Canaries in the Coal Mine

Today’s read: What’s Killing America’s Black Infants – The Nation

Because pregnant women and infants are so vulnerable– in many ways, they represent the most vulnerable members of our society– their survival is a key indicator of a society’s overall health. And by this measure, we are quite sick.

The maternal and infant mortality rates in the United States, particularly in states like Texas and among certain groups– people of color and the poor– are shockingly high, and getting worse. In Texas, just 11.4% of pregnant women are African-American, but they represent 29% of the state’s maternal deaths. Nationally, the mortality rate for black infants is twice that of white infants.

When I worked in a Louisiana maternity ward, I was shocked to see these outcomes up close. It drove home exactly who is bearing the brunt of these realities, and what the world looks like when you’re living inside these numbers.

At the hospital, we were seeing poor outcomes- and even deaths- mostly for one simple reason: because the underlying population health was so poor. This is despite the fact that the US spends more money on health care than any other country in the world. I’m not chalking these poor outcomes up to bad health during pregnancy, or insufficient prenatal care, although that is a part of it. The reality is more complicated and starts much earlier.

The women that we saw were sick before they became pregnant: diabetes, hypertension (which was present even for many teenagers), poor diet and malnutrition. Some women were also struggling with drug and alcohol addiction and mental illness. Many were experiencing more than one of these conditions. Also present for so many– if not all– of these women: extreme stress, which is a medical condition, and we would be foolish to ignore.

During pregnancy, these predisposing factors led to sky-high rates of gestational diabetes and preeclampsia. Women struggled with insufficient or absent prenatal care, partly due to a lack of knowledge about coverage, and also a lack of providers, hospitals and/or transport in some neighborhoods. The rates of C-section was shockingly high. Their babies were born small, and they were born early — so early, that we cheered any time a mother made it to thirty-five weeks. Their pregnancies were complicated and high-risk, and the resulting negative health conditions continued after they give birth. This is not normal. It is unacceptable.

Because of the color of my skin, I was also witness to the utter apathy of so many of those who have an ability to make a difference. They conflated “common” with “normal” so many times that I stopped keeping track. Just because you see a phenomenon every day does not mean that it is to be expected or accepted.  It showed me how little regard we as a society hold for the health of certain women and their families. This is not only morally repugnant, it is criminal.

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