Black Infant Mortality

Black mothers are more likely to experience an infant death than white mothers.   Nationally, in 2016, non-Hispanic black infants had an infant mortality rate of 10.9 deaths per 1000 births, compared to 4.9 deaths per 1000 births of non-Hispanic white infants.  In New Jersey, the infant mortality rate for black babies was 9.7 per 1000 compared to 3.0 per 1000 for white babies.  The most common reasons for an infant to die in the first year of life include: low birthweight, prematurity, congenital malformations, maternal complications, and sudden infant death syndrome (SIDS).

Black babies are more likely than white babies to be born prematurely (earlier than 37 weeks) and/or to be of low birthweight (less than 5 ½ lbs). The pre-term birth rate for black infants in 13.1%, compared to 8.3% in white infants.  Prematurity and low birthweight are the leading cause of infant death among black babies.  Babies born too early may have problems with their heart, liver, eyes or central nervous system, which can be severe enough in some cases to result in death.

Fortunately, most babies, black and white, are born at term and are healthy.   But when we see significantly more black women having serious pregnancy complications and significantly more black babies dying before their first birthday we need to understand what underlies that difference.  Health behaviors, family history, quality of medical care, all contribute.  However, we also know how much environment influences health.   There is no single reason for this disparity, but it is more than just the consequence of individual health behaviors or family history.

Above and beyond these factors, the health and wellness of black women and babies is adversely affected by the lived experience of racism.  Black women living in America experience a higher stress load throughout the course of their lives as a result of their experiences of racism

Racism and prejudice can play out in ways big and small in a black woman’s everyday life. It may be in day-to day social situations or interactions with coworkers.  She may encounter it when she seeks medical care, or it may impact the type of home or neighborhood she can live in.    Racism can limit her opportunities for education or work.  It has the potential to impact any and all aspects of her life.

Black women not only carry the burden of their own experiences of racism but also that of their children, their spouse, or other family members.  It can be a heavy burden to bear, and it can exact a heavy toll on their mental and physical health.

History has shown black women to be strong, to possess the strength and resilience to overcome the obstacles put in their path.  This strength can be a double-edged sword, however.  Sometimes the superhero level of strength necessary to succeed and to take care of children and family, leaves little time and energy for self-care.   While an asset, it can lead to negative coping mechanisms and stress that undermine a black woman’s health and that of her pregnancy.

Experiencing racism is stressful, and so it triggers the body’s natural stress response. As a result, a cascade of physiologic reactions occur,  affecting many different body systems.   When this happens repeatedly, over a lifetime, it results in a lot of “wear and tear” on the system, weakening it over time.   The consequences of excessive activation of the stress response system, resulting in prolonged exposure to increased levels of stress hormones like cortisol, increases the likelihood of developing certain chronic diseases such cardiovascular disease, diabetes, hypertension, etc.  Having these conditions while pregnant can pose serious risks to the health of both mother and baby.

The toxic stress associated with racism undermines a black woman’s reproductive health, resulting in a higher likelihood of pregnancy complications and a higher rate of premature and low birthweight babies. This situation makes it all the more important that black women take steps to be as healthy as they can be before conception as well as during pregnancy.

Learning to recognize and manage stress in positive ways is important.   There are many different approaches to take, such as deep breathing, mindfulness, meditation, yoga, etc. Sometimes sharing your feelings with others, whether friends, family, a therapist or a support group, may help lighten the load.  A healthy diet and regular exercise can also help minimize stress.  Being strong for everyone else is admirable, but it must be balanced with self-care.  Taking care of your own health is the best way to influence your baby’s health.

Caring for your and your baby’s health

There are many things you can do to maximize your own health and that of your baby.   A healthy pregnancy outcome not only depends on the care received during the pregnancy, it is also dependent on life experiences and care prior to pregnancy.  For this reason, and because many pregnancies are unplanned, it is never too early to start taking care of your physical and mental health.

There are many things you can do prior to becoming pregnant to give yourself the best chance to have a healthy baby.  These, as well as things to consider both during pregnancy and after delivery, are discussed in more detail below.

