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."

Sister Space: A Mother's Tale of Survival: Part 1

A Sister's Story: Erica Simone Turnipseed was having a great pregnancy when she developed HELLP syndrome at 24 weeks. HELLP stands for Hemolysis or rupture of the red blood cells, Elevated Liver enzyme levels in the blood, and Low blood levels of Platelets. HELLP is similar to preeclampsia, toxemia and pregnancy-induced hypertension. Erica's blood pressure climbed to over 240/110, her kidneys failed, and a priest came in to absolve her of her sins. The last thing she remembered thinking as she lay on the operating table was, if I die will I go to heaven? Erica survived. Her baby, named Grace Ayodele Webb, lived a miraculous four days before she died. This is Erica's story:

"The day started normally but I didn't feel very good. But I thought it was something that I ate. I began to feel worse and I thought, something is not right. I went outside to catch a cab to the hospital but because of the rain and the heavy traffic the trip took nearly an hour. During the time in that cab, I went from discomfort to pain to continuous pain to the point where I was crying. I felt like something was really going wrong. When I finally got to the hospital there was a lot of protein in my urine and my blood pressure was rising.

The doctor said I had the symptoms of HELLP syndrome and I was given two steroid injections to help mature the baby's lungs so we can make it to twenty-seven weeks. To them twenty-seven weeks was the magic number for my baby's chance of survival.

I was in some sort of Twilight Zone. I had heard things about preeclampsia and HELLP syndrome but it was in the back of the pregnancy books and I hadn't gotten that far yet.

Things got progressively worse and during the night, the doctor came and said that they were going to have to take the baby immediately. My kidneys had shut down and my blood platelets were low.

A perinatologist came in and explained to me the prognosis for a 24-week-old fetus. There were what seemed like hundreds of people in this frenetic energy all around and you know it's all for you. A priest came in and gave me the Sacrament of the Sick, which is something they do if they think you might not make it. I realized that I was really, really ill. I sensed that at 24 weeks, they didn't expect the baby to live, but what was now clear was they weren't sure if I was going to live.

I heard them yell, "200/110."

I'm not a doctor but I know that is too high to be anybody's blood pressure. By this point I'm crying and thinking, this might be it. You get to a point where you can choose to fear death, but if it's going to come, it's going to come. A priest came and prayed over me and for me. He absolved me of my sins. And I told them that I wanted to donate my organs. When it was time for anesthesia, he told me to count to ten. I remember counting to three and that was it.

When I woke up, the first thing I heard was, "She's alive, Erica." It was my partner, Kevin. The baby had been baptized and he saw it. He said he heard her cry. She was under one pound. They wouldn't let me go see her. They said I was too ill. My pressure had gone up to 240 before they were able to stabilize me. That was very tough. How can you say that to a mother? Part of my recovery was to see her…

Read the rest of Erica's story next week in SisterSpace.

Erica Turnipseed-Webb, a graduate of Yale, is now a married mother of two other children and author of A Love Noire and Hunger, two critically acclaimed novels. She lives with her husband, Kevin Webb, in Brooklyn, New York. Her life-changing story appeared in The Mocha Manual to a Fabulous Pregnancy by Kimberly Seals Allers.

Do you have a pregnancy story you'd like to share on SisterSpace? Email me at kimberly@mochamanual.com

New Orleans' Lower Ninth Draws Tourists, Not Aid

Recently I attended a conference on health disparities in communities of color. The National Health Policy Training Alliance for Communities of Color hosted over 40 journalists of all hues and ethnic origins to convene in New Orleans to discuss how we can better cover healthcare related issues and the health disparities that still plague our communities. For three days, we sat in a top floor of well-appointed hotel in the lovely French Quarter, having a lively discussion on how we can get better and more thorough coverage of the issues.

