The 18-year-old woman was a mystery when she arrived late in July to deliver her baby.
Doctors at the University of Maryland Medical Center knew nothing about her. By all indications, she had not seen a physician even once during her pregnancy.
Her baby was three months premature, but her body was ready to deliver. The baby was tiny -- only 1 1/2 pounds -- and his lungs weren't working yet. His life lasted about 23 hours.
A few hours after that, his mother was gone, too upset even to talk about the death or her medical future.
At least four times a week, somewhere in Baltimore, a baby dies. Eighteen out of a thousand infants here will die before they reach the age of 1 -- one of the worst infant-mortality rates in America.
But dead babies are only part of the picture. Every five hours, an underweight baby is born in Baltimore. While some will die prematurely, most will live, and their lives will often be troubled.
The tiny babies are far more likely to be mentally retarded or to develop cerebral palsy. They will also be prone to blindness, hearing ailments and seizure disorders. Some are born addicted to drugs. Aside from the individual suffering, they will be a drain on the public pocketbook for years.
Behind the discouraging numbers is a troubling fact: Many of the infant deaths and low birth weights could be prevented.
Given the chance, doctors can often spot and take care of problems such as bad nutrition, diabetes or high blood pressure in early pregnancy.
Medical care for pregnant women is generally available. So is government-funded insurance. Even so, getting Baltimore's poor women into medical care -- and out of harmful habits such as drugs and cigarettes -- has often eluded the city's medical community.
Commissions study the problem and make recommendations, but programs go underfunded or underused, according to experts. As a consequence, a wave of children with physical and developmental problems continues to flood the city.
Meanwhile, a staggering amount of money is spent saving the tiniest and sickest babies in the city's high-tech neonatal intensive care units. Even more is spent afterward, dealing with the children's lingering medical problems.
Experts across the city wonder why the same commitment cannot be made to women before they give birth.
"We see a picture of fragmented services and separate, small, uncoordinated programs which are severely understaffed," reads a recent report by Advocates for Children and Youth Inc.
