Fetal and Infant Mortality Review

Under the Boston Healthy Start Initiative, the Boston Public Health Commission (BPHC) established a Community Action Network (CAN). The 200-member CAN aims to end racial and ethnic disparities in infant mortality and adverse birth outcomes by mobilizing a community of caregivers, providers, and other stakeholders concerned about infant health equity. 

Driven by the advocacy efforts of a mother who lost her daughter a week before her due date, the CAN identified Fetal Infant Mortality Reviews (FIMR) as one of its two priority areas and utilized a three-pronged strategy to build, gain, and leverage momentum to address existing health inequities. First, it informed community members about birth inequities in Boston and the FIMR process. Second, it educated community members on advocacy through CAN meetings and presentations by BPHC’s Director of Intergovernmental Relations, focusing on the legislative process. Third, it engaged in outreach to elected officials and participated in hearings by sending letters, making phone calls, drafting a bill, identifying an elected official to sponsor it, and testifying at hearings in support of the legislation. Each prong built on the previous one, creating momentum that secured approval and funding from the City of Boston to establish a FIMR and contributed to the passage of H.4999, An Act Promoting Access to Midwifery Care and Out-of-Hospital Birth Options. The bill directs the Massachusetts Department of Public Health (MDPH) to establish a FIMR to review each fetal or infant death and grants MDPH the authority to collect relevant information from hospital records, local boards of health, and community organizations.