One factor not addressed in the reporting on infant mortality is the high rate among early teen pregnancies. More prone toward prematurity, the mortality rate for infants born to women under 18 is 13.5 deaths per thousand births.
There are a number of factors specific to this group other than those listed in the reports, I.e., socioeconomic status, race, lack of access to health care, etc.
The reproductive cycle of these girls is not always regular, thus not reliable in assessing the cause of missed periods. Even where periods are regular, the teen may not be aware of what a missed period might mean, or there is a strong power of denial present, out of fear of parental repercussions or social disapproval. This may seem ridiculous in this age of "everything you need to know about sex," but we should not assume common knowledge has reached everyone.
Another issue never explored may be the question of whether the sexual activity involved was consensual. If not, there is crisis upon crisis for the victim.
Whatever the reason, early, crucial health care in these pregnancies is often missing, even if access is available.
I hope in the process of exploring the issue of infant mortality, this cohort will be a prime target of concern.
Guenveur Burnell
Kent