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State of Alabama Infant Mortality Reduction Plan

Infant mortality continues to be a public health challenge, throughout the nation and in the state. It is a key indicator of the overall health of a society. Additionally, it gives insight into health equity, healthcare quality, and other pertinent factors that influence public health. This tragic health outcome is shaped by many elements within a community, including economic, social, and political factors. As such, this issue underscores the need for a multifaceted approach.

Tackling Infant Mortality

ADPH is taking strides to decrease infant mortality throughout the state. In 2018, the State of Alabama Infant Mortality Reduction Plan was adopted, and funding was provided for pilot projects in three counties – Macon, Montgomery, and Russell. Agencies involved in the initiative include:

Through collaborations, active engagement, and evidence-based interventions, it is our hope to see a 20% reduction in infant mortality in the pilot counties by the end of this initiative in 2023.

Seven Funded Strategies of the Infant Mortality Reduction Plan


Alpha hydroxyprogesterone caproate (a.k.a., 17P) is a hormone treatment that may be prescribed to women who have experienced a spontaneous previous preterm birth as a means to reduce their risk of having another preterm birth. This strategy focused on 17P education to providers and patients. However, nationwide, there have been challenges in access to 17P and in promoting its use. In October 2020, the Federal Food and Drug Administration made a recommendation to remove 17P from the market. This strategy was discontinued.

After consulting research from academic and policy sources, and exploring several possible strategies, Group Prenatal Care has been selected as the new prematurity strategy. Group Prenatal Care has been described as routine prenatal appointments combined with childbirth education classes and a pregnancy support group. A strong team of cross-sector stakeholders was gathered to form a strategy work group.


Scientific evidence well documents the benefits for mom, baby, and the environment if breastfeeding is initiated and then continued through at least the first six months of life. Hospitals, providers, and women of childbearing age will continue to be educated and supported on breastfeeding activities through this initiative.

Home Visitation

This strategy includes the expansion of home visitation programs, such as the Nurse-Family Partnership and Parents as Teachers. These programs provide support, parenting education, resource referrals, and school readiness for high-risk families who qualify.

Perinatal Regionalization

Through this plan, systems of perinatal care will be promoted and improved. These systems target designs for women to deliver infants at hospitals with appropriate resources to meet the medical needs of the mother and the infant.

Pre/Inter-conception Health (a.k.a., Well Woman)

This strategy focuses on care for women of childbearing age who are seen in the participating county health departments. The program aims to address chronic health conditions before or prior to a woman becoming pregnant as a means to improve birth outcomes.

Safe Sleep Education

Team members conduct safe sleep education and outreach so that anyone providing care to an infant under the age of one places infants in a safe sleep environment at each sleep time.

Screening, Brief Intervention, Referral to Treatment (SBIRT)

This tool will aid in identifying and providing referrals to women who may be experiencing substance abuse, domestic violence, and/or depression.


Relevant resources will be provided periodically to keep you informed of data and strategic efforts in place for infant mortality and reduction in Alabama.

Page last updated: June 28, 2023