 

Important Messages for Black Women Regarding Pregnancy

 

1.Be Empowered

Understanding the history of black women in America and how racism affects health may help provide context for your own feelings and experiences.  We encourage you to seek out sources of support and information form organizations such Ancient Song Doula or Black Mamas Matter.

2. Know your health risk factors.

Every individual has a unique family history that influences their health and that of their children.   This information is important for your  healthcare provider to know, so that he or she may recommend appropriate screening tests or other evaluations. This also would include any information abut your own birth and if your mother had any complications

Talk to your provider about screening or testing for certain conditions that tend to occur more commonly in African Americans such as sickle cell anemia, lupus, hypertension, diabetes, etc..  The Center for Disease Control has resources to help you with this.   You may wish to seek genetic counseling to help identify if there are any inherited disorders that you and/or your children may be at risk for.  A genetic counselor would be able to inform you of any special testing that may be relevant to your pregnancy.

If you have experienced a previous pregnancy loss, or prenatal complications in a past pregnancy, speak with a perinatologist to determine how best to manage your current or future pregnancies.

Family Portrait

CDC Family History

NJ Genetic Resource

  1. Start with a Plan – Work on improving your overall health

 Taking care of your health before pregnancy is an important way to improve your chance of having a healthy baby.  Many chronic health problems such as obesity, hypertension, diabetes, can cause pregnancy complications.  Seeing a physician regularly can help prevent these problems or better manage them prior to becoming pregnant.

Your doctor can tell you what vaccinations you may need.  This is important to avoid certain infectious disease that could cause problems during a pregnancy such as German measles (rubella).

Set up an appointment with a dentist.  Having regular dental care is important not just for your health but for that of your pregnancy.

Whether you are pregnant of not, set up an appointment with an OBGYN.  If you are not planning on becoming pregnant in the near future, you can discuss contraceptive options. Unintended pregnancies have a higher risk of complications because of unresolved maternal health conditions, delay in getting prenatal care, inadvertent exposure of the baby to environmental factors such as cigarette smoke, etc.

If you are trying to conceive then talk to your OBGYN about starting prenatal vitamins and folic acid supplementation

If you are smoking or using any other substances that could potentially harm you or your baby, talk to your doctor about quitting.

Regular exercise and good nutrition is critical for your own health and that of your pregnancy.  Try to get in some form of exercise on a regular basis

 

YMCA

My Fitness Pal App

ChooseMyPlate.gov

Moms Quit Connection

PAPP program

 

  1. To blessed to be stressed!

 Identify sources of stressors in your life and learn healthy ways to manage what can’t be removed

Identify stressors in your life, and how you are managing them,.  Are your coping mechanisms healthy?  Are they free, safe, and sustainable?  Practice stress reduction techniques such as mediation, deep breathing, player, etc. It is important to fid some time during the day that is “me time.   Self-care is very important for your mental and physical health.

The lived experience of racism can have a profound impact on your well-being.  Seek out sources of support or information to help you with this such as Black women’s health imperative and Mocha Moms.

 

  1. Establish Healthy Relationships: Environments and personal connections

Being pregnant and having a baby are exciting life events, but they can be challenging as well.  Being able to share your expectations with other mothers can be very helpful.   You may be able meet other mothers at community centers or parks, or other community facilities, or you may wish to join an established mothers support group.

You may find that you and your partner need individual counseling if there are relationship problems, physical or emotional abuse.

 

Therapy for Black Girls

Montclair B.A.B.Y.

 

  1. Create Your Pregnancy Tribe – carefully choose your provider and support network

The father of your baby can be an important source of support for you and your baby.  Having a strong support system can help things go smoothly during your pregnancy and labor.  Think about who you would like to have in your support network.  These individuals could be family, friends, coworkers, etc.  If you have other children, encourage them to participate as well.

In thinking about how you want your pregnancy and delivery to proceed, you will need to consider who your main provider will be.   This could be a physician or a midwife.  Explore your options and interview possible choices.  In addition, you may also want to have the support of a doula.

 

Midwives Alliance of North America

Choosing Wisely

Healthy Start

 

  1. Advocate for yourself – Develop a birth plan with your health care team

While you cannot anticipate everything that may happen during labor and the delivery of your baby, thinking through how you would like it to proceed in an ideal world is helpful.  Think about how you would like things to unfold, what is important to you, and what your goals are.  This includes items you want as well as things you do not want.  Communicating this with your partner, support network, and provider will help you to have the birth experience you desire.