Turns out the real story about health disparities and racial inequities was but 20 minutes away, across the bridge and down Claiborne Blvd in the Lower Ninth Ward of New Orleans. The Lower Ninth ward was destroyed during Hurricane Katrina five years ago. The area was the hardest hit when the levees broke and the low-income community residents were the last to get help. The images of bodies floating through the water still haunt me.

One would have no idea of what is still going on in the Lower Ninth Ward by walking through the downtown area of New Orleans. I too, enjoyed walking up and down Bourbon Street, looking at all the new apartments, shops and restaurants that were alive and bustling in the downtown area. There, you would think Katrina never happened. The city looks like back to business as usual.

Tale of Two Cities, Still

I've never been one to take things on face value. It is my experience that in most urban environments there is almost always a tale of two cities, and the tale of the brown city that exists across the railroad tracks or the bridge or whatever socioeconomic divide exists in that particular locale, is almost always starkly different.

So when a few of the local community leaders came to address us, what they had to say about the Lower Ninth Ward was appalling but not surprising. They said that of the $90 million that FEMA allocated to rebuilding, that the Lower Ninth Ward has not received any money. Nobody has been told a definitive answer as to why.

They said the Lower Ninth Ward only has one working school for kindergarten through 12 grade with 750 students and a 450 student long waiting list. There are no hospitals in the area and God help you if you need emergency care and have to travel across the bridge and across town to get it.

They expressed their outrage that tour companies bring bus loads of people through the Lower Ninth Ward everyday to gawk at their despair, yet never sharing any of their profits or stopping to support local businesses. They said that many displaced residents would love to return, but can't because there are no schools and no real health care options for the elderly.

Concrete Steps Lead to Empty Lots

On my last day in New Orleans, instead of buying souvenirs and taking in the tourist traps, I asked a friend to drive me to the Lower Ninth Ward. It looked mostly like a wasteland with a few nice new homes put up. I saw plenty of concrete steps that once led to a house, but now only lead to a field of 5- foot-tall grass. I saw where do-gooders like Brad Pitt and other organizations have helped rebuild new and colorful housing, that quite frankly, ust looks weird sitting next to devastation.

But what I mostly saw was the biggest disparity of them all--the wealth disparity. Money given to help those who have and no money to those who don't. In fact, it is clear that the powers that be have no intention of rebuilding that community. To them, Katrina has become a tragic opportunity to rid the city of some of its poorest residents--I mean, really, who wants them around anyway. So why rebuild so they can return?

Now a new plan for the Lower Ninth Ward is in the works and its message is clear: Poor blacks need not apply. New developments and higher rents are on the horizon, but there are no jobs to support them. Even though blacks built that city, created its music and its food culture, the winds of economic racism have no regard for history. So the displaced stay displaced. And the disparities linger. In health and in life.

Note: Please watch Spike Lee's latest documentary, If God is Willing and Da Creek Don't Rise on HBO http://www.hbo.com/documentaries/if-god-is-willing-and-da-creek-dont-rise/synopsis.html for a real look at the Lower Ninth Ward and the impact of the BP oil spill.

The Importance of World Breastfeeding Week In My Piece of the World

August 1-7 marks World Breastfeeding Week. The annual campaign, organized by the World Alliance for Breastfeeding Action, is the one week where over 170 countries worldwide pay attention to our breasts and their power to help our children.

It's no secret that I'm a huge advocate of breastfeeding as one of the most important things a woman can do to give her baby the best start in life and give herself some unparalleled health benefits. And the Black Maternal Health Project proudly supports breastfeeding and is deeply committed to understanding how we can increase breastfeeding rates among black women.

So while the campaign, now in its 19th year, speaks to the entire world, I'm speaking directly to my part of the world. The African American women who historically have had the lowest rates of breastfeeding for the recommended time periods or don't breastfeed at all.

For over 30 years, African American women have had the lowest breastfeeding rates, and though the numbers have greatly increased in recent years, black moms still have the lowest breastfeeding rates of all ethnicities. And when it comes to the gold standard of infant nutrition--six months of exclusive breastfeeding, among African Americans the rate is only 20% compared to 40% among whites.

