Fetal-Infant Mortality Review
What is FIMR?
Emerging as a public health strategy in the mid-1980s, Fetal Infant Mortality Review (FIMR) was created as a response to the alarming increase in the infant mortality rate in the United States associated with adverse reproductive and infant health outcomes at the local level. Throughout the country, FIMR is being utilized as an action-oriented community process that continually assesses, monitors, and works to improve service systems and community resources for women, infants, and families.
By reviewing the circumstances surrounding the lives and deaths of these mothers and infants, as well as those who are never born (fetal deaths), and then providing these findings to community action teams (CAT), FIMR teams can come up with creative ideas to help improve birth outcomes and reduce infant mortality rates. Research shows FIMR is an effective perinatal systems intervention as it examines infant mortality in the large context of social, economic and systems factors.
FIMR is:
- Community-based
- Action-oriented
- Used at the local level to:
- Assess
- Plan
- Improve, and
- Monitor service systems
- Develop policy
- Promoting the health and well-being of women
- A warning system that can describe effects of health care systems change
- A method for implementing continuous quality improvement
How does FIMR work?
The FIMR process is not about assigning blame. Rather it is an examination of circumstances surrounding the death to identify system gaps. The FIMR process brings a multi-disciplinary community team together to review de-identified infant and fetal death cases. Composed of health, social service, medical, nursing and other professionals, the FIMR case review team examines the case summary, which is comprised of information from medical data abstractions, in conjunction with a maternal interview. Data sources will include birth and death certificates, records from hospitals and physicians, WIC, and Healthy Start. The case is discussed based on all information gathered and gaps in the systems of care are identified.
Findings are summarized and used to create recommendations to improve the community’s service delivery systems and resources. Community leaders representing government, consumer, key institutions and health & human services organizations serve on the CAT, which acts to implement recommendations. CATs can enhance the credibility and visibility of issues related to Hoosier parents, infants and families about the need for these actions through presentations, media events and written reports. By initiating new creative solutions for service delivery to families and constantly monitoring their applicability and effectiveness within the community, CATs work to improve the health outcomes of mothers and infants in communities.
FIMR can be used to bolster a variety of Indiana perinatal surveillance efforts. This can and should include the incorporation of FIMR findings into institutionalized Title V activities, such as the 5-year needs assessment and annually reported performance measures. Aside from the obvious positive potential impact on the informed, data-driven resource improvements in Indiana communities, FIMR is a valuable tool to enhance Indiana’s Title V Needs Assessment by:
- Examining social, cultural, safety, and health systems factors that are associated with fetal and infant mortality through review of individual cases
- Identifying systems barriers and problems that need improvement through case-reviews
- Including maternal interview information from consumers to further identify actions needed
- Addressing ways of improving service systems and community resources to reduce future fetal and infant deaths
- Providing valuable qualitative data to use with the state’s quantitative infant mortality data
http://www.babiesgonetoosoon.org
Babies Gone Too Soon aims to help families find hope, strength and support. The organization began when four mothers of angel babies came together to find a way to remember their babies. They offer financial support for funeral expenses, including fees for obituaries in newspapers.
www.postpartum.net/get-help/
The mission of Postpartum Support International is to promote awareness, prevention and treatment of mental health issues related to childbearing in every country worldwide. They offer online support groups, connections to licensed mental health professionals for weekly calls and emergency calls or text hotlines.
http://firstcandle.org/bereavement/online-support-groups/
First Candle’s peer-to-peer online support groups are a safe and supportive place for individuals and their families to share information and experiences surrounding pregnancy and infant loss. As a member, you can connect with other people experiencing grief, anger, anxiety and depression.
https://www.preeclampsia.org/get-support
The Preeclampsia Foundation seeks to reduce maternal and infant illness and death due to preeclampsia, HELLP syndrome, and other hypertensive disorders of pregnancy by providing patient support and education, raising public awareness, catalyzing research, and improving healthcare practices. Read about other women’s experiences with preeclampsia and add your story, too.
https://nationalshare.org
The mission of Share Pregnancy and Infant Loss Support, Inc. is to serve those whose lives are touched by the tragic death of a baby through pregnancy loss, stillbirth, or in the first few months of life.
www.unspokenstories.org
Honest stories of pregnancy, parenthood and loss are too often unshared. Let’s tell the real story. Let’s build a supportive community that gives voice to your experience, from the joys of parenting to the heartbreak of loss.
View resources for clinicians
County and Regional FIMR Teams
Select a county to view local FIMR Team information, if applicable.
