Preterm Birth Essay

Infant mortality rate constitutes the death of a baby before their first birthday. Mortality rates around the world differ tremendously with America leading the first world countries at an alarming rate of 6.1 deaths per 1,000 births. Conversely, Finland and Japan secure the last, most desirable position, with deaths totaling 2.3 per 1,000 births, as of 2010. (Ovaska-Few, 2015) In 2014, over 23,000 babies died in the United States. (CDC, 2016) Exploring the mortality rates in America brings light to a dire need for additional interventions and research as to why this developing nation has the highest rate of infant deaths before the age of 1 year old. African Americans face the worst outcomes of infant death compared to whites, Latino, and their Native American peers in North Carolina. (Ovaska-Few, 2015) This paper will explore why African American are the leading race for infant mortality and the steps that health communities need to take to address this devastating occurrence.

“Compared with European Americans, African American infants experience disproportionately high rates of low birth weight (LBW) and preterm delivery and are more than twice as likely to die during their 1st year of life”(Giscombé, C. L., & Lobel, M., 2005). The infant mortality rate for African Americans is 13.7 deaths per 1000 live births, more than twice the rate (5.7) for White Americans in the U.S. (Kung, Hoyert, Xu, & Murphy, 2008). A lot of the racial disparity in infant mortality can be explained by low birthweight and preterm delivery, which are also disproportionately and often experienced by African Americans (Martin et al., 2007).

After a great deal of research and strong evidence to support such claims, I have come to the conclusion that the cause of the black and white infant mortality gap can be attributed to the near two-fold increased rates of low birth weight and preterm births, and the near three-fold increased rates of very low birth weight and very preterm births among black infants. However, the cause of the racial disparities between such birth outcome rates remains largely unexplained. Most studies focus on differential exposures to risk, such as high teen pregnancy rates, single motherhood, lower education levels, poverty, and even genetic causes, but these factors do not adequately account for the racial disparities in birth outcomes. Based off of the studies previously mentioned, the lack of prenatal support, social support, and high allostatic load appear to be some of the main factors that contribute to accounting for the black and white infant mortality gap. As a result, researches have recently proposed an alternative approach to examining racial-ethnic disparities in birth outcomes using a “life course perspective”. A life course perspective, as defined by scientist Michael Lu, is known to “conceptualize birth outcomes as the end product of not only the nine months of pregnancy but the entire life course of the mother before the pregnancy.”

Major disparities continue to exist in spite of America’s “Affordable Care Act”, Although minorities suffer disease five times greater than the rest of the nation, minorities represent the majority of the disparity. Infant Mortality has always been America’s indicator as to the state of the countries health status. America is one of the wealthiest and most powerful nations in the world, However, America ranks number 24th in the world for infant mortality. Puerto Rican and Indian women rank highest among ethnic classes with low infant mortality rates. Some researchers have found lack of prenatal access as the key contributing factor to low mortality and birth weights among these two ethnic classes.

In African American women low birth weight has been associated with several chronic diseases, such as obesity, hypertension, and diabetes mellitus. African American women increased risk of preterm birth is a longstanding epidemiological enigma and a major public health problem(ciatation from african american womens lifetime upward economic mobility and preterm birth). To further investigate this public health problem, I have analyzed the work of previous researchers who found a correlation between chronic disease, preterm birth risk factors, and low birth weight babies in women of african descent.

Premature birth is an important public health priority in terms of health of women and infants. Every year an estimated 15 million preterm babies are born and this number is still rising (WHO, 2015).In 2014, 1 of every 10 babies born in United States were premature and black infants were 50% more likely to be born premature than white, Hispanic and Asian/Pacific islander infants (CDC,2015). Almost 1 million children die each year due to complications of premature birth (WHO, 2015). Major survivors face lifelong disabilities like learning disabilities, hearing, visual, feeding, digestive, breathing and respiratory problems (CDC, 2015) and low birth weight (March of Dimes, 2014). A major challenge in decreasing the rate of preterm birth is

In the United States, there are disparities between the different racial groups when it comes to low birth weights and premature births. Evidence of this can be seen with information collected Reichman (2005). She found that African Americans have the highest rate with this accounting for 13.0%. While whites are reporting 6.5% and Hispanics are seeing figures of 6.5%. However, inside the Hispanic demographic there are differences in these numbers as Puerto Ricans have 9.4%. These disparities are not tied to economic status with many educated African American women having children of low birth weight. Whereas, there are differences between select segments of the Hispanic population in contrast with other sub groups. (Reichman, 2005)

Only 71% of black and Hispanic women received prenatal care compared with 84% of White women.

