Racism + Black Women + PreTerm Labor

African-American women are significantly more likely to lose a baby in the first year of life than white women, in an enduring medical mystery. It exists at all income and education levels, but is widest among more affluent, highly educated women. A college-educated black woman in the United States is more likely to lose her baby than a white woman with only a high school education. An African-American woman who starts prenatal care in her first trimester is more likely to lose her baby than a white woman with late or no prenatal care. A black woman who does not smoke has worse birth outcomes than a white woman who smokes. Read more here.

 

 

 

I am currently in the ninth month (36 weeks) of my third pregnancy. At 33 weeks I experienced the biggest scare of my life when I began to show signs of preterm labor. On Sunday night, during one of my fifteen nightly trips to the bathroom, I noticed I was spotting. I told myself I would wait until the morning to see if the spotting continued. Sure enough I woke Monday morning, with heavier spotting, unusual pelvic pressure, and contractions. I immediately called my midwife and was given a 9:00 am office appointment. At the appointment I was placed on the tocodynamometer to monitor any contractions. After an hour of showing no signs of contractions, I was given a fetal fibronectin test (FFT). During this exam my midwife noticed the bleeding and said I was 2cm dilated. She gave me a speech about the data showing Black women have high rates of preterm labor, but Black baby girls in NICU fare better than any other race of babies. At the end of her disquisition she got on the phone with the hospital to tell them she was sending me with my FFT to get a sonogram, steriods, and blood tests.

In the end, I had a negative FFT, but was put on modified bed rest for three weeks (until week 35). This experience lead me to do more research on the disparity pre term births in African American women. Below are some of the facts I've found during my preliminary research.

 

What is preterm labor?!

Preterm labor is the birth of a baby at less than 37 weeks gestation. According to the CDC's website here,

"an estimated 15 million babies are born too early every year. In 2014, preterm birth affected about 1 of every 10 infants born in the United States... Preterm birth is the greatest contributor to infant death, with most preterm-related deaths occurring among babies who were born very preterm (before 32 weeks). Preterm birth is also a leading cause of long-term neurological disabilities in children. A developing baby goes through important growth during the final weeks and months of pregnancy. Many organ systems, including the brain, lungs, and liver need the final weeks of pregnancy to fully develop."

What are the consequences of preterm birth?!

There is a higher risk of serious disability or death the earlier the baby is born. Some problems that a baby born too early may face include—

Preterm births also may cause emotional and economic burdens for families. Learn more about preterm birth.

What are the stats worldwide?!

Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born (Source). In 2014, the premature birth rate in the United States was about 9.6%. The percentage of premature births in the United States has decreased 8% since 2007; however, large differences in risk of preterm birth remain for racial and ethnic groups. In 2014, black infants were about 50% more likely to be born preterm than white, Hispanic, and Asian/Pacific Islander infants. 

The infant mortality rate among black infants is 2.4 times higher than that of white infants, primarily due to preterm birth. In the United States, the risk of preterm birth for Non-Hispanic black women is approximately 1.5 times the rate seen in white women. 

The 10 countries with the greatest number of preterm births:

  • India: 3 519 100
  • China: 1 172 300
  • Nigeria: 773 600
  • Pakistan: 748 100
  • Indonesia: 675 700
  • The United States of America: 517 400
  • Bangladesh: 424 100
  • The Philippines: 348 900
  • The Democratic Republic of the Congo: 341 400
  • Brazil: 279 300

The 10 countries with the highest rates of preterm birth per 100 live births:

  • Malawi: 18.1 per 100
  • Comoros: 16.7
  • Congo: 16.7
  • Zimbabwe: 16.6
  • Equatorial Guinea: 16.5
  • Mozambique: 16.4
  • Gabon: 16.3
  • Pakistan: 15.8
  • Indonesia: 15.5
  • Mauritania: 15.4

Why are African America women more prone to preterm labor?

"The more complex answer, some researchers say, has to do with stress - not only during pregnancy but during a lifetime of being black in America. Stress elevates certain hormones that are known to trigger labor; it may increase susceptibility to infections that are linked to premature delivery." {Source here}

As I do more research on the topic I will post interesting findings on the blog. Until then be well, stay healthy, and enjoy each day as if it were your last.