Black women’s risk of premature birth

Black women in the U.S. are 50% more likely to have a premature baby than white women. Research has identified a few reasons for this shocking statistic. And if you ask Black women, they’ll name additional causes for their increased risk for preterm birth that might surprise you if you do not share the same lived experience.

Preterm birth, also known as premature birth, is when a woman gives birth before the 37th week of pregnancy, rather than after 40 weeks, which is considered the length of a full-term pregnancy. According to the Centers for Disease Control and Prevention (CDC), babies born prematurely may experience long-term intellectual and developmental disabilities, along with:

• Breathing problems

• Feeding difficulties

• Hearing and vision loss

• Cerebral palsy

The CDC also reports that preterm birth can lead to infant mortality, which affects the Black community far more than other racial or ethnic groups. In fact, Black infants in the U.S. die at more than two times the rate of white babies. Whereas 4.8 white infants in 1,000 die before reaching 12 months old, 10.8 Black babies per 1,000 don’t make it to their first birthday.

The role of racism
Many studies have focused on access to quality education and health care, as well as socioeconomic inequalities between racial groups, as the root causes of differences in the number of preterm births. However, there have been findings that racial differences in preterm birth rates persist even among Black women who are highly educated, of high socioeconomic status and who have health insurance. One study found that college-educated Black women in the U.S. are more likely to give birth prematurely than white women with only a high school degree.

According to a study of a group of low-risk, pregnant Black women, education and economic status are not the primary factors leading to preterm births. The women reported that they believe preterm labor among Black women is due to the many physical, psychological and social stressors they experience on a daily basis. From the lack of social support to judgment by others and unhealthy behaviors, such as poor nutrition and lack of physical activity, combined with near constant racial discrimination, the women — and experts — agree that chronic elevated stress hormones can lead to preterm birth.

This persistent racism combined with these other stressors lead to what is known as “weathering.” This is the long-term deterioration of the health of Black women, not because of genetics or biology, but due to the toxic stress in their environments as well as centuries of ongoing exposure to overt and implicit racism.

Improving preterm birth rates
To decrease the number of preterm births among Black women, the San Diego County Perinatal Equity Initiative (PEI), which raises awareness of poor birth outcomes and inequities among Black women, asserts that Black women — like all women — have a right to respectful, safe and quality care during the pregnancy and birth experience.
This should include:

• Access to education and information about pregnancy, childbirth and decisions made throughout pregnancy and childbirth care

• The ability to ask questions, participate in decisions and provide informed consent for anything related to their well-being and the well-being of their children

• Quality, respectful care that honors their choices, preferences, preferred language, culture, religion and traditions

• Personal support before, during and after pregnancy and childbirth

The March of Dimes also recommends that women take steps to reduce their personal risk of premature birth. It is highly important that pregnant women go to their first prenatal care checkup as soon as they think they’re pregnant and continue attending all prenatal appointments throughout their pregnancy, even if they are feeling fine.
Additional recommendations:

• Reach and maintain a healthy weight before pregnancy and gain an appropriate amount of weight during pregnancy.

• Don’t smoke, drink alcohol, use street drugs or abuse prescription drugs. Talk to your doctor if you need help managing a substance use disorder.

• Seek treatment for chronic health conditions, such as high blood pressure, diabetes, depression and thyroid issues.

• Protect yourself from infections — talk to your doctor about appropriate vaccinations; practice good hygiene habits; avoid consuming raw meat, fish or eggs; practice safe sex; and do not touch cat feces.

• Reduce your stress by asking family and friends for help and talking to your supervisor or company’s HR department about how to lower your stress at work.

• Practice self-care — eat healthy foods, do something active every day, stay connected to loved ones and get enough sleep.

• Wait at least 18 months between giving birth and getting pregnant again.