A Georgia couple is suing an Atlanta-area hospital for the alleged decapitation of their baby during delivery.
While infant mortality in the U.S. is declining, deaths among infants born to Black and Indigenous families are disproportionately high.
Industry professionals weigh in on possible solutions to eliminate health disparities and improve infant health outcomes.

A recent incident involving an alleged decapitation of a baby has sparked a conversation about the infant mortality rates in the U.S. Although rates have decreased over the last several decades, infants born to both Black and American Indian/Alaska Native mothers are dying at disproportionate rates.

Explore the details of the case and hear from two perinatal nurse clinicians on possible solutions to improve infant health outcomes.

Georgia Mother Sues Hospital After Baby Decapitation During Delivery

Jessica Ross and her boyfriend, Treveon Isaish Taylor Sr., are suing Southern Regional Medical Center in Riverdale and obstetrician Dr. Tracey St. Julian — a physician not employed by the hospital — after alleging that excessive force was used to deliver their baby, according to a report by NBC News.

According to the lawsuit, shoulder dystocia was present — a condition in which a baby’s shoulders are stuck behind the mother’s pubic bone — and the baby did not properly descend, possibly due to this reason.

St. Julian used various methods to try to deliver the baby vaginally including traction, per the lawsuit. Ross pushed for three hours until a cesarean section was performed, resulting in the delivery of the baby’s decapitated body.

The couple alleged that the hospital tried to cover up the manner of death. They demanded to hold their baby but were told by hospital staff that they could only view him, according to a report by CNN.

“During this viewing, their baby was wrapped tightly in a blanket with his head propped on top of his body in a manner such that those viewing him could not identify that he had been decapitated,” said a family spokesperson in a statement.

According to the suit, they were also discouraged from getting an autopsy. In a statement, the hospital denied “the allegations of wrongdoing,” and is “cooperating with all investigations.”

Georgia is one of many U.S. states with an infant death rate greater than that of the national average.

Infant Mortality Rates in Georgia and Around the United States

Ross’ case sheds some light on U.S. infant mortality rates (IMR) — the number of infants per 1,000 live births who die before their first birthday. According to the latest statistics from the CDC, Georgia had an IMR of 6.28 in 2020 — the equivalent of 769 total infant deaths for the year. While rates in the state have declined in recent years, infant deaths continue to be a problem nationwide.

In 2020, 20,000 infants died in the U.S. — an IMR of 5.4. That same year, over half of all U.S. states had an IMR higher than the national average. Mississippi, Louisiana, Arkansas, and South Dakota were at the top of the list.

Infant Mortality Rates by State

State
Rates by Year (deaths per 1,000 live births)

2020
2019
2018

Alaska
5.1
5
6.3

Alabama
7
7.7
6.9

Arkansas
7.4
7
7.5

Arizona
5.2
5.4
5.7

California
3.9
4.2
4.2

Colorado
4.8
4.9
4.8

Connecticut
4.3
4.4
4.2

Delaware
5.1
6.4
5.9

Florida
5.8
6.1
6

Georgia
6.3
7
7.1

Hawaii
4.9
5.1
6.8

Iowa
4.4
5
5

Idaho
5.1
4.3
5.1

Illinois
5.5
5.7
6.6

Indiana
6.8
6.5
6.7

Kansas
6.6
5.4
6.4

Kentucky
6.4
5
6.1

Lousianna
7.6
8
7.7

Massachusetts
3.9
3.7
4.2

Maryland
5.7
5.8
6

Maine
6.3
5.4
5.5

Michigan
6.8
6.4
6.2

Minnesota
4.1
4.5
5.1

Missouri
5.9
6.1
6.4

Mississippi
8.1
8.7
8.4

Montana
5
4.8
4.8

North Carolina
6.8
6.8
6.8

North Dakota
5.5
7.5
5.6

Nebraska
5.7
4.9
5.8

New Hampshire
4.4
3.2
3.5

New Jersey
4
4.2
3.8

New Mexico
5.3
5.7
5.7

Nevada
4.6
5.7
6.1

New York
4.1
4.3
4.3

Ohio
6.7
6.9
6.9

Oklahoma
6
7
7.1

Oregon
4.2
4.9
4.2

Pennsylvania
5.6
5.9
5.9

Rhode Island
4
5.9
5

South Carolina
6.6
6.9
7.1

South Dakota
7.3
7
5.9

Tennessee
6.4
7
6.9

Texas
5.3
5.5
5.5

Utah
5.4
5.3
5.5

Virginia
5.8
5.8
5.6

Vermont
–*
–*
6.4

Washington
4.5
4.3
4.7

Wisconsin
6
5.9
6.1

West Virginia
7.3
6.1
7

Wyoming
5.2
7.2
5.3

Source: CDC

*Rate does not meet National Center for Health Statistics standards of reliability; based on fewer than 20 deaths in the numerator. The actual number of infant deaths in Vermont totaled 18 in 2020 and 15 in 2019.

