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Fetal-Infant Mortality Review

Fetal-Infant Mortality Review (FIMR) is an action-oriented community process that continually assesses, monitors, and works to improve service systems and community resources for women, infants, and families in Baltimore City. FIMR is an important part of the B'more for Healthy Babies Initiative because it enables us to identify factors that contribute to poor birth outcomes and monitor the progress of interventions to improve our city's service systems.

How FIMR Works

The Baltimore City Health Department gathers information about fetal and infant deaths in our city from public health, medical, and social services records. A public health nurse conducts interviews with mothers who have suffered losses, if the mother agrees, and then refers families to bereavement support and community resources.

Every month, the FIMR Case Review Team meets to review cases of fetal and infant deaths, paying special attention to social, economic, and health factors that may have contributed to the deaths. The Case Review Team is composed of health, social service, and other experts from the community. Based on summaries of case information and interviews with mothers, the team identifies trends and issues and makes recommendations for change.

FIMR meetings are completely confidential. No identifying information about the mother or her service providers is shared with the Case Review Team.

Community Action

The recommendations of the FIMR Case Review Team go directly to the B’more for Healthy Babies Steering Committee, which serves as Baltimore City FIMR’s Community Action Team. Anchored in the Mayor’s Office, the BHB Steering Committee is made up of a diverse group of community leaders. It oversees the BHB Core Implementation Team, which has met weekly since 2009 to review FIMR recommendations, prioritize issues, and design and implement interventions to improve service systems and resources in Baltimore City.

At the neighborhood level, Neighborhood Action Teams in two neighborhoods in Baltimore City with high infant mortality rates—Upton/Druid Heights and Patterson Park North & East—work to implement FIMR recommendations within their communities. They conduct neighborhood outreach and education on safe sleep, secondhand smoke and smoking cessation, family planning, obesity, and a range of other important issues.

BHB monitors the impact of interventions it implements through the monthly FIMR Case Review Team process, tracking changes in the overall number of deaths as well as changes to service systems and resources for women, infants, and families in Baltimore City.


Amerigroup * Baltimore City Health Department * Baltimore Medical System * Center for Infant and Child Loss * Family League of Baltimore City, Inc. * HealthCare Access Maryland, Inc. * Healthy Start * Johns Hopkins Bayview Medical Center * Johns Hopkins Hospital * Johns Hopkins School of Nursing * Medstar Harbor Hospital * Mercy Medical Center * New Vision House of Hope * Priority Partners * Roberta's House * Sinai Hospital * Saint Agnes Hospital * University of Maryland School of Medicine * University of Maryland School of Social Work * Women, Infants, and Children 

More Information

For more information about Baltimore City FIMR, contact Cathy Costa at cathy.costa@baltimorecity.gov

Annual Reports and Special Projects

View our FIMR Annual Reports to learn our recommendations for improving maternal and infant health in Baltimore:

- FY2015 Annual Report

- Intermin FY2016 Annual Report

FIMR Obesity Project

Project Kick-Off Slides

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Sponsored by the Office of
Mayor Bernard C."Jack" Young,
Baltimore City Health Department,
The Family League of Baltimore, and
CareFirst BlueCross BlueShield