There are many things that can make a pregnancy risky. Multiple births, high blood pressure, gestational diabetes, and maternal weight are just a few of the things that can be risk factors. Doctors are trained intensively on how to recognize risks and help mothers manage their risk.
But what do you do when your race makes your pregnancy high risk?
It's a distressing fact that babies of African-American mothers are more likely to be born too soon, too small and sometimes too sick to survive!!! But Why? And what can you do about it???
But what do you do when your race makes your pregnancy high risk?
It's a distressing fact that babies of African-American mothers are more likely to be born too soon, too small and sometimes too sick to survive!!! But Why? And what can you do about it???
Here’s some background:
On June 19th African-Americans will celebrate ͞Juneteenth which marks the day in 1865 that news of the signing of the
Emancipation Proclamation finally reached all of the states, effectively ending slavery in the United States. Following the ending of slavery, racially motivated crimes and racism in the U.S. increased . Over time that racism has become more insidious and indirect.
Research has proven that from before that time and to this day, microaggressions and overt racism have negatively impacted the collective physical and mental health of African-Americans.
What are microaggressions? Glad you asked. They are subtle racism experienced almost daily by people of color (POC). Here are some examples:
Microassaults where violence is not the goal but POC may feel threatened, such as hanging a noose outside of the National African-American Museum or waving a flag with a swastika on itoutside of a synagogue.
Microinsults which are intentional verbal or nonverbal insults in which a POC feels demeaned, such as telling someone to go back to … (insert name of foreign country) … despite that person being an American Citizen, a teacher telling an African-American student that their afro needs to be “fixed” or someone putting on black face and posting the pictures on Instagram.
MicroINvalidations which are subtle actions meant to negate the cultural reality of a POC, such as asking Asian-Americans what part of Asia they were from, telling an African-American that they sound so educated or greeting an African-American coworker saying, “What’s up, shawty” but greeting a Caucasian coworker by saying, “Good morning. How are you?”
The impact of microaggression on African-Americans and their health is certainly concerning. The constant stress and anxiety of dealing with microaggressions and racism is now thought to be one of the reasons African-American preterm birth and infant mortality rates are higher than any other race in the United States.
Increased stress and anxiety has been known to impact pregnancy, and African-American mothers have reported higher than average levels of stress and anxiety related to racism. As a result, African-American babies are 2.2 times more likely to be born prematurely (before 32 weeks gestation) when compared to Caucasian Americans. Out of all preterm births in the U.S.,Caucasian mothers accounted for 4.1% while African-American mothers made up 26%. And preterm birth is directly related to infant mortality. In the U.S. approximately 73% of African-American infants that died within the first year of birth were born prematurely. In 2013 African American mothers in the U.S. had a higher infant mortality rate (11.1 per 1000 births) than other less industrialized and less wealthy countries like Botswana (8.6 per 1000 births) and the same rate as Libya (11.1 per 1000 births).
On June 19th African-Americans will celebrate ͞Juneteenth which marks the day in 1865 that news of the signing of the
Emancipation Proclamation finally reached all of the states, effectively ending slavery in the United States. Following the ending of slavery, racially motivated crimes and racism in the U.S. increased . Over time that racism has become more insidious and indirect.
Research has proven that from before that time and to this day, microaggressions and overt racism have negatively impacted the collective physical and mental health of African-Americans.
What are microaggressions? Glad you asked. They are subtle racism experienced almost daily by people of color (POC). Here are some examples:
Microassaults where violence is not the goal but POC may feel threatened, such as hanging a noose outside of the National African-American Museum or waving a flag with a swastika on itoutside of a synagogue.
Microinsults which are intentional verbal or nonverbal insults in which a POC feels demeaned, such as telling someone to go back to … (insert name of foreign country) … despite that person being an American Citizen, a teacher telling an African-American student that their afro needs to be “fixed” or someone putting on black face and posting the pictures on Instagram.
