer of Mark Lammers. Audio sweetening provided by Mike Schwartz. Zach Kramer runs the lights and cameras. Derrick Smith is our production specialist and Jason Garrison is our production manager. Kellie May heads up our marketing and promotions, along with Mike Shea and Bridgett Dillenburger. Elyssa Stefenson handles the website and Josh Lusby and Steve Wright are our designers. Bill Dean and Andres Kruza are the engineers for the show and our Chief Content Officer is Colin Scianamblo. Our music is from Universal Production Music. Brick by Brick: Solutions for a Thriving Community is a production of CET and ThinkTV, Southwest Ohio PBS member stations.