Ain’t I a woman… A look at Maternal and Infant Mortality

As a part of my current  Infant Mortality Awareness Month series I decided to re-post this article originally written back in January on my YBR blog in response to Secretary of State, Hillary Clinton’s speech commemorating the 15th anniversary of the International Conference on Population and Development.

As I listened to the 20 minute talk I tried my best to remain optimistic. I certainly believe that the stated goals should indeed be a part of the global human rights agenda and the United States should be a part of the solution.  At the same time, I watched and thought that this was another speech of promises.   While the speech may have been motivational for some, as Secretary Clinton pledged the United States continued support for global improvements in women’s health care, I couldn’t help getting a little annoyed as I listened to her complete her speech.  Before I tell you exactly what got my feathers ruffled let me first give you some of the grave statistics women in other parts of the world face due to a lack of maternity and family planning services.

It is estimated that half a million women die each year due to birth related causes.  According to a maternal mortality report published by WHO:

“Of the estimated total of 536,000 maternal deaths worldwide in 2005, developing countries accounted for 99% (533,000) of these deaths.  Slightly more than half of the maternal deaths (270,000) occurred in the sub-Saharan Africa region alone, followed by South Asia (188,000). Thus, sub-Saharan Africa and South Asia accounted for 86% of global maternal deaths.”

In spite of the goals set at the Cairo convention, between 1990 and 2005 maternal mortality at the global level decreased less than 1% annually.

The international infant mortality rates are just as grim.  According to a 2002 report from the Guttmacher Institute,   “Each year, about 7.5 million babies born in Sub-Saharan Africa, Asia, Latin America, and the Middle East and North Africa die before their first birthday. ”

The international infant mortality rate for developing countries is 61. Meaning 61 babies die for every 1,000 live births.  In many places the rates are much higher than that average and in some of the worst areas more than 1 in 10 infants dies before age one.

WOW!!! This is crucial, and I can’t even begin to imagine what that looks like, or feels like for a community, for a country, for a people and for those women!  I won’t even begin to pretend I have any idea to know what that is like.

That being said, I have felt the pain of maternal and infant mortality that is taking place at unacceptable rates right here in the good ole U S of A.  While I have compassion for the women of the world I hurt directly and feel the pain for the women in my own back yard.  While the maternal and infant mortality rates in our country are a far cry from the horrific rates in developing countries I am still reminded that we have a lot of work to do right here at home ESPECIALLY in the African American community.

So to get back to Clinton’s speech….  I was actually taken aback to hear her say

“Every woman everywhere deserves high quality care.  Not only at her most vulnerable hour but at every single stage of life. That’s our goal and that’s our responsibility.  It’s also a matter of simple equity and fairness.  I’ve been in many places in many parts of the world where the rich, the educated, the well off, the connected, the powerful, the elite had access to every single form of healthcare, and yet it was denied.  Denied by law, denied by culture, denied by taboo denied by regulation denied by resources to the vast majority of women in the same societies.  That is unacceptable. “

And so in the well known words of Sojourner Truth, I ask on behalf of the African American women who die from child birth related causes at rates 2-4 times the rate of white women nationwide.  “Ain’t I a woman?” and don’t I deserve high quality care not only in my most vulnerable hour but at every single stage of my life?

I ask on behalf of little black babies who die at rates 2-4 times the rate of little white babies:  Where is the high quality care? The rates are so deplorable in fact in some African Americans communities, the infant mortality rate mirrors the rates found in DEVELOPING nations.

Clinton mentioned visiting places where the rich, the connected, and the powerful had better health care access. I wonder if one of the countries she visited was the United States??  Perhaps as she and the rest of our national leaders are travelling the world making health care assessments they should look into their own back yard where in Washington DC the infant mortality rate for black babies is nearly two and half times the national average at 16.95. (That’s nearly 17 babies per 1,000 live births who DIE before their first birthday)

In fact the 2005 statistics show that the infant mortality rate for African American infants in TWENTY-TWO states is more than TWICE the national average of 6.87! Secretary Clinton said it’s a “matter of simple equity and fairness.” Where is the equity and fairness in that?

In case you are not getting the point here, let me contrast this another way…  The infant mortality rate for white infants nationally is 5.73 (lower than the national average of 6.87) In 10 states white infants have a mortality rate greater than the national average. The highest rates are found in West Virginia with a rate of 7.93 deaths per 1000 live births.

Compare those numbers to these:  EVERY state with reported data for black infants shows an infant mortality rate GREATER than the national average.  The LOWEST black race specific rate is 8.18 (higher than the highest statistic for white infants.) The rates at the state level go as high as 18.89 deaths per 1000 live births!  It is well known that in pockets of the country, county rates are even higher.

Once at a high of 47.02, since 1940 the national infant mortality rate has definitely declined.  In spite of this national decline, the black/white disparity has always been there. The data showed then and continues to show now that African American babies still die at TWICE the rate of white infants. And so I ask again… WHERE is the equity and fairness in that?