MicroINvalidations which are subtle actions meant to negate the cultural reality of a POC, such as asking Asian-Americans what part of Asia they were from, telling an African-American that they sound so educated or greeting an African-American coworker saying, “What’s up, shawty” but greeting a Caucasian coworker by saying, “Good morning. How are you?”
The impact of microaggression on African-Americans and their health is certainly concerning. The constant stress and anxiety of dealing with microaggressions and racism is now thought to be one of the reasons African-American preterm birth and infant mortality rates are higher than any other race in the United States.
Increased stress and anxiety has been known to impact pregnancy, and African-American mothers have reported higher than average levels of stress and anxiety related to racism. As a result, African-American babies are 2.2 times more likely to be born prematurely (before 32 weeks gestation) when compared to Caucasian Americans. Out of all preterm births in the U.S.,Caucasian mothers accounted for 4.1% while African-American mothers made up 26%. And preterm birth is directly related to infant mortality. In the U.S. approximately 73% of African-American infants that died within the first year of birth were born prematurely. In 2013 African American mothers in the U.S. had a higher infant mortality rate (11.1 per 1000 births) than other less industrialized and less wealthy countries like Botswana (8.6 per 1000 births) and the same rate as Libya (11.1 per 1000 births).
So what can you do with this information? How can youaddress and cope with microaggressions and racism that’s so subtle you barely know it happened? What can you do to increase the chances of having a healthy, full term baby? And what can doulas do to minimize the effects of microaggressions on the African-American mothers we have the honor of supporting? These are some tough long reaching questions that definitely will require more research and thought. However, here are some tips that may help.
• Access prenatal care as early as possible and often: Seeing your care provider regularly and starting early can help you get the care you need to improve your health and help you carry your baby to term. If you have limited access to medical care, you may consider alternative ways of receiving care such as utilizing drop-in community clinics, tele-medicine and traveling clinics.
• Eat a healthy diet: Having a well-rounded diet full of fruits, vegetables, lean proteins and as few processed foods as possible is best for your pregnancy. It is especially important for African-American and Hispanic mothers who are at greater risk for heart disease, diabetes and high blood pressure when not pregnant. If you live in a “food desert” accessing healthy foods may be challenging. Finding community gardens, farmer’s markets or growing your own vegetables can help. Remember to also stay hydrated. Dehydration increases blood pressure and can effect insulin and hormone production. Consult your care provider before making changes to your diet.
• Find and use coping skills that reduce stress: Practicing good self-care is important for everyone but is vitally important when you are pregnant. Find time throughout the day to utilize relaxation techniques: Stretching, conscious breathing, progressive relaxation, a massage, journaling, meditation, walking, laughing at funny baby memes, screaming, taking a relaxing bath, getting a pedicure/ manicure, coloring in a coloring book and dreaming of how cute your baby will be are a few examples.
• Create a support system: Find a safe space to discuss your experiences and to positively vent your frustrations. Living in isolation when you’re experiencing emotional pain actually increases stress and anxiety. Talking and processing concerns makes difficulties more manageable.This is where childbirth classes and a doula can be a huge help!!!!
• Positively and proudly affirm your culture’s identity: Celebrate your culture’s contributions to our society, recognize the many attributes that make your culture uniquely special, proudly practice the traditions and rituals of your culture, participate in activities that supportpositive images of your culture and build a sense of diversity, understanding and inclusivity by exposing yourself to other cultures.
• Respond positively to instances of microaggressions/ racism: Coping with microaggressions can be tricky. Some microaggressions are so subtle that others may not be aware that they are committing them. Positively addressing concerns and then patiently educating when they occur keeps you from letting negative thoughts linger causing increased anxiety and stress. With overt racism remove yourself from any unsafe situation, process the incident with your support system, decide what actions, if any, should be taken, practice self-care techniques and realize that while horrible you have more allies than enemies.
