The Final Call

Black infant mortality, mothers and solutions

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The ugly facts are that the United States has one of the highest infant mortality rates (IMR) among industrialized counties and an under the radar high maternal (mother) mortality rate (MMR), which is higher than 40 other countries, according to a 2010 Amnesty International report. According to the World Health Organization, infant mortality is the death of an infant before its first birthday. These statistics are for the U.S. as a whole, but if Black babies and mothers are looked at specifically it gets worse. The Center for Disease Control (CDC) reports a Black infant mortality rate in America as 13 deaths per 1,000 births more than twice as high as Whites at less than 6 deaths per 1,000 births. This may not sound like a lot but you can do the math, about 4 million babies are born in the U.S. every year and many of those are Black and Brown babies as our birth rates are twice as high as Whites.

The mother’s educational level is usually found to be a contributing factor in predicting pre-term, low weight babies and infant mortality but this isn’t the case when it comes to Black women. All Black women regardless of educational level, income, or health insurance are found at risk. UCLA doctors’ theory of a genetic predisposition of Black infant mortality was defeated when they found that Africans who migrated to America have an infant mortality rate that is close to Whites. However, second generation African women born in America have the same infant mortality as Black women in America. The UCLA doctors concluded that a high Black infant mortality rate is not because the women are Black, but because they are Black in America: Which includes a lifetime of racism, poor environments, and chronic stress contributing to preterm labor and other factors.

By reading the bulk of reports, or watching popular documentaries like “The Business of Being Born” by Ricki Lake or “Pregnant in America” by Steve and Mandy Buonaugurio, it is easy to come to the simple conclusion that the labor and deliver medical practices in America should be changed to reflect other countries that do not use as many interventions. Interventions such as various induction procedures, drugs and surgery may be beneficial during emergencies but it is also noted that these same interventions often lead to emergencies. Cesarean delivery, also known as a C-section, is a surgical procedure used to deliver a baby through an incision in the mother’s abdomen and a second incision in the mother’s uterus. The United States has a 33 percent C-section rate, one of the highest in the world. It carries the risks of major surgery, including the heightened risk of breathing problems for baby and infection, blood clots and higher risk for future pregnancies for the mother as opposed to a natural preferred vaginal birth. This lends a hand to our high Black infant and maternal mortality rates. But there may be a simple solution to save our future.

Dr. Joy Lawn, a pediatrician, states, “Training more midwives and other community health workers could save the lives of many more babies.” In the U.S., midwives only attend approximately 8 percent of births, they attend approximately 75 percent of births in Europe and other industrialized countries. WebMD reports that births attended by a midwife had a 19 percent lower infant death rate and a 31 percent lower risk of delivering a low birth weight baby. Certified nurse-midwives are registered nurses who have graduated from a nurse-midwifery education program and have passed a national certification examination. The Midwife Alliance of North America website says statistics show births attended by midwives have lower infection rates, lower C-section rates, fewer complications and healthier outcomes—thus, lower overall medical costs—than physician-attended hospital births.

A woman should be revered and when a woman is with child it is a critical time, she should be tended to, looked after and cared for by not only by the man in her life, but by the entire “village” or community. The circumstances of the pregnancy are irrelevant; the fact is a baby is present and both mother and baby require an unstressed and loving environment. She must be well-informed and educated on what to do and what not to do and choose a health care provider that is truly concerned for her and her child’s well-being. Many of us in the Black community are in public health or are nurses and other health care providers, we need to save ourselves, educate and attend to our young parents and mothers-to-be of all ages. Let’s be a sisterhood and brotherhood of support, our future is at stake.

“Mothers, the newborn and children represent the well-being of a societyand its potential for the future. Their health needs cannot be left unmet

without harming the whole of society.” Lee Jong-wook, Director-General, World Health Organization, 2003-2006

Jamila X Toranzo is a doctoral student at Tennessee State University.