Category Archives: Perinatal Disparities

The perinatal morbidity and mortality disparities in this country are a crime. Black women and babies suffer the most and we need to talk about it!

Infant Mortality – Its Far Too Early to Celebrate

Last week, I got an email that made me really pause and take a deep breath.  It started like this…

“FOR IMMEDIATE RELEASE:

 AMCHP Celebrates 12 Percent Decline in U.S. Infant Mortality Rate Since 2005 – Calls for Continued Funding to Accelerate a Promising Trend

Washington, DC, April 17, 2013 – Today, the Centers for Disease Control and Prevention (CDC) released new data showing that following a plateau from 2000 through 2005, the U.S. infant mortality rate declined 12 percent from 2005 through 2011. A copy of the data brief entitled Recent Declines in Infant Mortality in the United States, 2005–2011 is available here. 

Michael Fraser, PhD, CAE, Chief Executive Officer for the Association of Maternal & Child Health Programs, highlighted this progress with the following statement:”

Now… Before I get to the statement… In case you don’t know, AMCHP is the Association of Maternal and Child Health Programs.  Their mission “is to support state maternal and child health programs and provide national leadership on issues affecting women and children.” You can learn more about them and what they do by visiting their website.

Below is the statement from Michael Fraser.  I have included the statement here in its entirety along with some commentary from yours truly… My comments are in green :-)

“The recent decline in infant mortality is a public health success story deserving national recognition and celebration. In short, we are helping more babies reach their first birthday than ever before and this is great news. (Sure its good news that the rates are declining but is this REALLY a time for celebration? I believe it’s far too early to celebrate.  Our Infant mortality rate remains high and our international standing remains embarrassingly low. This may be a time for reflection on what is working so progress can continue but celebration… I think it’s too soon for that.) The decline is also a strong indication that public health efforts supported by the Title V Maternal and Child Health Services Block Grant – along with other critical programs including Medicaid, the Children’s Health Insurance Program, WIC, Healthy Start, Community Health Centers, and critical efforts of the CDC and the National Institutes of Health are making a difference in saving babies lives.  The work of dedicated public practitioners and health care providers is definitely paying off and, for that, AMCHP and its members are extremely thankful. (Interesting how this statement speaks to “critical programs” that nationwide are currently facing budget cuts. In Louisiana, where I live as an example, Healthy Start recently received a huge budget reduction (a  near 50% reduction from what I have been told) and the monies going to our state’s Nurse Family Partnership program were also cut.  Healthy Start across the country is facing budget cuts and many programs may not even continue to receive funding.  What’s going to happen as these programs are reduced further or cut out entirely? What will the numbers say in a few more years? I bet they will be begin to creep up especially if we take time to celebrate instead of continuing the fight.)  Perhaps most encouraging is that the infant mortality rate declined the most (16 percent) for non-Hispanic black women. This may be an indication that deliberate efforts to promote health equity are beginning to create progress in reducing the alarming disparities between whites and blacks, but despite improvement these gaps are still unacceptable and need heightened attention and investment to accelerate progress.   (Not only are the gaps still unacceptable, the disparity remains virtually unchanged. The infant mortality rate for black babies continues to be TWICE the rate of white babies… Are we celebrating too soon? I think so.) Furthermore, improvements realized in the last five years reflect investments policymakers made years and even decades before. While this improvement is welcome news, budget cuts coinciding with the economic downturn and the current sequestration cuts will undoubtedly create major challenges to sustain this success. (EXACTLY. That’s what I’m saying.  These budget cuts he speaks of will reduce this “progress”  so ummmmm riiiight…. Like I said… its far too early to celebrate.)  Accordingly, AMCHP calls on the administration and Congress to reverse years of eroded public health funding, agree on a balanced approach to deficit reduction, and sustain critical investments in the health of women, children, and families.”  (End of Statement)

And they do. In fact last month, Dr Christopher A. Kus, MD, MPH, testified on behalf of the Association of Maternal & Child Health Programs (AMCHP) before the House of Representatives about stopping budget cuts and allocating $640 million to 2014 funding budge for the Title V Maternal and Child Health (MCH) Services Block Grant. But the reality is, the budgets are getting cut and programs are being lost all across the country.  So as far as I’m concerned… Its definitely to early to celebrate. 