References
• Unmasking Racial Microaggressions by Tori DeAngelis, American Psychological Association, 2009, Vol. 40, No. 2 http://www.apa.org/monitor/2009/02/microaggression.aspx
• Infant Mortality and African Americans; U.S. Department of Health and Human Services, Office of Minority Health. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=23 (2015 rates)
• Understanding Racial and Ethnic Disparities in U.S. Infant Mortality Rates; Marian F. MacDorman, Ph.D., and T.J. Mathews, M.S.; NCHS Data Brief, No. 74, September 2011https://www.cdc.gov/nchs/data/databriefs/db74.pdf (GREAT charts)
• Trends in Preterm-Related Infant Mortality by Race and Ethnicity: United States, 1999-2004; by Marian F. MacDorman, Ph.D.; William M. Callaghan, M.D., M.P.H.; T.J. Mathews, M.S.; Donna L. Hoyert, Ph.D.; and Kenneth D. Kochanek, M.A.,; Center For Disease Control and Prevention. https://www.cdc.gov/nchs/data/hestat/infantmort99-04/infantmort99-04.htm
• COUNTRY COMPARISON :: INFANT MORTALITY RATE; Central Intelligence Agency; https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html
• Stress, Health and African American Women: A Black History Month Notation by Carol J. Scott, MD.; The Blog, 02/27/2013. http://www.huffingtonpost.com/carol-j-scott-md/stresshealth-and-african-_b_2772596.html
• Fact Sheet: Health Disparities and Stress; American Psychological Associationhttp://www.apa.org/topics/health-disparities/fact-sheet-stress.aspx
• African-American Women and Their Babies at a Higher Risk for Pregnancy and Birth Complications; Centers ForDisease Control and Prevention-INFO. https://www.cdc.gov/media/subtopic/matte/pdf/cdcmattereleaseinfantmortality.pdf
• The Effects of Maternal Stress and Anxiety During Pregnancy; Maternal Substance Abuse and Child Development Project; Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences.http://www.psychiatry.emory.edu/PROGRAMS/GADrug/Feature%20Articles/Mothers/The%20effects%20of%20maternal%20stress%20and%20anxiety%20during%20pregnancy%20(mot07).pdf
• Psychological and Physiological Stress: Impact on Preterm Birth by Susan Gennaro, Mary Dawn Hennessy; Journal of Obstetric, Gynecologic, & Neonatal Nursing, Vol. 32 , No. 5, pages 668–675; 2003. DOI: 10.1177/0884217503257484 http://skat.ihmc.us/rid=1190514580000_1223891673_17997/0884217503257484.pdf
• Addressing Racial Microaggressions in Our Schools: Empower Yourself – Learn About Racial Microaggressions; Gwendolyn Miller; January 2015 https://racialmicroaggressions.wordpress.com/2015/01/17/how-do-you-respond-to-racial-microaggressions/
• Coping with Racism & Discrimination; California State University, Monterey Bayhttps://csumb.edu/pgcc/coping-racism-discrimination
• Coping With Racism and Discrimination: Considerations For Students of Color; University of California SanteCruz http://caps.ucsc.edu/pdf/coping-with-racism.pdf
• Proactively Coping With Racism; by Ryan C.T. DeLapp, MA, and Monnica T. Williams, PhD; Psychology Today; July 19, 2016. https://www.psychologytoday.com/blog/culturally-speaking/201607/proactively-coping-racism
• How To Deal With Racism By Ellen Hendriksen, PhD, Savvy Psychologist; Episode #057; February 13, 2015. http://www.quickanddirtytips.com/health-fitness/mental-health/how-to-deal-with-racism?page=1
• The Failure Of Prenatal Care Policy For The Poor by Mark Schlesinger and Karl Kronebusch; Health Affairs, Vol. 9, No. 4, (1990): pages 91-111; DOI: 10.1377/hlthaff.9.4.91 http://content.healthaffairs.org/content/9/4/91.full.pdf
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