SisterSpace: I Will Not Write a Blog for Infant Mortality Awareness Month

This is not a blog for infant mortality awareness month. Something so weighty deserves more than to be relegated to web log. I will not make any witty observations. I will not use any metaphors, similes, idioms, or analogies. There will be no alliteration or onomatopoeia used to help you get it.

There will be no opinions, only facts. The jarring sort that aren't typically welcome in a blog. This will not be entertaining. You will probably not "Like" this.

This is my virtual moment of silence for the babies who needlessly die every year. This is my silent cry in the blogosphere for greater awareness in the African American community where our babies are 2.3 more likely to die before their first birthday than in the white community. This risk exists for all black women regardless of income or education.

This is my anti-blog for the unborn who deserve to live to see their first birthday and my homage to those who didn't.

• Currently, the national infant mortality rate for Black babies is 13.7 per 1,000, compared to a rate of 5.6 per 1000 for White babies, 3.5 per 1000 for Asian babies, and 5.3 to 6 per 1000 for Latino babies.




• Black babies are four times as likely to die as infants due to complications related to low birth weight as compared to non-Hispanic white infants.




• African Americans have 2.3 times the infant mortality rate as non-Hispanic whites.




• African Americans had 1.8 times the sudden infant death syndrome mortality rate as non-Hispanic whites.




• College- and graduate-school educated black mothers have a higher infant mortality rate than white moms who didn't finish high school.




• The infant mortality rate for African American mothers with over 13 years of education was almost three times that of non-Hispanic white mothers.




• Black women who get prenatal care in the first trimester have double the infant mortality rate of white mothers with first-trimester care.




• Only 17 percent of all U.S. births were to African-American families, but 33 percent of all low-birth weight babies were African-American, according to one report.




• Black women with similar levels of prenatal care as Hispanic women (generally less educated and with lower incomes than blacks) have higher rates of low birth weight, preterm deliveries, and infant mortality.




• According to Dr. Michael Lu, assistant professor of obstetrics and gynecology and public health at UCLA, researchers have found that even when they control for such varied factors as poverty, housing, employment, medical risk, abuse, social support and so on, 90 percent of the differences in birth weight between black and white moms remains unaccounted for.

"Most studies have looked at black-white differences during pregnancy, for example, differences in prenatal care utilization or maternal behavior," he says. "What we're finding is that these differences really explain very little of the disparities in birth outcomes."

The Problem with Alicia Keys. And Too Many Black Women Like Her.

I just love Alicia Keys. On any given Saturday, you'll find my children and me closing out our usual Saturday morning dance party with a stirring rendition of "If I Ain't Got You," where we substitute each other's names in the chorus. My kid-friendly traveling CD features Alicia's live-out-your-dreams anthem "Unbreakable." And when I'm feeling unstoppable, Alicia's lyrics from Superwoman: "Still ,when I'm a mess, I still put on a vest, with an S on my chest. Oh yes, I'm a superwoman," really speak to me. Oh, and please don't get me all riled up about Empire State of Mind.

But I've got a growing problem or real concern about Alicia Keys and many black women like her when it comes to our pregnancies. A few weeks ago, I held my breath as I watched Alicia Keys climbing her preggers self on top of a piano at the BET Awards, albeit during an incredible tribute to Prince. But still. And then last weekend, she fell off her 4-inch heels and landed on her backside while performing at the Essence Music Festival in New Orleans.

I'm concerned because for over five years now, I've been on a personal mission to help black women have healthy pregnancies and healthy babies. That's what the Women's eNews Black Maternal Health Project is all about. When my first book, The Mocha Manual to a Fabulous Pregnancy (Amistad/HarperCollins) came out, it was the first of its kind, a hip and funny book to really talk to a new audience of savvy black women about the lifestyle issues and unique stressors that are affecting our pregnancy and birth outcomes.

Studies show that even successful, college educated black women are still twice as likely to have a low birth weight baby, twice as likely to have a pre-term baby and nearly three times more likely to die during childbirth than their white peers. Nobody knows the exact root cause of these disparities, and why education and class don't protect black women from poor birth outcomes as it does for white women.

