September 4th, 2009 
September is Infant Mortality Awareness Month. As a country we are failing our babies miserably. Too many never make it to their first birthday. An estimated 2 million babies die within their first 24 hours each year worldwide, and the United States has the second worst newborn mortality rate in the developed world, according to a recent report by Save the Children.
Diving into the report’s stats only darkens the picture: American babies are three times more likely to die in their first month than children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland, or Norway. Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which ranks near the bottom of industrialized nations, tying with Hungary, Malta, Poland, and Slovakia with five deaths per 1,000 births.
Although the newborn mortality rate in the United States has fallen in recent decades, it continues to disproportionately affect people of color, especially African Americans. Only 17 percent of all U.S. births were to African American families, but 33 percent of all low-birth-weight babies were African American, according to the report.
Indeed, the statistics on black babies are the most dismal of all. African Americans have 2.3 times the infant mortality rate of non-Hispanic whites. Black babies are four times as likely to die as infants due to complications related to low birth weight as non-Hispanic white infants. Other sobering statistics from the CDC:
- African Americans had 1.8 times the sudden infant death syndrome mortality rate as non-Hispanic whites, in 2005.
- The infant mortality rate for African American mothers with over 13 years of education was almost three times that of non-Hispanic white mothers in 2005.
This last statistic shows that education does not help protect black babies from poor birth outcomes like it does other ethnic groups, and poses a unique question about how to reverse the tide and save more black babies.
One of the theories being put forth by researchers is that black women tend to enter pregnancy unhealthy and overstressed and cannot reverse years of unhealthy habits and unresolved stress in the 40 weeks of pregnancy. The result is babies who are born too soon or too small – both avoidable outcomes. “In countries where mothers do well, children do well,” Charles MacCormack, president and CEO of Save the Children, said in a written statement accompanying the report.
As a country we have to figure out how to address this problem. Obviously teaching black women – and all women whose pregnancies are at risk in this country – to live healthier, less stressful lives isn’t going to happen overnight. And I don’t expect the government to figure out how to save our babies, or at least, I’m not willing to wait that long. As mothers, whose lives are all interconnected, we have to figure it out.
I’m going to fight it with the stories I write, the issues I bring up, and the positions I take. I’m also going to fight it with my pocketbook. This month at MochaManual.com we’re donating 50 percent of all our sale proceeds to the March of Dimes to further their research to help all of us have healthier babies. If you want to help me help us, click here to shop our line of maternity and new Dad tees, baby Onesies, gift baskets, and Mocha Manual books to help a worthy cause or just make your own donation to the March of Dimes.
Related
- Father involvement in pregnancy could reduce infant mortality
Studies have shown fathers who are active in their children’s upbringing can significantly benefit their children’s early development, academic achievement and well being. Now, a new study by University of South Florida researchers suggests that a father’s involvement before his child is born may play an important role in preventing death during the first year of life – particularly if the infant is black.
The USF team sought to evaluate whether the absence of fathers during pregnancy contributes to racial and ethnic disparities in infant survival and health. Their findings were recently reported online in the Journal of Community Health.
“Our study suggests that lack of paternal involvement during pregnancy is an important and potentially modifiable risk factor for infant mortality,” concluded the study’s lead author Amina Alio, PhD, research assistant professor of community and family health at the USF College of Public Health. “A significant proportion of infant deaths could be prevented if fathers were to become more involved.”
The researchers examined the records of all births in Florida from 1998 to 2005 – more than 1.39 million live births. Father involvement was defined by the presence of the father’s name on the infant’s birth certificate. While this measure does not assess the extent or quality of a father’s involvement during pregnancy, other studies have established a link between paternal information on a birth record and prenatal paternal involvement.
Among the study’s findings:
- Infants with absent fathers were more likely to be born with lower birth weights, to be preterm and small for gestational age.
- Regardless of race or ethnicity, the neonatal death rate of father-absent infants was nearly four times that of their counterparts with involved fathers.