I will celebrate when the rates of infant mortality in ALL communities is at a minimum and there are no longer racial disparities.  I will celebrate when we have equal distribution of health services and resources across all boundaries. When access is not tied to race or socio-economic status and when all women have equal access and ability to create and nurture a healthy pregnancy.  I will celebrate when women, without fear or coercion, without jumping through managed care hoops, and regardless of her insurance carrier can easily choose the provider and location for HER birth.  Then and only then will I celebrate. When I see this reality, I will happily pop a bottle, light a candle, hire a second line band, shout from the roof tops and I might even “Drop it like its hot!!” Until then… The fight continues. #FistUP… Do you think its too early to celebrate?

Video

Returning Power to Birth ~ The 2012 Black Midwives & Healers Conference

Back in October 2012, I had the pleasure to attend the ICTC 8th International Black Midwives and Healers Conference.  If you were there… WHAT??!! You already know :-)

If you weren’t there… well… as is often the case with my blogging, I had plans to blog about the conference as we went along and blog again once I got home. Welp… that never happend. Ya just get kinda caught up in the moment of things.  Fortunately for me/for us… My Sista Midwife Walidah Muhammad is expanding her skill set beyond the birthing bed to documentary creation. I LOVE it!!! Soooo with that said… take a look at the videos below. There is no way these clips can bring you the full energy of what we shared, did, learned, and felt during this conference. But perhaps they will give you a glimpse and help you understand what a gem the International Center for Traditional Childbearing is for all of us!

We… who believe in freedom cannot rest

Health Programming and Its Impact on Black Infant Mortality

Welcome to the Third Edition of the Black Birth Carnival. Hosted by Darcel of The Mahogany Way Birth Cafe and Nicole of Musings From The Mind of Sista Midwife.   The Topic: Infant Mortality Awareness: Saving OUR Babies. Many birth workers are talking about the alarming infant mortality rates in this country, but none are talking about infant mortality in the Black Community. That’s where this Blog Carnival comes in. We will talk about statistics, try to figure out why, and most importantly what we can do to help lower our infant mortality rates.   This post will be updated with live links by Noon, linking back to the other participants posts.

Below is a Guest Blog Post submitted by Amy Hereford especially for this blog carnival. After reading you can read my article for this carnival HERE.

Blacks babies under age one tend to die at more than two times the rate of white babies. Regardless of the increased educational, socioeconomic, and political power of US blacks, this rate difference has held steady for more than 40 years (http://www.minoritynurse.com/health-care-access/spotlight-infant-mortality-crisis).  Infant mortality data is representative of a country’s overall health and well-being. It is a way to quickly gauge how well a country treats its citizens by reviewing the death rates of its most vulnerable—which are babies under one year of age. Since black babies consistently die at double the rates of white babies, the entities responsible for healthcare in the US are charged with absorbing the message, forging new solutions and building action. However, many federal, state and local authorities are out of answers, stuck on old-world solutions, or simply don’t care.

The general understanding in public health is that health behaviors—what we know and do—have the most immediate impact on our overall health. We saw this with polio: if an individual gets a specific shot, that individual will not get polio. In fact, most of our ideas about public health stem from medical interventions doled out to the masses which end up improving community health. As the world becomes increasingly familiar with healthcare advances and new, life-saving technologies, we get more and more used to fast health improvements: identify a problem; sit down with leaders to come up with a solution; disseminate that solution; chart the impact; see improved health and move on to the next problem. It has not worked this way for those trying to improve rates of black infant deaths.

A lot of the responsibility for what we can do as a country to improve these numbers has fallen on the shoulders of pregnant women, and the nurses and doctors who treat them. Research done in the ‘70s, ‘80s and ‘90s linking infant deaths to maternal behaviors—like smoking, drinking, baby sleep positions—set up a relationship between health programmers and doctors; the health programmers collect information nationally and disseminate life-saving findings to doctors who, in turn, provide these interventions to their patients.While this form of information dissemination has helped to decrease the overall US rate of infant mortality, it has done very little for the rate difference between black and white infant deaths.

This is a hard pill for most health programmers to swallow. Health programmers are the policy and programming wonks that sit at the decision-making tables within federal, national, state and community authorities that make decisions about the services, initiatives and resources within our nation’s cities and counties. How could so much information be disseminated, so many services made more accessible, and still have such disparity between black and white infant death? One researcher, Michael Lu (http://www.arc.org/racewire/030210z_kashef.html), back in the early 2000s, found an answer that not many health entities were expecting. He found that racism, and the stress from racism, contribute to this disparity. Dr. Lu found that regardless of a black woman’s educational level, positive health behaviors, or socioeconomic status her baby still had double the chance of dying before age one compared to white women. Dr. Lu attributed his findings to racism and the mother’s stress associated with racism.