But one of the biggest self destructive behaviors among black women is what I call the Strong Black Woman Syndrome. The exact same problem Alicia sings about in her Superwoman song. We notoriously carry our communities, we carry our families and we carry our pain, but we put an S on our chest and project a "strong" image regardless of how broken we are inside. In our culture we are raised to view "weakness" as a character flaw. We must be strong. Period.

Having that conditioning is helpful in so many scenarios. But it can be damaging during pregnancy. In my many years talking to black women about pregnancy and championing the black female's pregnancy and parenting experience at www.MochaManual.com, I am still struck by the number of black women who don't see pregnancy as any deviation from their normal state of being. They expect to be able to continue to work just as hard, to continue to carry others, and to not take special care of themselves. We work and work and work because that's what we do. And even while taking on the most phenomenal journey known to womankind, we act like indestructible machines that can just keep going and going, and not as fragile humans charged with shepherding a new life into the world.

Alicia, we love you! But as one hard working black woman to another, I'm personally begging you to ease up on work and the piano climbing and allow yourself to be still.

Still.

Respect the journey of pregnancy. We know you are a superwoman. But your baby needs you to be super careful, super mindful and super stress free. We've got plenty of your great music to hold us over. I just want you to focus on the most important production of your life.

What's in Your Womb? Pre-programming for the rest of your life, that's what.

Do you have heart disease, high blood pressure, diabetes or high cholesterol? Like many people, you're probably thinking that your diet, exercise (or lack of it), or weight play a significant contributing factor. And they likely do. But there's something else to consider. Are you ready? Here's the 64 million dollar question: Were you a low-birth weight baby?

Did you know that being a low birth weight baby could make you more susceptible to having heart disease or high blood pressure 40 or 50 years later?

This amazing nugget relates to a new discovery in epigenetics, called fetal programming. Fetal programming refers to the process whereby a stimulus or insult at a critical point in fetal development creates permanent changes in the structure and function of the baby's vital organs, leaving lasting or even lifelong consequences for health.

The idea of fetal programming was first introduced by Dr. David Barker and his colleagues at the University of Southampton in England. Barker and his team made a connection to poor fetal growth inside the womb (which resulted in low-birth weight) and coronary heart disease, diabetes, high blood pressure, diabetes, high cholesterol and a many more chronic adult illnesses later in life.

Barker hypothesized that similar to programming a computer, a baby's heart and other vital organs are actually "programmed" inside the womb. If something negative happens during pregnancy then those organs may not get the proper programming and never fully function at their best over a lifetime.

It's an amazing way of thinking about the long term effects of pregnancy beyond just what happens at delivery. It was one of the many Aha! moments I had last week, as Dr. Michael Lu, from UCLA, presented on the Life Course Perspective as part of the Women's eNews Black Maternal Health Conference (click here to watch the webcast)

Lu discussed the "Barker hypothesis" and showed that although it was initially met with some skepticism in the scientific community, over the past decade more and more scientific evidence is building to support this idea.

Two key areas that Dr. Lu highlights:

• Maternal stress linked to ADHD in children. When a woman is stressed out during pregnancy, her baby is immersed in a stress hormone called cortisol. Studies indicate that over exposure to cortisol in the womb results in permanent changes in the structure and function of the fetal brain. There are more and more studies linking maternal anxiety and stress during pregnancy to neurological disorders in children, including ADHD.
  
   


• Maternal nutrition linked to childhood obesity.  Poor fetal nutrition cause permanent alterations in key organs such as the pancreas, kidneys and blood vessels which can lead to diabetes, hypertension and heart disease later in life. In addition, poor fetal nutrition affects the genes the help the body use and store energy more efficiently. They are called the "thrifty genes." In our food-crazy society, those turned on "thrifty genes" mean that body will hang onto to every calorie possible, predisposing a child to a lifelong struggle with obesity.

The point is, so much is happening in the womb that affects your baby not just at their birth but for the rest of  life. And if we really want to prevent obesity and heart disease in children and adults, then we have to go back to the womb and make sure those organs are properly optimized from the start.

Learn more about what you can do to prepare your womb for optimal fetal programming by reading Dr. Lu's book.