- The risk of poor birth outcomes was highest for infants born to black women whose babies’ fathers were absent during their pregnancies. Even after adjusting for socioeconomic differences, these babies were seven times more likely to die in infancy than babies born to Hispanic and white women in the same situation.
- Obstetric complications contributing to premature births, such as anemia, chronic high blood pressure, eclampsia and placental abruption, were more prevalent among women whose babies’ fathers were absent during pregnancy.
- Expectant mothers in the father-absent group tended to be younger, more educated, more likely to never have given birth, more likely to be black, and had a higher percentage of risk factors like smoking and inadequate prenatal care than mothers in the father-involved group.
Paternal support may decrease the mother’s emotional stress, which has been linked to poor pregnancy outcomes, or promote healthy prenatal behavior, Dr. Alio suggested. For instance, some studies, including USF’s, indicate that pregnant women with absent partners are more likely to report smoking during pregnancy and get inadequate prenatal care. Barriers to expectant fathers’ involvement in the lives of their pregnant partners, including issues like unemployment, relationship status, and participation in prenatal visits, must be examined to increase the role of men during pregnancy, she said.
Improving the involvement of expectant fathers holds promise for reducing costly medical treatments for the complications of premature births as well as reducing infant mortality rates, particularly in black communities, Dr. Alio said. “When fathers are involved, children thrive in school and in their development. So, it should be no surprise that when fathers are present in the lives of pregnant mothers, babies fare much better.”
- July is Cord Blood Awareness Month
July has been designated Cord Blood Awareness Month by the National Health Information Center and a society of the American Hospital Association, with the goal of educating others about the medical value of cord blood stem cells. To recognize the occasion, throughout the month The Stem Cell Source will be highlighting useful information and resources for parents who want to learn more about cord blood banking.
While awareness of the medical value of cord blood stem cells is on the rise, the need for more education remains. According to a 2006 study published in the Journal of Reproductive Medicine, three out of four expectant mothers who have heard of cord blood banking consider themselves minimally informed.
The need for greater education was the driving force behind the creation of the Cord Blood Education Center, an online program that informs expectant parents about their options for cord blood. Developed by Cord Blood Registry with input from healthcare providers, stem cell researchers and experts in public banking, the program describes all of the options available to expectant parents and is designed to give them access to information early enough in pregnancy so that they can make an informed choice about the storage, donation or disposal of their newborn’s cord blood stem cells.
Even if you are aware about cord blood stem cells, you may not know all of the facts. Take a moment to explore the Cord Blood Education Center and be sure to pass it on to others who can benefit from cord blood education.
- Women are becoming mothers later worldwide
First-time mothers are getting older across the country and around the world, according to new federal data released today that show the average age of new moms increased to 25 in the USA and 29 in several countries, including Japan and Switzerland.
The report from the National Center for Health Statistics on this trend in delayed childbearing compared statistics from 1970 and 2006. In the USA, it found dramatic increases in the average age during the 1970s and 1980s and a less dramatic but steady rise since.
The average age increased in all states and the District of Columbia and for all racial and ethnic groups. In 2006, Massachusetts, at 27.7 years, had the highest average age at first birth and Mississippi had the lowest at 22.6 years.
Elizabeth Gregory, director of the Women’s Studies Program at the University of Houston, says there are many reasons for the increase in age at first birth. She says the birth control pill, which debuted in the 1960s, allowed people to plan their families. Also, Gregory, 51, says increases in longevity have allowed people to start families later and “expect to be around to take care of them.”
For her 2008 book Ready: Why Women Are Embracing the New Later Motherhood, Gregory, an English professor, interviewed 113 moms who had first children later in life. She says many cited getting their education and getting established at work as reasons for a delay.
“They had to get to the point where they were making a decent salary and had the clout to negotiate a family-friendly schedule and not lose their seniority,” says Gregory, who had her first child at 39 and adopted a second daughter at age 48.
