Earlier this week I had the pleasure of moderating a virtual panel discussion with four highly intelligent, articulate, well-educated and passionate women: Dr. Kristina Box, state health commissioner, Indiana State Department of Health; Bianca Wilson-Gillespie, advocate, mother and volunteer doula-in-training; Dr. Indy Lane, obstetrician and gynecologist, Community Health Network; and Ashley Rainey, a labor and delivery nurse, and clinical educator.
The panel was a collaboration between the Recorder, Indiana Minority Health Coalition and WFYI-Side Effects Public Media.
While it was a joy for me to be on stage with these women, the topic we discussed wasn’t a joyful one: maternal mortality. I have to admit my ignorance on this topic. I didn’t realize the rates for maternal and infant mortality were so high until a few months ago. Because so much is based off experience, I wrongly assumed that mothers and babies leave the hospital healthy and vibrant because that’s all I saw. I assumed those dramatically high rates were a thing of the past thanks to better medical care and better education for expectant and new moms.
The truth shocked me. In Indiana, 53 Black moms die per 100,000 births, and 42 white moms die per 100,000 births. The U.S. rate is 21 deaths for 100,000 births. As the data show, none of these numbers are good.
When it comes to infant mortality, in Indiana 623 babies died before their first birthday in 2016. Donetta Gee-Weiler, COO for Community Health Network North Region, broke that number down with a visual that made me feel like I’d been punched in the gut: that’s nearly 42 school buses at maximum capacity. Forty-two buses worth of children died — likely for reasons that could’ve been prevented.
Of the 13 zip codes with the highest infant mortality rate, seven are in Marion County — most of them concentrated on the city’s east side. Zip code 46226 had the highest infant mortality rate, with 46 deaths from 2012 to 2016 for a rate of 13.0. Broken down, the rate of infant mortality is 15.1 for Blacks.
This isn’t just a cause for concern. It’s a call for action. For all of us.
It’s a public health crisis as well as a social crisis since many of the outcomes from systemic oppression play a role in the disparities experienced by the Black community.
A woman’s general health plays a huge role in her pregnancy health. Obesity, high blood pressure, diabetes, stress and mental health issues all put mothers-to-be and their babies at risk. Indiana, in general, has a high obesity rate and is considered an unhealthy state. The numbers are even worse for Indiana’s Black population. Poor diets and a sedentary lifestyle are wreaking havoc on our health and wellness. We often eat the foods we grew up eating because we like them although we know the foods don’t like us. We often shun exercise. However, many of us live in food deserts where access to nutritious food is scarce, and many of us can’t afford a gym membership or don’t have the time or energy to exercise because we’re working to survive. While we may have bad habits such as smoking, many times Black neighborhoods were regulated to highly-polluted areas of town, creating environmental factors that also play a role in the mortality rates. Racism causes undue stress, contributing to mental and physical illness.
Conversely, there’s no denying systemic oppression created disparities in medical care and access to that care, which adversely affects health outcomes. Today, many in the medical profession are working to repair the wrongs of the past, however, unconscious bias may cause nurses and physicians to view and care for Black patients differently without recognizing they’re doing so or the harm they’re causing.
The high death rates for Black mothers and babies cut across all socioeconomic classes, so it’s not just poor moms and their babies who are dying — it’s Black moms who have “good” insurance and financial means and their babies. It’s a community-wide crisis.
This editorial is just scratching the surface with regard to maternal mortality.
I will moderate a second discussion, which will focus on infant mortality, at 11 a.m. Jan. 8, 2019. Again, the panel discussion is in collaboration with Indiana Minority Health Coalition and Side Effects Public Media and will be live streamed via YouTube. You can register at happierbirthdays.eventbrite.com.
