Black women in the U.S. give birth to premature babies almost twice as often as white women do. A team of researchers at the University of Maryland School of Public Health wanted to know what causes this disparity, and if anything could be done about it.
The resulting study found that some of the major factors linked to the disparity were hypertension during pregnancy, marital status and paternity acknowledgment, maternal education level, source of payment for delivery, and amount of time between pregnancies. The factors they identified, the researchers say, account for about 38 percent of the preterm births (up to 37 weeks) and 31 percent of the very preterm births (up to 32 weeks) in black women.
Many of the contributors identified, whether socioeconomic or health related, translate to elevated stress levels among black women — and this adds to previous research linking stress and experiences of racism to high blood pressure and other medical issues for African Americans. Ama Chandra, an African American registered nurse and singer who gave birth to two children prematurely, told Maryland Today, “Our communities deal with a lot of stress and trauma, and there is a huge impact on the body.”
So what can be done to specifically reduce the risk of premature birth among African Americans? Marie Thoma, the lead author of the study, says, “What we need to focus on is reducing barriers in social and health care systems so that we can better support black mothers before, during and after pregnancy.” She also believes that there should be a greater focus on hypertension, even before pregnancy.
Chandra suggests that “People should be assigned a doula and have people who meet with them regularly to help manage stress.” In addition, as someone who has also experienced six miscarriages, she says, “If you have had a loss, you should be flagged and they should know to assess you.”
Premature birth is just one of a host of serious risks that black mothers and pregnant women are up against, and programs like Sister Doulas are determined to start turning the statistics around. The Kansas City, Missouri, program trains black doulas to work with black parents-to-be — and Hakima Tafunzi Payne, a labor and delivery nurse who heads the nonprofit organization behind Sister Doulas, says, “Having that cultural companioning and comfort really makes a difference to our mothers and fathers. … When you wrap families in a cocoon of love and acceptance, they do better.”
While her doula program has a positive impact, Payne warns that much more is needed to address black maternal health disparities: “I created a work-around to protect black families until the system changes. This is not an entirely clinical problem — this problem is rooted in systemic racism.”