Becoming National Leaders

The South Carolina Birth Outcomes Initiative has become an example for the rest of the country on how to reduce newborn infant mortality

In a recent study by the Centers for Disease Control and Prevention that’s been getting some national coverage, South Carolina is one of the states leading the way in reducing infant mortality rates in the United States. Some reports, like this one from CNN, even call out the state’s deliberate collective effort through the South Carolina Birth Outcomes Initiative (SCBOI), as key to that success.

In the past decade—and largely thanks to the SCBOI’s collective efforts—South Carolina has seen a more than 20% drop in its infant mortality rate (IMR). There have been a host of related initiatives aimed at reducing this top-line metric, from all 44 birthing hospitals making a commitment to stop non-medically necessary early elective deliveries (EEDs) to making sure more hospitals are Baby Friendly certified. Because of the nature of the initiative, other organizations have supported these efforts. For instance, SC Medicaid and BlueCross BlueShield of South Carolina stopped reimbursing non-medically necessary EEDs between 37 and 38 weeks as a way of reducing those more risk-laden births, while Medicaid also supported the widespread use of long-acting reversible contraceptives (LARCs) by covering the cost of inpatient insertion in the postpartum period. 

The racial disparity gap remains an issue in South Carolina just as it does for the nation, but even there we are making progress. Greenville Health System’s gradual grant-funded rollout of the CenteringPregnancy© model has markedly improved health outcomes for women and their newborns, and initial findings suggest that the approach could reduce and possibly even eliminate the racial disparities in preterm births, something which could also help reduce the higher IMR for African-Americans in the state. 

SCBOI continues to work and expand on its core objectives in order to improve the health outcomes for all newborns in South Carolina. The group holds open meetings every month here at SCHA. For the latest on SCBOI as well as resources and a meeting schedule, go to