When Betty Morrow-Taylor decided to have a baby, she did everything the right way. She was healthy. She didn’t drink, never smoked and wasn’t overweight. She was educated and received prenatal care during her pregnancies. Yet despite Morrow-Taylor best efforts to deliver a healthy baby, she endured two miscarriages, and one of her two sons was born premature.
“I was a woman who had no issues — yet landed in those statistics,” said Morrow-Taylor, a manager of patient services for a biotech pharmaceutical company in North Carolina.
Morrow-Taylor’s story isn’t unique. Black women are more than twice as likely than white women to experience infant mortality or deliver premature babies. In 2005, infant mortality rates for black women due to premature births were more than double the national average, 6 deaths per 1,000 births, to 2.4 per 1,000 births, according to the Centers for Disease Control and Prevention. And when compared to their white counterparts, black women’s infant mortality rates related to premature births was more than three times higher.
Although black infant mortality rates have declined by 4.3 percent from 2000 to 2006, the rate, 13 deaths per 1,000 births, was still nearly double the national average, according to the Centers for Disease Control and Prevention. September is infant mortality awareness month.
Morrow-Taylor said she was shocked when she learned about the disproportionate incidence of infant mortality and premature births in the black community. “It’s a crisis that’s going in that doesn’t get much attention,” she said. “There’s a lot of women out there who share my story.”
African-American female college graduates also suffer an infant mortality rate that is more than double that of their white counterparts — 10.2 deaths per 1,000 births compared to 3.7 per 1,000. In fact, white women who dropped out of high school have a lower rate of infant mortality than college-educated black women — 9.9 deaths per 1,000 births to 10.2, according to the Vital Statistics of the United States.
“Why is it that African-American women with college degrees still have worse birth outcomes than white women who haven’t graduated high school?” asked Larry Adelman, the creator and executive producer of Unnatural Causes a documentary that explores health disparities in the U.S., including black infant mortality. “That is utterly striking.”
In Adelman’s film, health experts argue that the stress of a lifetime navigating a racially stratified society, as well as dealing with racism that is structural, interpersonal and internalized, weathers the body and could be to blame for the prevalence of infant mortality and low birth weight in the black community. For example, when the body is stressed, it produces cortisol, a hormone that can induce labor, Adelman said.
Black women who are born outside of the U.S. have a higher rate of infant mortality than other races–10 deaths per every 1,000 births–but it’s still lower than native born black women, who had a rate of 13 deaths for every 1,000 babies born in 2006, according to the U.S. Vital Statistics System.
“Until we address these issues head on — of what it means to live in a racist society–we’re not going to address this,” Adelman said.
Dr. Gail Christopher, a naturopath and the vice president of program strategy W.K. Kellogg Foundation one of the advisors on the “Unnatural Causes” documentary. She said as African-American women move up the success ladder, they can feel the strain from both real and perceived incidents of racism, which can harm their unborn child.
“Stress is not just a psychological response, it’s a physical one,” Dr. Christopher said. “The more successful we are as blacks, the more stress we’ve encountered in a society defined by white privilege. There are daily challenges that many women face in defying the odds. There is a psychological price that you pay.”
Before working with the W.K. Kellogg Foundation, Dr. Christopher had a large private practice, where she treated some women who’d lost babies or had trouble conceiving. Dr. Christopher, who is African-American, said one of the reasons why she is so committed to reducing black infant mortality is that her first-born child, a girl, died when she was still a newborn.
“There are just no words to describe that experience,” the now mother-of-two said. “It was the experience of losing her that really drove me into my life’s work in the healing profession.”
The general assumption in the medical community is that increased access to prenatal care is the answer to reducing infant mortality, Dr. Christopher said. But she said this crisis goes beyond ramping up visits to the doctor’s office–it’s about eliminating stress in the environment of the mom-to-be by giving her the tools to mitigate it.
Dr. Christopher said the U.S. should learn from Cuba, where government officials have dramatically reduced the country’s rate of infant mortality housing at-risk pregnant women in a group home setting. There, vulnerable women receive support from one another as well as the government. She said a national support group for people who have been affected by infant mortality–and specifically African-American women–is needed. She also urged mothers to breastfeed their newborns.
“Research shows that a breastfed baby has a greater likelihood of staying alive and being healthy,” she said.
Dr. Diane Ashton, deputy medical director for the March of Dimes, is a trained obstetrician and gynecologist, and has worked in hospitals that serve minority and underserved communities. The March of Dimes is in the midst of a campaign to raise public awareness about preventing pre-term births. Their programs include partnering with the U.S. Department of Health to provide smoking cessation for girls, domestic violence screenings and referral of substance abuse problems.
“We know that poverty is involved,” she said. “We know that levels of stress is involved. We know that racism is involved in the outcomes that we’re seeing. Our efforts had to be fairly multifocal.”
Dr. Ashton said women who want to have a baby should first ensure any illnesses, like diabetes or heart disease, are under control. They should be engaged in reproductive health planning, get early prenatal care, as well obtain proper orthodontic treatment to protect themselves and their baby.
“So much of the health of the baby depends on the health of the mother before and during their pregnancy,” Dr. Ashton said.