It’s Prematurity Awareness Month, but it’s the first time I’ve ever paid attention. Previously I’d heard discussions around preemies and even had a couple of them in my own family. But I didn’t understand the implications of what it means to be born premature until recently.
During my first pregnancy, I believed that the No. 1 predictor for my birth experience would be the amount of research I did. I expected the second predictor to be my willingness to adapt to change as a parent. I was in my early 20s but wise well beyond my years (or so I thought), and I believed birth was one of few areas in life one could expect colorblind treatment.
My son was born at 38 weeks and four days, and from the moment he arrived, my faith in a bias-free medical system began to fade. In the weeks that would follow, I would be silenced and ignored as a complication put my life in jeopardy.
Years later, I’m aware of the risks that accompany my black womanhood. I’m more likely to have post-birth complications and at an increased risk for death. Any baby I carry shares those risk factors. And now that I am pregnant a second time, I’m paying particular attention to my risk for institutional racism in the medical system.
With the research of the past three years heavy on my shoulders, it’s painstakingly clear that the risk of premature delivery is one that I cannot shake.
This month, the March of Dimes released its annual premature birth report card, and the data revealed significant racial/ethnic and geographic disparities of babies that have a higher chance of a preterm birth based simply on race and Zip code.
Nationally, preterm birthrates are at 9.93 percent. However, without a full breakdown, it’s easy to miss the lack of equity in birth. Based on the aggregated March of Dimes data, white women have a premature birthrate of 8.9 percent, compared with 13.4 percent for black women. And according to the Centers for Disease Control and Prevention, black women are three to four times more likely to die from birth complications.
Premature birth is the No. 1 contributor to infant death in the United States. Considering that infant mortality is already highest in the black community, we can’t afford to overlook the early arrival of our babies any longer.
Although many premature babies go on to live healthy lives, prematurity, especially those born before 32 weeks, is correlated with an elevated risk for developmental issues, vision/hearing problems and difficulty feeding.
The full cause for premature delivery is unknown. But the impact of any birth-related obstacle can be compounded by chronic exposure to racism, bias in medical treatment and socioeconomic barriers that limit access to quality prenatal care. In isolation, any one of those is a threat, but cumulatively, the factors cost us thousands of moms and babies.
I wasn’t raised to consider prematurity as a problem. My upbringing reinforced that babies come when they (and God) are ready for them to make an appearance. At the same time, it was nothing to hear of a baby being born three or more weeks early. Just this year, my niece was born a full month before her expected due date. My social media timelines are filled with former classmates having twins before 32 weeks. These early births aren’t new to me; over time they have been normalized and almost expected.
But in the past few years, it’s become apparent that the black community is unknowingly in the midst of a prematurity epidemic. And I’m worried none of us are paying attention.
As more black celebrities like Beyoncé Knowles, Serena Williams and, more recently, Michelle Obama provide dialogue around their reproductive experiences, black women are finally getting the opportunity to share their realities. It’s a disturbing fact that our mothers and babies face an elevated risk for complications and death, regardless of income and education level. For the first time, the research is being done to back us up.
We need an intervention. The black community, myself included, needs to reshape our thinking to view prematurity for what it is instead an aspect of God’s plan. It’s a symptom of centuries of marginalization, a curse that will take our babies if we allow it. At the same time, the black community cannot be solely responsible for eradicating a health epidemic we didn’t cause.
As I do what I can to make it full-term with this pregnancy, I’m hyper-aware that each Braxton-Hicks contraction I feel could send me down a path of life-threatening interventions. The anxiety presents another challenge on the road to a healthy delivery. I look forward to seeing my little girl’s face — but not yet.