A city's grief: Memphis' infant death epidemic

Tiny, precious graves
A pickup truck and a backhoe show up on the days, usually Tuesdays and Thursdays with good weather, when babies are buried at the county cemetery. The first carries the little wooden coffins, and the second digs the whole, maybe three feet wide, where they are placed a foot apart.

The caretaker is an ordained minister named Robert Savage who has done the job for three decades, and some days before or after driving in the takes to mark the numbered plates above the coffins, he will offer humble comfort to families who show up there. The mothers are often missing, still in the hospital.

In 2005, the local newspaper here, The Commercial Appeal, published an award-winning series called Born to Die that all but forced the people of Memphis and Shelby County and their leaders to confront the ghastly infant mortality figures.

It told the heartbreaking story of a 19-year-old mother named Fredesha Bradley who gave birth to twins; one who died of seizures in intensive care and one who survived and slept face-down in a bed, with a baseball bat nearby for safety.

Nine babies in the family’s last three generations had failed to turn 1.

The newspaper series landed on this town like a lead safe.

“Folks had no idea it was this bad,” says Yvonne Madlock, who heads the city and county health department.

Within a year, the state of Tennessee — ranked 48th in the nation for infant mortality — had launched a program called 1 For All that took aim at all sides of the problem, encouraging healthier pregnancies and preaching how to care for children.

Still, Madlock acknowledges, the obstacles can seem daunting.

Maybe a young mother-to-be can’t get sick leave to see her doctor. Time off is money lost for rent. Maybe she’s in denial, and doesn’t even have the pregnancy confirmed until the baby has already been harmed. Maybe she is ashamed to visit a clinic. Maybe she has no insurance.

“I’m not crazy. I’m not Pollyanna,” Madlock says. “Change isn’t immediate. Certain things just take sustained effort.”

Making changes
While devoted health officials here have been working quietly on the problem for years, only in the past two years did Memphis and Shelby County launch a broad, coordinated attack.

The governor’s office committed more than $3 million in grants to boost grass-roots programs that try to keep women of childbearing age healthy and to pay for better equipment and add workers at city health clinics.

At the moment, health leaders in Memphis are placing their faith in a relatively new idea called “centering pregnancy,” which gathers about a dozen women with similar due dates and coaches them through their pregnancies. They take their own measurement at each meeting, call each other with questions.

The idea: Solve the medical problem by getting vital prenatal care to women who otherwise might not have it, and chip away at the social problem by building a community who women who trust and rely on each other, and perhaps as well at some of the shame and inaccurate information that may have been passed down in families.

Two studies in the journal Obstetrics & Gynecology, including one that came out this August, have found the models led women to be better prepared to handle their pregnancies. One of the two studies also found the model led to higher birth weight, especially for premature babies.

The county has the program up and running at one of its clinics, with plans for two more soon. And Christ Community, where Taylor works, is expecting a state grant soon to start one of its own.

Taylor, who wears earrings depicting babies in the womb — head down, the optimal way, she points out when a guest inquires about them — can barely contain her excitement.

“They are acknowledged. They are heard,” she says. “They interact with each other. It produces a community support for each other. You’re actually growing a community and teaching women to take care of themselves.”

'A man possessed'
Sheldon Korones grew up on the Lower East Side of Manhattan, and his grandfather, a Russian Jewish immigrant, was a wainwright, a powerful man who fixed wagons.

The grandfather observed the Sabbath on Saturday, and closed his shop then and worked instead on Sunday, in violation of city blue laws. One Sunday he was working on a wagon, chained to an anvil to keep it in place, when the cops showed up and ordered him to stop.

The police picked up a sledgehammer and went for the chain. The man puts his fists there and said, “You break the hands first.”

That is, at 83, how Korones sees his work. You would have to break his hands to stop him from trying to save the babies who keep turning up at the intensive care unit he started 40 years ago.

And yet it is difficult to spend much time talking with him and come away feeling anything but despair for the babies in this city where babies die at such an alarming rate.

“We have treated 48,000 babies here,” he says. “Infant mortality is still a problem, and the reason for that, my friend, is we are after the fact. We’re a Band-Aid. As soon as a premature baby is born, society has failed.”

But the statistics: When the intensive care unit was started, about a quarter of the babies who arrived there died. Last year, the unit admitted 1,200 and lost just 35, about 2 percent. Twenty of the 35 weighed less than 2 pounds.

“I’ve watched this problem since the days of LBJ,” he says. “I’ve gone to meeting after meeting and we’re saying the same damn thing we said back there. I started as a man possessed. And I remain a man possessed.”

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