The Alabama Department of Public Health (ADPH) announces that the infant
mortality rate of 7.8 deaths per 1,000 live births in 2023 increased
over the 2022 rate in Alabama. This represents the deaths of 449 infants
of the 57,835 live births in 2023 who did not reach 1 year of age.
Alabama’s infant mortality rate remains higher than the United States
provisional rate of 5.6.
Among racial groups, the infant mortality rate for white infants rose to
5.7 (229 infant deaths) from 4.3 in 2022, and the infant mortality rate
for Black infants increased to 13.0 (204 infant deaths) from 12.4 in
2022. Alabama recorded its lowest overall infant mortality rate ever,
6.7, in 2022.
The three leading causes of infant deaths in 2023 were:
·        Congenital malformations, deformations and abnormalities
(20.7%)
·        Disorders related to short gestation and low birth weight, not
elsewhere classified (14.3%)
·        Sudden infant death syndrome (6.5%)

State Health Officer Dr. Scott Harris said, “Many factors contribute
to infant mortality, including race, poverty, educational levels, and
access. It is discouraging that racial disparities remain in birth
outcomes, and the Black infant mortality rate is twice the rate for
white infants. A possible reason is limited access to prenatal care and
the proximity of hospitals to where these mothers live. Challenges to
improve the health of all mothers and babies continue. There is no easy
solution; we must follow evidence-based practices to save lives.”
Selected pregnancy and birth statistics include the following:
·        The three-year infant mortality rate for the years 2021-2023,
7.4, equaled the three-year rate for the years 2019-2021. The 2023 rate
of 7.8 is the highest single-year rate since 2016 when the infant
mortality rate was 9.1.
·        Medicaid was the method of payment for 45 percent of all
births in 2023; 52 percent of infant deaths were to mothers whose
deliveries were paid by Medicaid. Private insurance paid for 50 percent
of all births, and 39 percent of infant deaths were to mothers with
deliveries paid by private insurance.
·        The percent of births with no prenatal care (2.6) in 2023 was
tied with the year 2020 as the highest in the past decade.
·        The percent of births with maternal smoking has steadily
declined and fell to its lowest level in a decade, 3.9 percent. However,
according to the Alabama Pregnancy Risk Assessment and Monitoring System
(PRAMS) survey, in 2022, 16.1 percent of mothers reported using
e-cigarettes or other electronic nicotine products in the past two
years; 52.7 percent of those mothers used them more than once a day
during the three months before they became pregnant.
·        The number of births to teenagers has been decreasing and fell
to the lowest number ever (3,467). The percent of births to teenagers
remained at a historic low of 6.0 for the second year.

ADPH programs focus on the reduction of infant deaths, including the
following initiatives:
·        In response to a lack of access to prenatal care in rural
counties, ADPH is partnering with medical providers to provide prenatal
care to low-risk women in up to nine county health departments through
in-person or telehealth visits, up to 36 weeks of pregnancy.
·        To help prevent sleep-related infant deaths, the Cribs for
Kids program provides cribs for families without a safe place for their
babies to sleep. In the past three years, the program has provided 2,500
cribs at no charge to the families.
·        The Clear the Crib Challenge was implemented in 2023 to reduce
the risk of sudden infant deaths and suffocation. This promotion
challenges participants to clear a crib of all items except a firm
mattress, fitted sheet, and the baby. This social media promotion
encourages sharing the ABCs of safe sleep–alone, back, crib.
·        The Well Woman Program promotes healthy living, prevention,
and early detection of disease for women ages 15 to 55, resulting in
healthier pregnancies. The program will expand from nine counties in the
past fiscal year to 12 counties in fiscal year 2025, providing
preconception, interconception, and postconception care.
·        ALL Babies has expanded to statewide coverage for pregnant
women without other insurance who fall within the income guidelines of
the program.
·        Nurses from the Fetal Infant Mortality Review Program, based
in five major delivering hospitals, review most fetal and all infant
deaths. Case summaries are presented to a regional multi-disciplinary
committee to determine the cause of death and ways to prevent future
deaths.

Additional programs include the Count the Kicks phone application to
count fetal kicks, increased education on the impact of sexually
transmitted diseases on pregnancies and newborns, promotion of car seat
safety, and WIC participation to improve nutrition for infants and young
children. WIC serves women who are pregnant, recently had a baby, or are
breastfeeding; infants; and children up to 5 years of age.
Graphs and detailed charts are available at the ADPH website at