The upcoming issue of The Nation forces us to look at some hard truths about the way our society is doing in terms of its tiniest, most vulnerable human beings—and about the physical toll that discrimination and oppression take on both mothers and young babies. The lead article, called “What’s Killing America’s Black Infants?” reads a little bit like a detective story, starting with the tragic loss of one woman’s young baby and trying to follow researchers as they asked the question: why does this happen so often?
ach year in the United States, more than 23,000 infants die before reaching their first birthday,” writes author Zoë Carpenter. “Though the mortality rate varies widely by state and county, the average in the United States is higher than in the rest of the world’s wealthy countries, worse than in Poland and Slovakia.”
So why are we so far behind? Well, she notes that not everyone giving birth contributes to those statistics. In fact, “across the United States, black infants die at a rate that’s more than twice as high as that of white infants.” Carpenter follows the trends in research over the years. First, people were convinced that this disparity was due to medical access: black expectant moms weren’t getting prenatal care or were suffering from health disparities. Then, they looked for genetic answers but found little conclusive.
Now, a growing body of research suggests that the cumulative stress of living under racism is so great it actually affects maternal and infant health—on its own. It’s not about health or educational disparities, in other words, but about the experience of racism itself. For instance, Carpenter writes that “Black women who received prenatal care starting in the first trimester were still losing children at higher rates than white women who never saw a doctor during their pregnancies.” And furthermore,Another study found that even black women with advanced degrees—doctors, lawyers, MBAs—were more likely to lose infants than white women who hadn’t graduated from high school.”
Here’s what’s actually at play: chronic stress. The kind that comes from discrimination, discrimination so deep and ingrained that many white doctors actually think black people feel less pain.
Let that one sink in for a moment.
Carpenter explains how this results in bad health outcomes:
“Chronic stress raises amounts of cortisone, a hormone that at elevated levels triggers labor. It can also cause an inflammatory response that restricts blood flow to the placenta, stunting infant growth. But it’s not just stress during pregnancy that matters: Health experts now think that stress throughout the span of a woman’s life can prompt biological changes that affect the health of her future children. Stress can disrupt immune, vascular, metabolic, and endocrine systems, and cause cells to age more quickly.”
Further along, the article examines efforts to ameliorate these effects and save infants’ lives in Milwaukee, Wisconsin, noting that to curb a problem as complex as this one, a multi-pronged, long-term effort is needed. And so is awareness, both personal and societal. Indeed, a companion article by Dani McClain about her own pregnancy shows the lengths she had to go to feel like she was being treated fairly as well as the struggle she faced finding a birthing class, doula and regimen of care that felt appropriate to her as a black woman. She says, “It wasn’t until I’d gotten a second opinion from a black female ob-gyn that I accepted that a C-section was the right choice. I felt more confident that she’d been able to see me as a human being, just like her.”
The Jewish community knows, from its own history, the internalized, deep-seated stress of discrimination, the fears and uprooting such oppression creates. And all mothers understand that the constant anxiety of pregnancy and the early years are greatly worsened when other stressors are added.
As a new mom myself, imagining all those unjustly grief-stricken mothers across the country made me understand that this shameful, very American problem belongs to all of us. It’s about the racist legacy of a country founded on slavery and buttressed by Jim Crow—and it won’t go away until we confront that legacy.