For many women, nothing could be more painful than losing a child. But that’s exactly what happened to Dr. Sharon Ingram, a board-certified OBGYN in Florida. She was in medical school when her four-month-old son passed away from sudden infant death syndrome (SIDS) at a local daycare center.
She lost her first-born nearly 20 years ago, but it’s a day she’ll never forget. “I dropped out of medical school because I thought that I should have been not studying,” Ingram said to ABC this week. “I thought I should have been with him because maybe I could have made a difference, although I know now that you cannot.”
Ingram’s story spotlights a common trend in the U.S. Black babies are around twice as likely to die than their white counterparts during the first few years of life. The CDC estimates that around 20,000 infants die every year from a range of issues, including disorders related to low gestation, congenital deformities, and everyday accidents.
To highlight the problem, April 11th to the 17th is now known as Black Maternal Health Week in the U.S. The event was founded by the Black Mamas Matter Coalition (BMMC) as a way of deepening our understanding of these problems, so we can work towards a more equitable future where mothers don’t have to worry about losing their children unexpectedly.
Saying Goodbye to Her Son
Alton Jr., or A.J. as the family called him, died just before his first birthday. Looking back on his death, Ingram now realizes her baby faced a higher risk of infant mortality simply because he was black.
“A.J. wasn’t sleeping on his belly, I had prenatal care, he wasn’t low birth rate, but there were still some risk factors that we overlooked,” she said. “One, I was black, two, I had a son, and, three, he passed away in December, in a cold climate.”
Ingram remembers being shocked when her race was listed as a risk factor for infant mortality.
It’s a trend that has persisted in the U.S. for years.
“If we look at the last five years, we are doing a good job at decreasing the infant mortality rate in general but the gap [between black and white babies] is still there, so though the overall rate is going down, the gap is still double,” Ingram said. “It makes you step back and say, ‘Why is this happening?’”
The Office on Minority Health from the U.S. Department of Health and Human Services says that black babies are four times as likely to develop complications due to low birth rate and are over twice as likely to die from SIDS compared to non-Hispanic whites.
Why Black Babies Are More at Risk
Ingram sees implicit bias and institutional racism as part of the problem. Black women are less likely to receive prenatal care than their white counterparts. The CDC says black women are more than twice as likely to die during childbirth or during the months after than white, Asian, and Latina women. This trend holds true across education and income levels.
Studies show black women have a 70% greater risk of severe maternal morbidity during pregnancy after adjusting for co-factors.
Stress, discrimination, and healthcare inequalities all contribute to the problem. Even if a black woman is healthy, her baby may still be at risk.
Rachel R. Hardeman, Ph.D., an associate professor at the University of Minnesota School of Public Health and founding director of the Center for Antiracism Research for Health Equity, spoke about how racism can affect the mother’s physical health.
“What we know is that the stress and the cumulative disadvantage of racism throughout the life course brings black women into pregnancy at less than optimal health. It’s literally sort of the wear and tear on the body, a chronic stress that’s taking a toll on the body and prompting these biological changes in many women that then affect their health and the health of their babies,” she said.
Hardeman adds that implicit bias among providers only makes the situation worse. “And not only that, but then they come into a health care system that historically has not provided equitable care to black people.”
Supporting Black Families
The BMMC created Black Maternal Health Week four years ago to help address these issues. This week, the organization got its wish when the White House officially marked the event on the calendar via a presidential proclamation.
Vice-President Kamala Harris was on hand to honor the occasion.
“Over the years, I’ve heard many stories. Stories of women who are experiencing postpartum depression, only to be dismissed. Stories of women telling their doctors they were experiencing pain, only to be ignored. Stories of women who could not hold their newborn baby because that child had to be on life support or receive a blood transfusion after blood transfusion after blood transfusion,” she said during a roundtable with community organizers.
“Black women deserve to be heard. Their voices deserve to be respected, and like all people, they must be treated with dignity,” Harris added, while describing the situation as a “maternal health crisis.”
The Biden Administration plans to invest $200 million in racial bias training among healthcare providers as part of the American Rescue Package, which was signed into law last month.
Hardeman published a landmark study last year that found black newborns’ in-hospital death rate was 58% lower when black newborns were cared for by black physicians rather than white physicians, but still remained higher than that of white newborns.
“We’re not talking about individual racist physicians who are doing bad things to black infants. That’s not at all what we’re seeing here,” Hardeman added. “What I think we’re seeing are health care delivery systems where racism is baked into all aspects of the system.”
Increasing diversity and training providers to be sensitive to implicit bias should help reduce these disparities. “We have to be willing to reimagine what care should look like for black birthing people and for everyone,” Hardeman said. “I think there’s a real opportunity to rethink how we’re doing things versus sort of plugging the holes or stopping the bleeding.”