Map: Wyoming Department of Health. Photo: Lindsay D’Addato
Wyoming’s infant mortality rate is 6.89 deaths per 1,000 live births, very close to the national average over the same period. Infant mortality rates were highest in Carbon and Fremont Counties and lowest in Hot Springs, Johnson and Weston Counties.

Northern Arapahos May Give Expectant Mothers ‘Baby Boxes’

Ron Feemster, WyoFile
12/10/13

The Northern Arapaho Women Infants and Children program hopes to welcome new children into the tribe with maternity boxes, a gift idea for expectant mothers it borrowed from the government of Finland.

Vonda Wells, the tribe’s WIC director, says she got the idea from a BBC article about the boxes, which she passed out to her staff. Every Finnish woman can apply to receive a maternity box upon providing proof to the government that she is about five months pregnant and receiving prenatal medical care.

“It’s a way of welcoming babies to the tribe,” said Wells. “Welcoming newcomers. When we have a young woman who is about to have a baby, it’s a gift.”

The Finnish maternity box, also called a baby box, is a sturdy cardboard crate filled with baby clothes, nursing supplies, diapers, towels, blankets, a bib, even a picture book and a toy. At the bottom of the box is a mattress. Almost every Finnish child begins life sleeping on the mattress in the bottom of the box. The box is the child’s first crib.

“Every mother gets this box,” said Marita Kritsos, 52, an administrative officer in the Finnish Consulate in Los Angeles. “I got a box. My mother got it, my grandmother got it.” Kritsos, who has daughters aged 20 and 22, says she expects her daughters to receive maternity boxes as well, although she hopes they wait a few years.

Vonda Wells, director of Northern Arapaho Women Infants and Children, pitched the baby box program to the business council. (Ron Feemster)In Finland, the government program is not considered welfare, in the sense that Americans might think of it, but a part of the relationship between the state and its citizens. The government gives the box to all women, regardless of income or social status.

Between 59,000 and 60,000 children were born in Finland in each of the past five years, according to a Finnish government website. Although mothers have the option to receive a grant of 140 Euros (about $190) instead of the box, almost all mothers take the box — and not just because the goods are worth more than the money.

“You get the feeling that someone is looking out for you,” said Kritsos. “It’s a secure feeling. And it’s a bit of reality. You realize when you get the box that you are really going to have a baby.”

Among the baby box’s benefits to the government — and to the tribe if it implements the program — is steering expectant mothers toward prenatal care. “You need to provide proof of a health exam,” said Kritsos.

The opportunity to educate mothers about their own health and that of their children is one of the benefits Wells sees.

“The young girls need guidance,” said Wells. “They used to get guidance from aunts and uncles.” Now, she says, that guidance sometimes comes from outside the family, in school or early Head Start. But she would like to see the tribe take a larger role in developing and maintaining family bonds.

Wells pitched her idea to the Northern Arapaho Business Council, but the tribal leaders have yet to respond. They did not return calls about the new program.

“The roles of family life have blurred,” Wells said, noting that infants had baby boards in the days before the tribe settled on the reservation. “Our people struggle with alcoholism and drugs. And contact with the West. The roles have been negated. You can’t care for a child if you are on drugs or involved with alcohol. But we still have people stepping in to take care of their children.”

Families on the Wind River reservation have battled poverty for generations. Next to lack of access to medical care, poverty is a main driver of infant mortality.

“From 2001-2011, the infant mortality rate among infants born to Native American women in Wyoming was 14.7 per 1,000 live births,” said Ashley Busacker, senior epidemiology advisor for maternal and child health at the Wyoming Health Department. “An infant death is considered a death in the first year of life. “The infant mortality rate among infants born to Wyoming white women was 6.45 per 1,000 live births.”

A six-month old child sits in a Finnish maternity box. Some of the clothes were not included in the government package. (Courtesy Heta Melantie)The Native infant mortality rate in Wyoming over the last decade is about the same as the estimated 2013 rate for Syria, a country torn by civil war, according to infant mortality statistics published each year by the Central Intelligence Agency. Using figures from the Centers for Disease Control, the CIA estimates the U.S. rate this year to be 5.9 infant deaths per 1,000 live births. In Finland, just 3.4 infants die for every thousand who live.

One easily preventable form of childhood death is the asphyxiation of infants who are “co-sleeping” with a parent who rolls over on the child in bed. Although exact statistics are tough to come by, the Associated Press reported 10 such deaths in Fremont County between 1999 and 2010 and another in 2012.

The box would be a good solution, said Wells. WIC already gives out cribs to women who need them. Wells estimates that she had given away 15 cribs in the past two or three months. She said that not every family has a separate space and a separate bed for a new child.

WIC staffers do home visits to all clients as part of the regular program. They also educate parents in how to set up and use the crib.

“We have a little mini-training on safe sleep,” Wells said. “It’s short. We just help them understand that the baby needs its own place to sleep. We talk about the right position for the baby. And no co-sleeping.”

The Wyoming Department of Health and the Fremont County Public Health Department also have outreach programs to help young families learn to care for their newborns.

“From what I’ve been told about the baby boxes, it seems that they would be a way to provide a safe sleep environment,” said Busacker. “And we know safe sleep environments help reduce the risk of infant mortality.”

Each crib, which is purchased in part by the Fremont Community Public Health Department, can be expanded into a playpen as the child gets older. The one drawback: the cribs are expensive.

“The box is cheap,” said Wells. “We could give it to every mother. We support the premise that your child is a gift and the future of our tribe as the Arapaho people. What the tribe is saying is that your baby is important for the future.”

This story was originally published here by WyoFile.com. WyoFile is a nonprofit news service focused on Wyoming people, places and policy.

Ron Feemster covers the Wind River Indian Reservation for WyoFile in addition to his duties as a general reporter. Feemster was a Visiting Professor of Journalism at the Indian Institute of Journalism & New Media in Bangalore, India, and previously taught journalism at Northwest College in Powell. He has reported for The New York Times, Associated Press, Newsday, NPR and others. Contact Ron at ron@wyofile.com.

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