The African American community also bears the burden of the maternal mortality statistics in our country.  In general the rates are low, however it is well noted that African American women die at twice the rate of the national average and at THREE TIMES the rate of Caucasian women from child birth related causes.

As I gathered this statistical information, I also uncovered a bit more than I had bargained for.  I was not prepared for the discovery that our maternal mortality rate is slowly rising!! Yes you read that correctly… RISING!

It is duly noted that some of the rise is because of changes in our reporting systems that took place in 1999 and 2003.  In fact, changes continue to take place as states revise their death certificates to include a separate question about pregnancy.  I am then forced to wonder…  Are the numbers we currently use possibly just a tip of the ice berg.  As the data continues to be collected and changes are made at the state level, how much will the numbers rise.

We must also remain cautious not to assume all of the rise is related to data collection changes.  In 2003, the maternal mortality rate was 12.1 deaths per 100,000 live births in the United States.  In 2005 that number had risen to 15.1.  Here’s the kicker…. The 2005 rate for Caucasian women 11.1. The rate for African American women 36.5.  This is more than THREE times the rate of Caucasian women!  The disparity here is mind blowing and is absolutely unacceptable.

The health disparities between white and black Americans are not new. They have been on the debate table for decades and unfortunately, in the maternal child health arena nothing has changed.  The level of disparities has NOT changed in SIXTY years!!!

“If we believe that human rights are women’s rights and women’s rights are human rights then we cannot accept the ongoing marginalization of half the world’s population.  We cannot accept it morally, politically socially or economically” — Secretary Clinton

Hopefully “WE” also believe that ALL women are human and “WE” cannot accept the ongoing marginalization of 13% of this country’s population.  It’s past time to reverse these trends in this country.  It is deplorable and we cannot accept it morally, politically, socially, or economically.

Understanding that we can’t fix a problem until we know we have one, my goal here was to introduce you or re-introduce you to the problem and encourage you to bring this information into your conversations.

References:
National Vital Statistics Reports, Volume 56, Number 10, April 2008
Maternal mortality and related concepts. National Center for Health Statistics. Vital Health Stat 3(33). 2007.

Maternal mortality in 2005 : estimates developed by WHO, UNICEF, UNFPA, and the World Bank. WHO. 2007

Guttmacher Institute – Issue in Brief – Family Planning Can Reduce High Infant Mortality Levels – April 2002

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2 responses to “Ain’t I a woman… A look at Maternal and Infant Mortality

  1. I don’t think there is enough information here. I would like to see statistics for the number of children per mother/age ane income class. I think these factors have considerably more to do with infant and maternal mortality than race alone. It seems as though you are saying african americans receive poorer quality healthcare, but what if it is the fact that they are not seeking care. And what on earth can healthcare do to lower infant mortality for SIDS, which I would have to think is what the majority of the deaths are from. I think there is way more to this picture than the color of skin. And why on earth are we, as human race, responsible for helping those that will not help themselves? I am all for helping the needy and giving someone oppertunities but I do not feel it is atone birthright to continually allowed to birth and raise children on the governments dime this goes for everyone white black green or purple. Why are we as a human race responsible for carrying the weight of those who refuse to. We should always help those who can’t but we really need to stop giving the hand outs to those who can.

    • Hi Brittney,

      While you make one point that infant and maternal mortality rates have many factors i.e. maternal age, socio economic status, access to care… the FACTS continue to show that REGARDLESS of class, educational level, socioeconomic status, or level of care African American women and babies suffer more during and after childbirth. SIDS while a contributor to infant mortality its not the greatest factor. The rates of pre-term babies, low birth weight babies, and extreme premature babies have more to do with the increased rates than SIDS and again there are stats to show that while all things are connected RACE is directly a factor in the statistics.

      Yes its sobering and unfortunate but RACE ALONE in many cases is simply the only deciding factor. We cannot deny that in this country we continue to have a systematic racism that permeates every part of our society. This long standing racism continues to manifests itself in many ways. We cannot as a group of Americans ignore the connection between race and class/socioeconomic status, race and educational level, nor race and access to medical care. These things go hand in hand. And as a result the African American women and babies suffer more. Why are we as a human race be responsible… IMHO it’s what God Fearing, Spiritual people do.

      I would encourage you to take a look at the video published by the Office of Minority Health. The video is 35 minutes and discusses some of what I mention above. You can access that video here.

      http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=117

      I then would encourage you to take a read of some of the many fabulous bloggers that commented on the video during a recent Blog Carnival that can be accessed here.

      http://www.theunnecesarean.com/blog/2010/7/4/a-carnival-for-your-fourth-of-july.html

      If you want to see more direct numbers related to age etc, check out the documents I reference at the bottom of the post.

      Believe it or not what happens to African American babies, those who die and those who survive directly impacts ALL of us including YOU. So why you may not feel personally responsible do know that you are being personally affected.

      Blessings
      Nicole

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