I was working within maternal and child health with a national physician organization as a health programmer. I remember the various cascades of surprise as Dr. Lu’s research on racism and the deathly effects it has on black infants began to be disseminated at conferences, in newsletters and between colleagues. No one knew what to say. In most  professional settings, unless you wanted trouble, racism and prejudice were hardly mentioned (out loud). So, for health programmers to address racism… Well, how were we supposed to do that, especially if the racism Dr. Lu found as life-threatening wasn’t even coming from the doctors or nurses serving the pregnant patients? It was coming from everywhere; where the women worked, where they lived, where they shopped; wherever they encountered racism whether perceived or real.

The research on racism and its effects on birth outcomes has been out for almost 10 years and more and more research has been—and is being—developed that adds to or confirms Dr. Lu’s original research. But, still, there is very little focus from health programmers on how to aim their efforts on racism and reduce its impact on pregnant black women. There are many reasons for this.

First, the people sitting around the decision-making table may be racist themselves and struggling with motivation to move the project in life-saving directions.  As a black woman and in my career as a health programmer, I had one supervisor who—regardless of how nice I tried to be—always questioned me on whether I was angry about this or that, and once even called me “hostile.” This is one man that I would say “is not ready” to provide input into what can save the lives of black infants. However, he was a leader at the office and trusted by his authorities and funders even though my personal experiences with him and my own survival sense pegged him as racist.

Secondly, many health programmers may suffer from inertia, meaning that they are so focused in one direction (say, for instance, smoking cessation) that they no longer know how to think on other solutions for pregnant women. I recently ran across this phenomenon at a local nonprofit that serves pregnant women. There was a befuddled leader who was convinced that the best way to reach young black women was through the church, Afrocentric storytelling, and traditional African garb. This kind of health programming was innovative in the ‘80s and ‘90s and probably not really effective then either. Current research did not interest this leader. She knew what she wanted to do, regardless of what the research was saying about black infant mortality.

Lastly, the general racism that shows up on jobs tends to run counter to establishing the best health programs. For instance, I’ve worked for about eight different agencies over a 15-year span of time; at more than half of them I was placed on the black health committee regardless of whether I was interested in doing that work or not (I was). Others sitting around the table didn’t care about what we were discussing, doing, or planning. At each one of these organizations, leadership did not place these committees as a high priority even though many were being funded to innovate around healthcare solutions for black Americans.

Health programming innovation is not happening at the planning tables, communities, or on the national scene. On top of that, racism is a very powerful force. Many organizations and people struggle with their own issues surrounding this hot-button topic. Decreasing the difference between black and white infant mortality rates is going to take willingness and an ability for health programmers to brave new frontiers in health interventions. Perhaps this frontier, racism and its effects on health, is the scariest for American health programmers to discuss, due to the history of America and our tendency to not talk about it. But just like what is hinted at in the research of Dr. Lu and all of the other researchers finding similar evidence, health interventions directly addressing racism at work, school, and within our own souls is bound to do the most good and have truly lasting impacts on the health of black babies and black communities; which is bound to have totally positive impacts on America as a nation.

****
Please take the time to visit the other participants posts. They are very thought-provoking and each woman has written about amazing solutions for lowering the Infant Mortality rate in the Black Community.

Amy: Health Programming and It’s Impact on Black Infant Mortality. Guest Post on Musings From The Mind of Sista Midwife.

Darcel: Black Infant Mortality and Your Responsibility. The Mahogany Way Birth Cafe

Nicole: Stop The Talking… Implement SOLUTIONS! Sista Midwife Productions

Darline Turner-Lee: Standing For Little Brown Babies By Supporting Their Mothers. Mamas on Bedrest & Beyond

Monday Musing – still no lights / Our babies are dying

So this evening I sit using my cell phone to write a quick post for an evening Monday Musing.  I am using my phone and will post this without ever seeing it on a computer screen. This is not something I normally do but since I still have no power since Hurricaine Isaac *SCREAMING* its my only option. Yes I could go to a friends who has power but they are dealing with their own mess and that’s not really the issue. I had plans to write a really nice post about the fact that today all across the country women protested for women centered care for the Improving Birth Rally as a part of Empowered Birth Awareness Week.

My post was not going to be really about these rallies directly  but was going to be more about the fact that this is the beginning of Infant Mortality Awareness Month and most of the women participating in those protests don’t even realize it. I applaud the organizers for their work they have done to empower women to have better birth experiences. Their work helps all women and were it not for Isaac I would have participated here in Louisiana.  Mother friendly care can have a positive impact on infant mortality.

