I’ve known for years that the most dangerous thing most people do to their kids every day is to put them in a car. Car crashes have long been the leading cause of death for children in America, due mostly to a national transportation system with a safety record far worse than its peer countries. Preventing these tragedies is a big motivation for people working on transportation policy in American cities.
But it’s another thing when it’s your own kid in the back seat. That’s the feeling I had two months ago after my daughter was born, faced the reality of securing a newborn baby into a motor vehicle. One of the more comforting moments of our stay at Regions Hospital was when a hospital worker arrived to help us figure out how to use our new car seat.
“I’m here for your car-seat training,” said the staffer, an expert whose sole job was to help new parents correctly use a car seat.
She wheeled in a large contraption, a full-size automobile bench, and together we practiced wedging a six-pound human being into a whole mess of complicated plastic. To be honest, the first time you fit a squirming newborn’s arm through the strap of a Graco Snugride Snug-lock 35 is a little nerve-wracking.
The lesson was part of a pilot project at Regions Hospital that brings car-seat education to new parents. For the last two years, they’ve been running a unique effort to do car-seat instruction in the hospital, right where the newborn babies and their parents are located.
“They [the hospital workers] take care of these moms and these babies, and do all these things to make sure everyone’s healthy and safe,” explained Shonette Micco, the injury prevention supervisor at Regions Hospital. “And the next thing you know, they’re getting discharged and no one’s there to help them be safe on the road.”
Along with other efforts at injury prevention, Micco wrote the grants to fund the program that brings car-seat training experts directly into the newborn ward.
For most Minnesota hospitals, car-seat safety is outside the scope of what maternity wards offer. Regions’ two-year grant-funded trial is aimed at helping overcome some of the barriers around car-seat safety. The program is funded by a grant from the Minnesota Department of Public Safety, and its office of Traffic Safety. The first year’s grant was $150,000, with the second year’s funding a at a lower level, allowing staffing for in-patient car-seat instruction five days a week.
Standard of care
Hospital administration is famously bureaucratic. Every detail, down to the last Q-tip, is accounted for according to the byzantine rules of insurance and deductibles. As a result, even important things like safety education often take a back seat (pardon the pun) to more pressing needs like health checks, lactation, and recovery. The administrative term for this process, “standard of care” for new families, typically leaves out car-seat instruction, in spite of the risks that car crashes pose to children.
As with many frustrating aspects of the American health care system, the reason for the omission is cost. Finding money to fund staff for car-seat instruction is almost impossible. That’s where the state and federal grants step in.
“The cost of motor vehicle crashes and long-term injuries cost way more than what it might cost to fund and support dedicated car-seat education service within a hospital,” Micco told me. “Anyone in the field gets why this is important, [but] there just isn’t a reimbursement component no way to have sustainable funding.”
One challenge is that outcomes for crash reduction are nearly impossible to track. Statisticians can’t count injuries that don’t happen thanks to safety measures, and so nobody really knows how much of a difference the training might make for Twin Cities children. The one thing they do know: By coming directly into the hospital, staff are reaching many more people than car-seat programs typically do.
Typical “car-seat clinics” happen in places like fire stations and community rec centers, for decades the main route for that education around infant car seats. But like many traditional community engagement approaches, these efforts rely on active engagement. They most often connect with people who are already most likely to have resources.
“Car-seat education has typically been community focused, [like] clinics at a fire station,” said Micco. “That is very important, but you’re already getting the people that know enough to know they need to know more. By doing it in-patient we’re actually reaching our patient population, getting to people we’re otherwise not seeing in our clinics.”
Another huge benefit of the in-patient program involves language barriers. Hospitals like Regions are equipped with thorough interpreter services that can translate critical information into the many languages spoken throughout the city.
Then there are people who don’t have cars in the first place, which in St. Paul is around 15% of the population. While getting the education training is always optional, the in-patient visits allow new parents without cars to learn about car seats, which they might someday have to use. By being universal, the effort reaches a far wider audience of new parents.
Lessening the risks
Holding a newborn baby for the first time can anxiety-inducing, to say the very least. The first few times you tackle basic tasks like feeding or changing a baby — tasks that will become second nature — can be downright terrifying.
That’s certainly true for car seats. A few months into parenthood, strapping Ruthie into her car seat has become almost an afterthought. As with many things involving ubiquitous car travel, it’s easy to forget the risks involved with driving every day.
But at any moment, tragedy could strike. A moment of careless inattention or some other driver speeding too fast or blowing through a red light might have horrific consequences. After all, speeding and reckless driving have been increasingly rapidly over the last few years, and especially during the COVID pandemic, which has seen a spike in dangerous crashes on Twin Cities roads. Thanks to the unprompted visit from the specialist, at least I’ll always be sure I’m using the car seat correctly.