Jordan Allred, Deseret News
Researchers at the University of Utah are hoping to increase the health of babies born to the state's African refugee population by offering proper prenatal care and instruction.

SALT LAKE CITY — When adjusted for population, Utah has the highest birth rate in the nation, with 17.6 new babies per 1,000 people annually, according to United States Census data.

But not all of those babies come easily, or as healthily as possible.

Utah is also home to the nation's tenth-fastest growing refugee resettlement sites, putting a lot of African women out of touch with their own families and traditional cultural methods of pregnancy and the delivery of their babies.

"These are people for whom preventive care is a new idea," said Jane Dyer, a certified nurse-midwife, assistant professor at the University of Utah's College of Nursing and a lead researcher in a three-year pilot study that intends to provide disparate communities with trained perinatal health workers who are familiar with the various cultures — starting with African refugees.

The study, made possible by the Belle S. Spafford Endowed Chair will enroll 25 Somali and 15 South Sudanese refugee women, who are statistically more likely to experience problems with pregnancy and delivery, according to Utah birth certificate data housed at the state's Department of Health.

Dyer said that for the African population living in Utah, available health care is also an unfamiliar idea and the U.S. health care system can be harder to navigate. She said the women tend to enter care later in their pregnancies and bring with them a host of existing health conditions, including anemia, that can lead to other problems in pregnancy.

Family planning and spacing children at healthy intervals for the mother is also relatively uncommon for the population of refugee women, who tend to have large families.

The language barrier and aspects of isolation also impact when and how women of all cultures get prenatal care.

U. researchers plan to train someone who speaks the language and can visit these women in more comfortable and relaxed circumstances than a doctor's office, to address concerns and explain why certain, albeit unfamiliar practices and procedures should take place throughout pregnancy.

"These are women who, culturally and linguistically, have challenges that need to be addressed," Dyer said. Routine office visits are often not enough.

Some pregnancy-related issues unique to the refugee population experiences include high blood pressure or seizures, over- or under-weight babies and sometimes heavy bleeding, according to the data. In addition to anemia, lung disease and renal disease — which are common among African populations — also contribute to problems with delivery, including fetal distress and even death.

The group of researchers, which includes prominent social workers and an obstetrician/gynecologist with connections in the refugee community, as well as others, hopes to provide a training model that can be replicated for other populations that may be isolated or otherwise in need of better care. Community health worker programs are also reimbursable under the Affordable Care Act, making it more sustainable once the "bugs are worked out," Dyer said.

"We expect this to result in healthier mothers and babies, and a replicable model for a program that can help other groups of women," she said.

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