higher in African-Americans?
Stress has been linked to one of the most common and consequential pregnancy complications, preterm birth. Studies showed that infants of African American mothers are more likely to be born preterm than infants of white mothers (Mohamed et al., 2014). But, why is preterm birth rate higher in African-Americans?
Women of color are 49 percent more likely than whites to deliver prematurely, and black infants are twice as likely as white babies to die before their first birthday (Mohamed et al., 2014). In this case, the stress, financial instability, lack of nutritional food, and comorbidities may put in jeopardy the patient and infant’s life. Although the Affordable Care Act (ACA) created historical advances in health insurance coverage, millions still go without health insurance each year, many of the people of color (Mohamed et al., 2014).
Low-income, lack of financial resources, maternal pre-pregnancy weight, exposure to stress, and maternal health status prior to pregnancy may lead to fetal growth restriction. Research showed that African American women are more likely to experience fetal growth restriction (FGR), a significant contributor to neonatal morbidity and mortality, than are women of other races and ethnicities (Bryant, 2010). The patient has to be enrolled in public programs such as the Special Supplemental Food Program for Women, Infants, and Children, to avoid food insecurity during pregnancy that may have a beneficial effect on FGR risk among women (Bryant, 2010).
According to Bryant (2010), there are multiple disparities in obstetrical outcomes between women of different race or ethnicities. The author suggests that stress induced by racial and gender discrimination plays a significant role in maternal and infant mortality. According to Kliff (2018), infants in the United States have a 76 percent higher risk of death compared with infants in other wealthy nations and African American women experience the most elevated rates of maternal and infant death. This inequity in health status can be reduced by properly addressing the social determinants of health and advocating for a system of more culturally and linguistically appropriate care for all. (Kliff, 2018).
In this case, it will be our responsibility as health care providers to encourage that all care is patient-centered, culturally appropriate, and listens to women’s needs. This new visit at the office represents a good opportunity for screening and education of the patient in a culturally sensitive manner about steps she can take to prevent disease conditions and any negative birth outcomes.
