Reproductive justice and infant mortality

Liberals believe in a woman’s right to choose whether to become pregnant or not.  This right includes access to sex education, birth control and legal abortion.  But if the right to choose is to be fully realized, it should include the right to have a child and ensure the child is well cared for.

imrsThe United States in general, and my home city of Rochester, NY, in particular, have an unusually high rate of infant mortality, especially among poor African-American women.  It’s not quite as bad as the statistics indicate, because the USA counts as infant deaths what many other industrial countries count as miscarriages.  But even taking that into account, it’s pretty bad.

If you break down the figures, the American problem is mainly a high infant mortality rate among African-Americans.  In 2010, 614 out of every 100,000 American babies died in the first year of life.  Broken down by race, the rate per 100,000 was 1,146 black babies, 518 non-Hispanic white babies and 528 Hispanic babies.

This is partly due to lack of good medical care and advice, and partly due to a much higher rate of premature births among African-American mothers.  Nobody is sure why African American women have more premature births, but one factor is stress.  Women in Medicaid, single mothers and mothers whose husbands are deployed in the military are more likely to have premature births.

infantmortalitybyraceethnicitySome people think that the stress of racism is a factor.  I would not dismiss that idea out of hand.  I’ve felt extremely self-conscious on occasions when I was the only white person in the room, and I have often wondered what it would be like to be black and have to deal with this feeling all the time.

Immigrant black women have fewer premature births than native-born black women, which supports the theory, although, as the third chart indicates, immigrant white women also have fewer premature births.  Another fact that supports the stress theory is there is the same disparity between upper-class black and white mothers as among the poor.

My city of Rochester, NY, is known for medical research and excellent medical care.  Back in the 1990s, First Lady Hillary Clinton visited to praise Rochester’s community-rated health insurance.  But the figures indicate that our city as a whole, and our African-American residents are much worse and that, for some reason, the infant mortality rate among Hispanics is unusually high.

infantmortalitybyraceimmigrationstatus12The infant mortality rate in Monroe County is reported 1,420 per 100,000 births for African-Americans, 1,170 for Hispanics and 450 for whites.  The infant mortality rate in the city of Rochester is also 1,170 per 100,000, but 420 in the predominantly white Monroe County suburbs.

I don’t see anything obvious to be done about the stress of racism, but there is a lot that can be done to make sure pregnant women and new mothers get medical help and adequate nutrition.

The infant mortality rate is going down, although slowly, and there are programs that have made dramatic improvements, such as Kaiser Permanente Northeast California Early Start, Syracuse’s Health Start and the University of Rochester’s Baby Love.  The Affordable Care Act includes the Maternal, Infant and Early Childhood Home Visiting Program, which provides grants for such local programs.

It seems to me that if you believe in women’s right to choose, the right to choice does not end at birth.  If you believe in the right to life, the right to life does not end at birth, either.  Preventing deaths of infants in childbirth should be a purpose all Americans support.

LINKS

Our infant mortality rate is a national embarrassment by Christopher Ingraham of the Washington Post.

Gone too soon: What’s behind the high U.S. infant mortality rate? by Sarah C.P. Williams for Stanford Medicine.

A Quiet Crisis: Racial Disparity and Infant Mortality by Jessica Tomer for Minority Nurse.

Can racism explain the increased rates of maternal and infant mortality among African Americans? by Kirsten Hartil for the Einstein Journal of Medicine and Biology web log.

Why do black infants die so much more often than white infants? by Andrian Florida for Southern California Public Radio.

My friend Hal Bauer called my attention to the following links.

Infant mortality in Rochester, New York, a broadcast by Daisy Rosario for Latino USA.  Very important.

In city’s history of infant death, some see a crisis by David Andreatta for the (Rochester) Democrat and Chronicle (2012).

Gone too soon: Why Monroe County’s high rate of infant deaths is discussed in hushed tones by David Andreatta for the Democrat and Chronicle (2012)

What Works: How Syracuse cut infant mortality in half by James T. Mulder for the Syracuse Post-Standard.

Healthy Babies ROC: Prenatal Network of Monroe County web site.

Monroe County Executive and Legislature Leaders Forge New Effort to Address Infant Mortality press release.

Reproductive justice is the current Unitarian Universalist study-action issue.  Here’s a link about that.

UUA: Reproductive Justice.

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3 Responses to “Reproductive justice and infant mortality”

  1. thetinfoilhatsociety Says:

    We also have more mandated vaccines than any other country in the world, including a mandatory vaccine and a vitamin K injection on the day of birth. Correlation does not equal causation, but it does make me wonder.

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  2. philebersole Says:

    Where is the correlation?

    The cause or causes are the high infant mortality rate in the United States, whatever they are, are things that affect African-American and native American mothers a great deal, Hispanic mothers very little (except, for some reason, here in Rochester NY) and non-Hispanic white mothers not at all.

    The infant mortality rate of non-Hispanic white infants is in line with the average in industrial countries. It is the African-American infants who are dying at such a high rate.

    Unless the data show African American infants are vaccinated more frequently that non-Hispanic white infants, there is no correlation.

    Furthermore the high infant mortality rate among African American women is associated with premature births. I don’t see how vaccinations could be a factor in this.

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  3. Deb Meeker Says:

    I think you have given a clue in your piece that does correlate, and that is less access to good prenatal and pregnancy care for African American women. Even such important medical advice as taking a special high potency vitamin with extra folic acid, has proven helpful for healthy pregnancies and newborns. Do the African American statistics show us if the necessary medical care is generally available, and if such prescriptions are affordable to them?

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