I know that some of the women who participated nation wide may have known but as I purused the facebook pages and websites…. Not one word. Not one solid word about the fact that its Infant Mortality Awareness month.Not one slogan for a sign that mentioned the connection between infant mortality and quality care.

Am I fully surprised? Not really and that’s the unfortunate part. It brings me back to some posts that asked the question “when will you care?” When will you care that the United States ranks behind 40 other nations when recent infant mortality  stats are compared.  When will we get a national rally to save OUR babies who die greater than twice the rate of white babies???  When will you care??

I would link to it… but since I’m on my PHONE.   WITH. NO. POWER and no real internet access….! I will invite you to search for it in my archives *_*

Its a real question.though When will you care? And if you rallied today… Honestly… Did you know it was Infant Mortality Awareness Month?

#BlackBirth Carnival Call For Submissions: Infant Mortality Awareness – Saving OUR Babies


Hello and Welcome to the Third Edition of the Black Birth Blog Carnival: Infant Mortality Awareness – Saving OUR Babies. Hosted by Darcel of The Mahogany Way Birth Cafe and Nicole of Musings From The Mind of Sista Midwife.The Black Birth Carnival has been amazing in so many ways. Whether you participate by blogging, or sharing on various social networks, we thank you for joining us in talking about and celebrating Black Birth.

Have you missed the previous Black Birth Carnivals? If so you can read the first installment - Birthing While Black and the second installment, Not Without Our Fathers now.

While we normally hold the carnival on the 2nd Tuesday ofthe month, we will run this carnival on the 3rd Tuesday of the month, September18th in order to give respect to those affected by September 11th.

It’s no secret that the Black Community has the highest rate of infant mortality. Black babies are more than two times more likely to die than White babies before their first birthday. A very sobering statistic. There are MANY causes for this disparity, including low birth weight, prematurity, SUIDS(sudden unexplained infant death syndrome), maternal complications, lack of prenatal care, and even racism.

If you search the internet you will find article after article on our high infant mortality rates.While the numbers are good to know and helps us learn, there don’t appear to be many articles on ways to reduce Black Infant Mortality from the perspective of Black women and men. That’s where this blog carnival comes in!

We are inviting you to share with us your thoughts on infant mortality in the Black Community. When did you first become aware of infant mortality rates in the black community? Did you even know it was a concern? Do you know the rates for your specific state or country? What do you think will help to lower our infant mortality rates? Does your birth community do anything special for the month of Septermber for Infant Mortality Awareness Month? How can we raise awareness and make our voices heard on this very important subject? What can we do as a community to save OUR babies? We want to hear from you!
No voice is too small to be heard! If you are a black mother, or father we want to hear from you. Don’t have a blog and want to write? We can host you on one of our blogs.

You do not have to answer all of the questions above in your post, we are just throwing out possible writing prompts.

 What is a Blog Carnival?

A blog carnival is a collection of blog posts from a variety of bloggers on a particular subject, published on the same day. This blog carnival will be published/go live on Tuesday Septermber 18thh. In addition to posting his/her article, each blogger provides links to all of the other posts submitted. Because of this, blog carnivals are a great way to learn about other fabulous bloggers. They give you an opportunity to connect with others and have the potential to increase traffic to your blog. If you do not have a personal blog and want to participate, please email us ASAP at BlackBirthCarnival at gmail dot com so that we can find a host blog for your article submission.

Guidelines and Instructions for Submissions

We are looking for posts that are well written, informative, thought provoking and relevant to the theme of the carnival. We prefer that you submit a new, unpublished post for the carnival however, if you feel you have the“perfectpost” that has been previously published we will accept it.

Please email your post to us at BlackBirthCarnival at gmail dot com no later than Tuesday, september 11th Be sure to put September Carnival in the subject line of the email and don’t forget to give us the title of your post. We cannot accept your submission without a title.

You will receive an HTML code with instructions via email no later than Saturday, September 15th. You will need to place this code in your blog post so that you will link up with all of the other blogs participating in the carnival. For the success of the carnival, it’s important that you add this code. Please do not publish your post until after midnight on the 18th. We are excited about this new Blog Carnival and we look forward to receiving your submissions.

In Birth and Love Darcel & Nicole
Follow us on Twitter @MahoganyWayMama & @Sistamidwife
Twitter hashtag #BlackBirth