Infant Mortality in BIPOC Populations

Although IMRs in the U.S. are on the decline overall, deaths remain highest among Black, Indigenous, and people of color (BIPOC).

According to CDC data, infants born to Black mothers died at a rate of 10.1 per 1,000 live births compared to 4.5 among those born to white mothers — almost double the rate. The mortality rate of infants born to American Indian/Alaska Native mothers was 7.9 that year.

While statistics show an improvement in IMRs from 2018 to 2019 across all ethnic and racial groups, death rates among infants born to BIPOC mothers are still highest.

The Leading Causes of Infant Mortality in the United States, by Race

In the Georgia incident, a cause of death for Ross’ baby has not been released yet. Although the case may be considered a fetal demise or stillbirth rather than an infant death, there remains a need to address the causes of most infant deaths in the U.S.

The top three leading causes of infant mortality in 2020 were congenital malformations (birth defects) (21%), disorders related to short gestation or low birth weight (16%), and sudden infant death syndrome (7%). Infants born to both Black and American Indian/Native Alaskan mothers die at much higher rates from low birth weight and birth defects in particular.

Infant deaths and mortality rates for the top 5 leading causes of death for African Americans, 2020

Rank
Cause of Death
Non-Hispanic Black Death Rate

1
Low birthweight
214.4

2
Congenital malformations
133.1

3
Sudden infant death syndrome (SIDS)
89.1

4
Accidents (unintentional injuries)
70.8

5
Maternal complications
63.6

Rates per 100,000 live births
Source: CDC

Infant deaths and mortality rates for the top 5 leading causes of death for American Indians/Alaska Natives, 2020

Rank
Cause of Death
American Indian/Alaska Native Death Rate

1
Congenital malformations
152.9

2
Low birthweight
97.0

3
Accidents (unintentional injuries)
85.8

4
Sudden infant death syndrome (SIDS)
82.0

5
Maternal complications
–*

Rates per 100,000 live births
Source: CDC

*Rate does not meet National Center for Health Statistics standards of reliability; based on fewer than 20 deaths in the numerator.

The CDC defines low birth weight in infants as weighing less than 5 lbs. 8 oz. Low birth weight is a worldwide problem. Globally, more than 80% of newborns who die every year have a low birth weight, reports the World Health Organization (WHO). While birth defects may be a non-modifiable risk factor for infant mortality, low birth weight may be partially preventable.

According to the WHO, low birth weight is associated with poor maternal nutrition, hypertensive pregnancy disease (or preeclampsia), and inadequate maternal care.

Health disparities play a role in infant mortality as factors like access to quality care, affordability of healthcare, healthy food availability, and environmental safety can significantly impact infant health.

Healthcare Professionals Weigh In on Possible Solutions

The solution to eliminating health disparities and improving the overall health of all infants requires a collaborative effort from nursing leaders, legislators, and communities. Two perinatal nurse clinicians discuss ways to bring about change in the workplace and community.

Changes in the Workplace

Lacey Miller, DNP, CNS, APRN, RNC-OB, C-EFM, is a perinatal clinical nurse specialist and legislative coordinator for the Washington State Section of the Association of Women’s Health. She references a 2020 study that suggests Black newborns are significantly less likely to die when cared for by Black physicians.

“We must find ways to eliminate infant mortality for all babies,” says Miller. “To do so, we need to eliminate systemic racist influences on the health of Black birthing people and infants, and on the ability to diversify the healthcare workforce.”

Megan Ludeña, MN, RNC-OB, NPD-BC, nursing expert in perinatal care, nursing workforce diversity, and nursing professional development, also believes that an ethnically and racially diverse workforce is necessary to improve patient outcomes.

“There are numerous studies that show better outcomes from a diverse healthcare workforce,” she says. “[We must] acknowledge that our healthcare system is not set up equitably and work to dismantle that.”

Ludeña, who is also an expert in healthcare equity and workplace policy development, takes it a step further and recommends changing the workplace culture.

“[We must] comb through our practices, policies, and workflows with an anti-racist lens, and then modify those things,” she says. “What language do we use in our policies? How do we speak about our patients in the report room/break room? What do we share about our patients that is irrelevant to the context of their care?”

Changes in the Community

While workplace changes may be necessary, leaders working together with the community may be the final piece to the puzzle. Miller, who has worked in both the U.S. and Uganda, believes that community engagement is vital.

“I truly believe that engaging and funding the communities most affected will expose and solve the issues surrounding healthcare disparities, and that these solutions will help everyone,” she says. “Our society must invite, listen to, and give power to the communities who are most affected.”

Miller further addresses the necessity of change within communities.

“Optimal health of a birthing person begins with optimal health of the birthing people from generations before them,” she says. “We will continue to see benefits for generations to come if we invest in the health of our people today.”

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Page last reviewed on September 26, 2023

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