Contact
Linzi Horsley
Fetal-Infant Mortality Programs Director
Indiana Department of Health, Division of Fatality Review and Prevention
317-509-4119, lhorsley@health.in.gov
Olivia Gonzalez
Northern IN FIMR Coordinator
ogonzalez@health.in.gov
Melanie Pote
Southern IN FIMR Coordinator
mpote@health.in.gov
County Name Here
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Grant County Regional FIMR
Marion Health System
Point of Contact
Abby Flenar
abby.flenar@marionhealth.com
Gail Elbert
gail.elbert@marionhealth.com
Cindy Futrell
cindy.futrell@marionhealth.com
West Central IN FIMR
Tippecanoe County Health Department
Point of Contact
Aubrey Kitchel
akitchel@tippecanoe.in.gov
West Central IN FIMR
Tippecanoe County Health Department
Point of Contact
Aubrey Kitchel
akitchel@tippecanoe.in.gov
Cass County Regional FIMR
Logansport Memorial Hospital
Point of Contact
Trista Green
tgreen@logansportmemorial.org
Kim Flora
kflora@logansportmemorial.org
Angie Soupley
asoupley@logansportmemorial.org
Clark County Regional FIMR
LifeSpring Health System
Point of Contact
Breeze Peele
breeze.peele@lifespringhealthsystems.org
Wabash Valley FIMR
Richard G. Lugar Center for Rural Health - Union Hospital
Point of Contact
Heather Anderson
heaanderson@uhhg.org
West Central IN FIMR
Tippecanoe County Health Department
Point of Contact
Aubrey Kitchel
akitchel@tippecanoe.in.gov
Daviess County Regional FIMR
Daviess Community Hospital
Point of Contact
Desiree' Lewis - FIMR Coordinator
dlewis@dchosp.org
Shawna O'Kelley Brinson, RN - OB/Nursery Director
sokelley@dchosp.org
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Southeastern IN FIMR
Vanderburgh County Health Department
Point of Contact
Bonnie Miller
bmiller@vanderburghcounty.in.gov
Lynn Herr
lherr@vanderburghcounty.in.gov
Elkhart County FIMR
Elkhart County Health Department
Point of Contact
Andrew Bylsma
abylsma@elkhartcounty.com
Melanie Sizemore
msizemore@elkhartcounty.com
East Central IN FIMR
Wayne County Health Department
Point of Contact
Cynthia Blue
cblue@co.wayne.in.us
Halley Lilley
hlilley@co.wayne.in.us
Clark County Regional FIMR
LifeSpring Health System
Point of Contact
Breeze Peele
breeze.peele@lifespringhealthsystems.org
Cass County Regional FIMR
Logansport Memorial Hospital
Point of Contact
Trista Green
tgreen@logansportmemorial.org
Kim Flora
kflora@logansportmemorial.org
Angie Soupley
asoupley@logansportmemorial.org
Southeastern IN FIMR
Vanderburgh County Health Department
Point of Contact
Bonnie Miller
bmiller@vanderburghcounty.in.gov
Lynn Herr
lherr@vanderburghcounty.in.gov
Grant County Regional FIMR
Marion Health System
Point of Contact
Abby Flenar
abby.flenar@marionhealth.com
Gail Elbert
gail.elbert@marionhealth.com
Cindy Futrell
cindy.futrell@marionhealth.com
Emily Snyder
Emily.Snyder@hamiltoncounty.in.gov
Kaylen Underhill
Kaylen.Underhill@hamiltoncounty.in.gov
Harrison County FIMR
Harrison County Health Department
Point of Contact
Theresa Buechele
tbuechele@harrisoncounty.in.gov
East Central IN FIMR
Wayne County Health Department
Point of Contact
Cynthia Blue
cblue@co.wayne.in.us
Halley Lilley
hlilley@co.wayne.in.us
Howard County FIMR
Point of Contact
Jennifer Sexton
jennifer.sexton@howardcountyin.gov
Brenda Parker
brenda.parker@howardcountyin.gov
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Northwestern IN FIMR
Franciscan Health
Point of Contact
Bernadette Taylor
bernadette.taylor@franciscanalliance.org
Jackie Carter
jackie.carter@franciscanalliance.org
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Northwestern IN FIMR
Franciscan Health
Point of Contact
Bernadette Taylor
bernadette.taylor@franciscanalliance.org
Jackie Carter
jackie.carter@franciscanalliance.org
Madison County FIMR
Madison County Health Department
Point of Contact
Holly Leech
hleech@madisoncounty.in.gov
Sarah Neal
sneal@madisoncounty.in.gov
Marion County - Indianapolis Healthy Babies FIMR
Marion County Public Health Department - Indianapolis Healthy Babies
Point of Contact
Teri Conard
tconard@marionhealth.org
Daviess County Regional FIMR
Daviess Community Hospital
Point of Contact
Desiree' Lewis - FIMR Coordinator
dlewis@dchosp.org
Shawna O'Kelley Brinson, RN - OB/Nursery Director
sokelley@dchosp.org
Cass County Regional FIMR
Logansport Memorial Hospital
Point of Contact
Trista Green
tgreen@logansportmemorial.org
Kim Flora
kflora@logansportmemorial.org
Angie Soupley
asoupley@logansportmemorial.org
Northwestern IN FIMR
Franciscan Health
Point of Contact
Bernadette Taylor
bernadette.taylor@franciscanalliance.org
Jackie Carter
jackie.carter@franciscanalliance.org
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Wabash Valley FIMR
Richard G. Lugar Center for Rural Health - Union Hospital
Point of Contact
Heather Anderson
heaanderson@uhhg.org
Daviess County Regional FIMR
Daviess Community Hospital
Point of Contact
Desiree' Lewis - FIMR Coordinator
dlewis@dchosp.org
Shawna O'Kelley Brinson, RN - OB/Nursery Director
sokelley@dchosp.org
Porter County FIMR
Porter County Health Department
Point of Contact
Hayley Gerstler
Hayley.Gerstler@porterco.org
Southeastern IN FIMR
Vanderburgh County Health Department
Point of Contact
Bonnie Miller
bmiller@vanderburghcounty.in.gov
Lynn Herr
lherr@vanderburghcounty.in.gov
Cass County Regional FIMR
Logansport Memorial Hospital
Point of Contact
Trista Green
tgreen@logansportmemorial.org
Kim Flora
kflora@logansportmemorial.org
Angie Soupley
asoupley@logansportmemorial.org
East Central IN FIMR
Wayne County Health Department
Point of Contact
Cynthia Blue
cblue@co.wayne.in.us
Halley Lilley
hlilley@co.wayne.in.us
East Central IN FIMR
Wayne County Health Department
Point of Contact
Cynthia Blue
cblue@co.wayne.in.us
Halley Lilley
hlilley@co.wayne.in.us
Clark County Regional FIMR
LifeSpring Health System
Point of Contact
Breeze Peele
breeze.peele@lifespringhealthsystems.org
Shelby County FIMR
Point of Contact
Amy Reel
areel@shelbyhealthindiana.com
Denise Holland
dholland@majorhospital.org
St. Joseph County FIMR
Beacon Health System
Point of Contact
Sally Dixon, RN, BA - FIMR Coordinator
sadixon@beaconhealthsystem.org
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Wabash Valley FIMR
Richard G. Lugar Center for Rural Health - Union Hospital
Point of Contact
Heather Anderson
heaanderson@uhhg.org
West Central IN FIMR
Tippecanoe County Health Department
Point of Contact
Aubrey Kitchel
akitchel@tippecanoe.in.gov
Grant County Regional FIMR
Marion Health System
Point of Contact
Abby Flenar
abby.flenar@marionhealth.com
Gail Elbert
gail.elbert@marionhealth.com
Cindy Futrell
cindy.futrell@marionhealth.com
East Central IN FIMR
Wayne County Health Department
Point of Contact
Cynthia Blue
cblue@co.wayne.in.us
Halley Lilley
hlilley@co.wayne.in.us
Southeastern IN FIMR
Vanderburgh County Health Department
Point of Contact
Bonnie Miller
bmiller@vanderburghcounty.in.gov
Lynn Herr
lherr@vanderburghcounty.in.gov
Wabash Valley FIMR
Richard G. Lugar Center for Rural Health - Union Hospital
Point of Contact
Heather Anderson
heaanderson@uhhg.org
Wabash Valley FIMR
Richard G. Lugar Center for Rural Health - Union Hospital
Point of Contact
Heather Anderson
heaanderson@uhhg.org
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
Warren County FIMR
Warren County Health Department
Point of Contact
Breanna Blackburn
vitalrecords@warrencounty.in.gov
Laci Frodge
healthadministrator@warrencounty.in.gov
Southeastern IN FIMR
Vanderburgh County Health Department
Point of Contact
Bonnie Miller
bmiller@vanderburghcounty.in.gov
Lynn Herr
lherr@vanderburghcounty.in.gov
Clark County Regional FIMR
LifeSpring Health System
Point of Contact
Breeze Peele
breeze.peele@lifespringhealthsystems.org
East Central IN FIMR
Wayne County Health Department
Point of Contact
Cynthia Blue
cblue@co.wayne.in.us
Halley Lilley
hlilley@co.wayne.in.us
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com
West Central IN FIMR
Tippecanoe County Health Department
Point of Contact
Aubrey Kitchel
akitchel@tippecanoe.in.gov
Northeastern IN FIMR
Parkview Health
Point of Contact
Britte Nihart
britte.nihart2@parkview.com
Alaina Schultz
alaina.schultz@parkview.com
Stephanie Gehring
stephanie.gehring@parkview.com