As part of this, you should consider alternate scenarios, and what your thoughts and feelings are about them.  Fore example: c-section vs vaginal birth, medication/anesthesia during labor, etc.

Make sure your chosen providers listen to and respect you.  If you feel they are not listening or being respectful, you may need to replace them.

Sometimes things can change suddenly during labor and circumstances may make it difficult for you to advocate for yourself.  Make sure you have support from someone who understands your plan and can speak for you.

 

  1. Know and Care for your Pregnancy Body: tune in to the baby’s movements, how you feel, and how to identify when something is wrong

 Be aware of your baby’s movements. As you enter the third trimester of your pregnancy, your provider will recommend that you start monitoring the baby’s movements by doing “kick counts” daily.  This is a simple way to assess fetal well-being.  Becoming in tune with the particular pattern of activity in your pregnancy is helpful in establishing what is “normal” for your baby.  This can provide comfort and reassurance.  It can also help you better recognize when something might be off and in need of further evaluation by your provider.

Also be aware of warning signs such as selling of hand and feet, severe headache, vaginal bleeding, fever, etc.  They may be a sign of serious health issues and so should be brought to the attention of your provider immediately.

Regular prenatal care is important.  Even if you are feeling well, monitoring your pregnancy on a regular basis can provide assurance that it is progressing in a healthy way and can identify early warning signs of potential problems.  These can then be managed early, avoiding potentially serious complications later on.  Make sure to keep all your prenatal appointments.

One tool that can help you manage your pregnancy is the Pregnancy Calendar.

 

  1. Baby’s here – care for yourself, understand the changes of the 4th trimester

It will take many weeks for your body to heal from delivery.  You should be aware of warning signs in the postpartum period that could indicate potential problems, such as bleeding, infection, etc.

Forming a strong emotional bond with your newborn is essential to his or her physical mental and emotional development.  This may be difficult to do if you have postpartum depression.  Learn the signs of postpartum depression. If you are feeling particularly sad or anxious, reach out for help.  Individual or group counseling may be helpful. The Partnership maintains a list of support group resources here.

Breastfeeding

Breastfeeding has benefits for both mom and baby.  It helps promote mom’s health and healing following childbirth.  Women who breastfeed lower their risk of developing type 2 diabetes and breast/ovarian cancer.   Breastfeeding can decrease the chance of infection and many other illnesses in baby such as asthma, eczema, SIDS, obesity, type 2 diabetes, etc. Breast milk has the right balance of fats, sugar, water and protein to help baby’s growth and development.

 

Talk to your doctor about options for contraceptives.  There are many health benefits to having pregnancies spaced 2-3 years apart.  Not only does it give mom’s body time to heal and recover, it can reduce the chance of complications in a subsequent pregnancy such as prematurity low birthweight, and infant death.

 

Emotional Phone Support Program

Speak up when you are Down Pamphlet

Chocolate milk mommies breast feeding support

 

  1. Start your baby off right – pediatrician newborn safety and financial planning

 Pediatrician

Select your pediatrician before the baby is born.  Schedule well baby visits and become familiar with the vaccination schedule

Safe Sleeping

SIDS (sudden infant death syndrome) is a leading to cause of infant deaths. There are several things you can do to decrease the chance of this happening to your baby.  Safe sleep habits for baby include:  putting baby to sleep on his or her back, keeping the crib free of soft objects or loose bedding, and sleeping only in his or her own crib (not sharing a bed with parent(s) or others).

Car Safety

When riding in a motor vehicle, your child must always be properly restrained in a securely latched child car seat.  There are numerous child safety seat check events across the state. To find one near you, click here.

Financial planning

It is never to early to start a savings account for your baby

Childcare

Plan ahead to make arrangements for childcare

 

CDC Vaccination Schedule Tool

American Academy of Pediatrics – Schedule of Well Child Care Visits

SIDS Center of NJ

New Jersey Seat Check Sites

Apply for NJ Childcare Subsidy

 

Getting Involved

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