Tara Simmons-Graves knows about adversity, but she also knows about overcoming it. She looks fondly at her 13-month-old twin daughters, and remembers the sister that they lost on Easter morning in 2004.

She gave birth prematurely to triplet girls on Dec. 30, 2003. India, Paris and Asia were each born weighing under 3 pounds. and each had life-threatening complications which temporarily sent their mother on an emotional roller coaster.

Asia had to have a foot of her bowel and appendix removed because of a stricture in her intestines; India had a breathing problem. Paris had blood in her lungs from an under-developed vessel and doctors feared she wouldn't make it through the night.

Graves took several trips to the neo-natal intensive care unit at Palmetto Health Richland Hospital in Columbia to check on her tiny babies and trembled at the thought of having to answer her home phone when hospital officials called.

She didn't know if Asia's intestinal surgery was going to go well, or if her infant would have to wear a colostomy bag. She didn't know if Paris was going to leave her too soon. She didn't know much of anything beyond being concerned for her babies' welfare.

Graves had to undergo training in CPR and the operation of apnea monitors as part of the challenges she faced in taking care of her small babies, all of whom eventually went home to be with their parents and two others siblings.

"I would definitely say it's a struggle, but you have to believe and trust in the Lord that everything is going to work out. Don't give up, and do all you can for your children or baby," said Graves, who lost the oldest of the triplets, India, to sudden infant death syndrome at three months of age.

The 29-year-old is now working to keep the memory of her daughter alive and dotes on her remaining children, including RahKeem, 11, Lalah, 4, and Asia and Paris, who are progressing wonderfully.

"There's something mental to deal with in not knowing how your child is going to come out. You don't know whether they're going to blind, deaf or whatever. They told me these babies wouldn't walk or talk, but look at them now. They can walk, talk and do everything else. Doctor's don't always have the last say-so, that's for sure. I've been more than blessed," Graves said.

It is her desire to encourage other mothers of low-birth weight babies that has earned her the designation as an ambassador during Low Country Healthy Start's First Annual Infant Mortality Awareness Walk to be held from 8 a.m. to 11 a.m. Saturday, March 26, at William J. Clark Middle School in Orangeburg.

"I definitely take that as a great privilege, and I'm very excited about it. I encourage all women that are pregnant to go to all prenatal appointments, take folic acid and not be afraid to ask questions during your doctor's visit. I'm going to try to do something for the (Orangeburg) area in the area of premature babies. It will be something in remembrance of India," Graves said.

‘It's a public health issue'

In it's seventh year of operation, the Denmark-based Low Country Healthy Start is a maternal and infant wellness program administered through the South Carolina State Office of Rural Health and funded through the U.S. Department of Health and Human Services.

LCHS Program Director Virginia Berry White, LMSW, said the community is welcome to participate in the walk, particularly the parents and families of a low birth weight baby, or a very low birth weight baby weighing less than 5 pounds 8 oz.

A two-mile trek will be made around the middle school track before Orangeburg Mayor Pro Tem Bernard Haire signs a proclamation designating March 26 as Infant Mortality Awareness Day.

Mothers will then be allowed to give testimonies of their and their families' experience in caring for or losing a baby who was born too soon. Each will serve as "ambassadors" and will be given medallions for their efforts in facing their challenges.

Orangeburg resident Crystal Myers, whose year-old son, Christopher, was born two months premature and weighed in at 3 pounds will join Graves as an ambassador.

The March of Dimes; Orangeburg County Department of Health and Environmental Control; Orangeburg County Department of Social Services; Family Health Center; TRMC; representatives from the NICU Unit at Palmetto Health Richland hospital, and LCHS are all among the exhibitors who will be disseminating informational brochures and other health materials during Saturday's event.

"We're continuing to bring awareness to the issue of infant mortality. It's not just one family's problem; it's really a public health issue," White said.

A state DHEC report released Jan. 13 revealed that the state's infant death rate dropped nearly 11 percent between 2002 and 2003 and that there was a statewide infant mortality rate among blacks and other minority groups by 15.6 percent from 2002 to 2003.

White said the state DHEC's 2005 Maternal Child Health Data Book also revealed that African-American infant mortality rates significantly decreased in Orangeburg from 46 deaths from 1998-2000 to 28 deaths from 2001-2003.

Even with this progress, White said the issue of health disparities is great between whites and African-Americans and other minorities. Access to adequate and risk-appropriate health care and first-trimester admission to prenatal care were among the disparate areas, particularly in LCHS's service area which includes Orangeburg, Bamberg, Allendale and Hampton counties.

From 2001-2003, 54 babies in the LCHS service area died before the age of 1; African-Americans represented 87 percent of that population. There were 582 pregnant women in the LCHS service area during the same period, and roughly 10 percent didn't receive adequate prenatal care and roughly 12 percent gave birth to babies weighing less than 5 pounds. 8 oz.

'We give them the education they need'

"First-trimester admission to prenatal care is a fundamental measure used to evaluate not only the effectiveness of the prenatal system, but also access to care," White said, noting that making an early connection with pregnant women and following them postpartum is the best chance for LCHS to help women positively impact their health.

Healthy Start's perinatal resource coordinators and perinatal outreach workers visit in the homes and coordinate services for local women. Healthy Start licensed social workers also conduct intensive, bi-weekly home visits to disseminate information and educate women on the signs and symptoms of early labor.

The social workers teach from a "Partners for Healthy Babies" curriculum and conduct a "Four P's" assessment to gather a woman's family history for indicators of alcohol, tobacco or other drug abuse. Outreach workers also encourage women who may suspect that they are pregnant to take an early pregnancy test (EPT), after which they are referred to a health care provider based on positive results.

White has said the outreach workers a list of providers and their phone numbers and immediately match a patient with a health care provider.

Even before a woman is pregnant, if she is of child-bearing age, she should have annual physicals and take a multivitamin containing 400 micrograms of folic acid every day beginning three months before conception, according to The Pregnancy and Newborn Health Center of the South Carolina Chapter of the March of Dimes Foundation. The U.S. Public Health Service recommends the daily dosage of folic acid to reduce the risk of having their pregnancy affected by spina bifida or other neural tube defects. The center also recommends women follow their health care provider's guidance regarding weight, diet, exercise, smoking cessation, alcohol consumption and other harmful behaviors.

"A lot of women think it won't happen to them and say, 'I've been doing what I'm supposed to do.' You can still do everything you're supposed to do, follow the doctor's instructions and still have a low birthweight baby," LCHS perinatal coordinator Tracy Golden said, who said she and other LCHS workers are there to support women with a educational care plan.

White said the LCHS is also selling $1 cards which contain a baby's foot prints and the LCHS slogan, "Taking steps to ensure the health and well-being of tomorrow's children." Proceeds from the sale will be used to raise money for client services, including: scholarships and books; cultural and educational trips; exercise and nutrition programs; smoking cessation classes and limited childcare and transportation services.

LCHS administrative assistant Kenita Pitts said Graves and others ambassadors will serve as beacons of hope in the fight against infant mortality and premature birth.

"They overcame, and we come in to give them the education that they need. That's really what it's all about, just helping each other get through," Pitts said.

For more information on the card sale, contact LCHS toll-free at 1-888-581-0319. For more information on the upcoming infant mortality awareness walk, contact Pitts at the same number, or mail: Low Country Healthy Start, P.O. Box 367, 4899 Carolina Highway, Denmark, SC 29042.

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