-Race or ethnicity: Historically, minority populations in the United States have had higher rates of preterm delivery. In 2007, non-Hispanic White women accounted for the lowest number of preterm births in the United States, accounting for only 11.5% of all preterm births (MacDorman, 2011). In contrast, non-Hispanic Blacks, Puerto Ricans, American Indians and Hispanic women had preterm birth levels of 18.3%, 14.5%, 13.9% and 12.3% respectively (MacDorman, 2011). The Asian minority had the lowest risk at 10.9% (MacDorman, 2011). Some studies have attributed such significant differences to racial disparities in resources and health care (Dominguez, 2008; Vanderbilt & Wright, 2013). However, other studies such as Menon’s et al, which looked at differences in White versus Black women, suggest that racial disparities in preterm birth may

Socioeconomic conditions also played a role in my preterm birth, because I live with someone who smoked cigarettes and also used illicit drugs from time to time. As a result I delivered a baby girl at 24 weeks gestation which is 16 weeks premature and was just two weeks beyond the point of viability. My child weighed 1 lb. 8 oz. and was 12 inches long. The psychological effects after the birth of my child were even more devastating. Knowing that the situation could have been prevented has always weighed heavy on my mind as my child battle with many issues due to her prematurity. These issues resulted in the use of oxygen, and apnea monitor, and also a feeding tube. In the beginning there were many developmental delays such as, she did call until she was one years old and she did not walk until she was two years old. Though those were the short term effects, there are also long-term effects such as lack of confidence and attention deficit disorder. Vision problems are another long- term effect that my daughter suffered from preterm birth. In many cases, the retina will detach from the eye causing blindness around the actual due date. Fortunately for me and my daughter we were able to avoid the detachment but we still have to deal with the vision problems caused by early delivery.

When it comes to marriage and race certainly plays an important factor. Black women give birth out of wedlock at a higher rate when compared to White or Hispanic women, and are twice as likely to divorce more than white or Hispanic women. And yet while the levels of out-of- 4 wedlock childbearing are higher for blacks, the trends have been steadily declining since the early 1990s, whereas they have been rising for whites and Hispanics (Ooms, 2002).

Prenatal care is medical care for pregnant woman and is important for a healthy pregnancy. Its key components include regular checkups and prenatal testing, eating healthfully, exercising, and beginning as soon as one knows she is pregnant.

Preterm Birth is one of the most important and interesting topics to any prospective parent. One of the reasons is because it happens so often and unexpectedly. Preterm Birth has become a personal interest in research simply because it has made a tremendous impact in my life. Having a Preterm Birth has taught me lots of things, such as, to grow as a person and as a mother, to see things from a different perspective, to get up, continue with my life, and perhaps to learn how to say “good bye” to a little one without even saying “hello.” For all the reasons above, there are some questions I would like to address: Why do preterm births happen and how can it be prevented? What kind of help is offered to parents and family members who go through the process of having a preterm birth? How effective and relevant is that help?

Birth of a child can be such a happy time, especially when the little one is very healthy. We all have seen the movies when a new child is born, some of us are lucky to see it first hand. Some of us do get goose bumps, me being one of them. It is just so exciting to see that little life come out of what has been in that big belly for nine months. We sometimes refer to the birth of a child as labor. If only it was as easy as the name sounds. However, it is not. There are three main stages in birth. The first stage is the longest stage that can last 12 to 14 hours with the first birth, and later births are shorter. Dilation and effacement of the cervix take place here. That is when the uterine contractions gradually become more frequent and

8oz. and were thus considered low birth weight births. Preterm births increased from 9.4% in 1984 to 11% in 1993(as cited in MCN, 1998). African Americans had low birth weights that more than doubled those of whites and very low birth weights were three times higher. Many of the low birth weight births resulted in death. According to the National Vital Statistics Report, the figures for the United States from 1998 are as follows: