African American Women & Pregnancy

A look at health disparities facing African American women

during pregnancy in the U.S.

Maternal Mortality Black women in the US are almost 4 times more

likely to die of pregnancy-related causes than white women.

Black women have a higher risk than white women for dying from every pregnancy-related cause of death reported, including the three leading causes (i.e., hemorrhage, pregnancy-induced hypertension, and embolism).

In a study from 1987-1996 Maternal Mortality (MMR) for blacks ranged from 8.7-28.7 in 26 states, whereas the MMR for whites ranged from 2.7-9.2 (CDC).

Infant Mortality Rate of infant mortality for U.S. Non-Hispanic

black women in 2005:13.63/1,000 live births (a slight increase from 2000’s 13.5), a higher rate than any other minority or ethnicity in the country (CDC).

The rate of infant mortality for white women:

5.7/1000 live births.

Black women with college degrees had higher rates of infant mortality than white women who were high school drop outs (10.2 vs. 9.9)...Education is not a predictor of good birth outcomes for African American women. Kim Anderson is an example of this.

Our government originally set a goal for infant mortality of all races to be at 4.5 per 1000 by 2010...

Low Birth Weight- Genetic?

Infants born to African American women are twice as likely to be born low birth weight and 3.9 times more likely to die from complications due to low birth weight.

In a study comparing African American women to African Immigrants and White women, they found African American women on average, having baby’s that weighed 8-9oz less than the similar rates of African Immigrants and White women. Within a year of living in the U.S., the African Immigrants rates were closer to the African Americans

Oklahoma PRAMS Study Infant mortality rate in Oklahoma for Black women from

2004-2006 was 15.1 per 1000 live births compared to 6.5 per 1000 live births in White women.

Black women were less likely to use tobacco or alcohol during pregnancy, however the rate of smoking during pregnancy in Black women increased significantly from 1996-2006.

Black women are less likely to take a multivitamin prior to pregnancy.

Pregnancies are more likely to be unintended for Black women than White women.

Black women are as likely to receive adequate levels of prenatal care as White women.

Early Motherhood U.S. has the highest rate of teen birth in the

world: 41.9 live births per 1,000 teens (age 15-19) gave birth in 2006 (UNFPA).

The rate of black teens giving birth in 2006 was 63.7 per 1,000 teens and for white teens, 26.6 per 1,000 teens (In 1991, rate for black teens was 118!)

Between 2005 and 2006, birth rates

increased 3 to 5 percent both for non-Hispanic white and non-Hispanic black.

A recent study found that the public costs of teenage childbearing in the U.S. are about 9.1 billion annually

Daily Stress Researchers are beginning to look into the

effects of racial stress on women of color as a reason for high rates of preterm labor. Chronic stress can wear on one’s hormonal system, immune inflammatory functions and metabolic efficiency.

It is thought Cortisol flowing through a stressed

mother, likely enters the fetus, causing it to mature faster, be born preterm and of low birth weight while causing poor prefrontal cortex brain development and behavioral problems in the future.

A study done in 2008, found a correlation between prenatal psychosocial stress and an increased chance of the offspring developing insulin resistance in adult life.

Breastfeeding Rates Black women have the lowest rates of breastfeeding in the

country (65% NHB, 80% MA, 79% NHW) In 2008 65% of African American women reported ever

breastfeeding (in 1975 it was 35%)

20% reported of breastfeeding at six months

Only 9.8% were exclusively breastfeeding at six months

There are many theories as to why African American’s within the U.S. have the lowest rates of breastfeeding such as...

Lack of support from partners and family. Grandmother support is key in successful breastfeeding.

Less access to resources and education More pressure to return to work shortly after the birth of their

child, do to financial pressure A historical association to slavery, when African American

women were forced to serve as wet nurses, made women from previous generations (our grandmothers and mothers) use formula as a statement of defiance against cultural defamation.

Insurance A recent study found women age 25

are charged up to 84% more for health. insurance coverage than 25 year old men

In 2007, 10.4% of white people were medically uninsured vs. 19.5% of black people.

The uninsured rate of white children in 2007 was 7.3% vs. 12.2% of black children.

Words from Michelle Obama

“When insurance companies deny coverage to women for preexisting conditions or refuse to cover treatment, it can devastate an entire family. When women make less than men for the same work, that hurts families who find themselves with less income and have to work harder just to get by. And when employers don’t allow employees the flexibility to care for their family, that hurts children, it hurts grandparents, it hurts husbands, and it puts a strain on an entire household.”• Michelle Obama, Women’s Summit, June 1, 2010

The JJ Way

Jennie Joseph, a British-trained midwife who practices in Florida, has created an effective prenatal form of care that has reduced low-birth-rate and preterm birth among the at-risk women she works with (mostly African Americans and Hispanics).

Focuses on bonding, support, encouragement, empowerment for mom and partner.

One year study, 12/2006-12/2007, 100 uninsured women received the, “JJ Way” prenatal model of care. Results: of the 30 African American women involved in the study ALL delivered >37 wks with infant of normal birth weight (5 lbs 8 oz).

Steps toward Improvement More research on racial

stress More blogs for African

American women More programs geared

toward African American women and teens

Use of JJ’s Way Nation-wide

National policy on paid maternity leave

My Sources Schulma, Kori. The White House Blog:Posted June 01, 2010. Women’s Summit,

Reno NV http://www.whitehouse.gov/blog/2010/06/01/keep-moving- forward Harutyunyan, Ruzanna. Pregnant African American Women Face Health Care

Barriers. 10/25/2008 http://www.emaxhealth.com/2/89/25795/pregnant-african-american-women-face-health-care-barriers.htm

Harutyunyan, Ruzanna. Pregnant African American Women Face Health Care Barriers. 10/25/2008 http://www.emaxhealth.com/2/89/25795/pregnant-african-american-women-face-health-care-barriers.htm

Bezruchka, Steven. Powerpoint: “Public Health For Midwives: Societal Midwifery.” Departments of Global Health & Health Services, School of Public Health, University of Washingto. Presented 5/25/10 at Seattle Midwifery School.

Sondik, Edward. “Breastfeeding in the US: Findings from National Health and Nutrition Examination Survey 1999-2006” CDC http://www.cdc.gov/nchs/data/databriefs/db05.htm

CDC “State specific maternal mortality among black and white women rom 1987-1996.” 06/1999 <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4823a3.htm>

DeNavas, Carmen. “Income, Poverty and Health Insurance Coverage in the US, 2007.” Issued August 2008 US Dept of Commerce.

Oaklahoma PRAMS study: Oaklahoma State Dept of Heath 2004-2006 <www.ok.gov/health/documents/African%20Am_Sept_08.pdf>