The proportion of first births among women age 35 and older increased nearly eight times between 1970 and 2006. In 2006, about 1 out of 12 first births were to women of 35 years or more, compared with 1 out of 100 in 1970.
At the same time, first births to mothers under age 20 dropped. Only 21% of first births were to teen mothers in 2006, compared to 36% in 1970.
However, the USA’s high teen birth rate is the reason the overall age at first birth isn’t as high as other developed countries, says T.J. Mathews, a co-author of the report.
Data from the United Nations Demographic Yearbook for 2006 shows that the teen birth rate in the USA was more than eight times higher than the birth rate in Japan, seven times higher than in Denmark and Sweden and more than three times as high as in Canada. The data compiled by the United Nations Statistics Division is based on annual questionnaires to more than 230 national statistical offices around the world, which include basic data on population trends, births, deaths, marriage and divorce.
The teen birth rate in the USA increased 3% in 2006, ending a 34% drop in births among women ages 15-19 from 1991 to 2005. Even with that long period of decline in the teen birth rate, Sarah Brown, CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy, says the new report illustrates how much more needs to be done to address the problem of teen pregnancy and teen births.
The federal report also found that among racial and ethnic groups in 2006:
- •The oldest average age at first birth (28.5 years) was to Asian or Pacific Islander women.
- •The youngest (21.9 years) was to Alaska Native women.
- •The age of 26.0 for white women at first birth is older than the average for the U.S. population at 25.0.
- •The average age at first birth for black women was 22.7 years.
- •The average age for first-time mothers was 23.1 years among Hispanics.
- Baby Crib Mirror – Black, White & Red- Infant-Stim
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Baby Crib Mirror – Black, White & Red- Infant-Stim - Black women at increased risk for weakened heart muscle at childbirth
Black women are at significantly increased risk for developing a potentially deadly weakening of the heart muscle around the time of childbirth, researchers report.
A study examining the incidence of peripartum cardiomyopathy in women who gave birth at a Medical College of Georgia’s teaching hospital between July 2003 and July 2008, showed that while 55 percent of the women were white, 93 percent of those who developed cardiomyopathy were black, said Dr. Mindy B. Gentry, an MCG cardiologist.
“When it hits, it’s totally unexpected because these are young, otherwise healthy women with young children. (They aren’t patients) you’d expect to have any sort of health problem much less heart failure,” Dr. Gentry said.
Other risk factors include hypertension, being unmarried, smoking during pregnancy and having more than two previous pregnancies, but African-American race was the most important predictor, said Dr. Gentry, corresponding author on the study published in the Journal of the American College of Cardiology.
Two previously published studies from Haiti and South Africa found a higher incidence of peripartum cardiomyopathy than in other parts of the world but essentially all the participants were black. The heterogeneous population giving birth at MCGHealth Medical Center made it easier to assess the effect of race, Dr. Gentry noted.
Further research is needed to identify potential environmental and/or genetic factors associated with African descent that explain the increased risk, the researchers said. They have begun follow up studies looking for any racial differences in healthy hearts following delivery, such as how much blood is ejected with each beat.
Peripartum cardiomyopathy typically occurs in the last month of pregnancy or the first few months after delivery. Symptoms include shortness of breath, particularly when lying down, as excess fluid congests the lungs and the rest of the body. The suffocating backlog is caused by an enlarged, stiff heart muscle that no longer pumps efficiently.
Drugs can improve pumping efficiency. About half the time, the condition spontaneously reverses but it can cause debilitation and death, with mortality rates ranging from 15-56 percent. Of the 28 women with peripartum cardiomyopathy in the MCG study, one patient died and another required a heart transplant.
In every pregnancy, the blood volume increases about 50 percent to accommodate increased demands from the placenta and baby. Heart rate increases to help circulate the extra blood, Dr. Gentry said. Black women also are at increased risk for abnormal increases in blood pressure, called preeclampsia, that can occur late in pregnancy.