Some of these forces have been brewing for decades. A long time ago, black women were notorious for nursing. In fact, slave owners used and purchased black women as wet nurses for their own children, often forcing these mothers to stop nursing their own infants to care for others. "On the one hand, wet nursing claimed the benefits of breastfeeding for the offspring of white masters while denying or limiting those health advantages to slave infants. On the other hand, wet nursing required slave mothers to transfer to white offspring the nurturing and affection they should have been able to allocate to their own children," writes historian Wilma A. Dunaway, in the book The African American Family in Slavery and Emancipation, published by Cambridge University Press. And since breastfeeding reduces fertility, slave owners forced black women to stop breastfeeding early so that they could continue breeding, often to health detriment of their infants, Dunaway writes.

But there's more to our story than a stunted and complex breastfeeding experience at the hands of slave owners hundreds of years ago, though many may argue that some vestiges of slavery still exist in the mindset of the black community. Aggressive marketing by the formula companies in the 1930s and 40s made formula feeding the choice of the elite, "the substance for sophisticates" --white or black. And who doesn't want to be like the rich and famous. That marketing continues to this day, down to the formula company-sponsored bag of goodies you probably received on the way out of the hospital. Then there's something I call the National Geographic factor--that is, most of the images we see of black women breastfeeding are semi-naked women in Africa whose lives seem so far away from the African American lifestyle and experience.

To help remedy the global situation BAWA takes aim at hospitals and other maternity care providers. This year the campaign focuses on "Just 10 Steps--the Baby Friendly Way" showcasing the 10 steps hospitals need to do to encourage breastfeeding. Those ten points include:

• Have a written breastfeeding policy that is routinely communicated to all health care staff.




• Help mothers initiate breastfeeding within a half-hour of birth.




• Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.




• Give newborn infants no food or drink other than breastmilk unless medically indicated.




• Practice rooming-in -- allow mothers and infants to remain together -- 24 hours a day.




• Encourage breastfeeding on demand.




• Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants. (read all 10 points at www.worldbreastfeedingweek.org)

In our community, we need to talk and encourage each other more. And speak out. We still long for an African American role model in breastfeeding, like a Michelle Obama. In the meantime, if you are already on the breastfeeding bandwagon, tell others. Check out the "I Breastfeed Because . . . " campaign sponsored by Ameda, a leading breast pump maker. Mothers who are currently breastfeeding and or have in the past can log onto www.ibreastfeedbecause.com to upload 20-second videos that share the reasons why they chose to breastfeed.

The Importance of World Breastfeeding Week In My Piece of the World

August 1-7 marks World Breastfeeding Week. The annual campaign, organized by the World Alliance for Breastfeeding Action, is the one week where over 170 countries worldwide pay attention to our breasts and their power to help our children.

It's no secret that I'm a huge advocate of breastfeeding as one of the most important things a woman can do to give her baby the best start in life and give herself some unparalleled health benefits. And the Black Maternal Health Project proudly supports breastfeeding and is deeply committed to understanding how we can increase breastfeeding rates among black women.

So while the campaign, now in its 19th year, speaks to the entire world, I'm speaking directly to my part of the world. The African American women who historically have had the lowest rates of breastfeeding for the recommended time periods or don't breastfeed at all.

For over 30 years, African American women have had the lowest breastfeeding rates, and though the numbers have greatly increased in recent years, black moms still have the lowest breastfeeding rates of all ethnicities. And when it comes to the gold standard of infant nutrition--six months of exclusive breastfeeding, among African Americans the rate is only 20% compared to 40% among whites.

Some of these forces have been brewing for decades. A long time ago, black women were notorious for nursing. In fact, slave owners used and purchased black women as wet nurses for their own children, often forcing these mothers to stop nursing their own infants to care for others. "On the one hand, wet nursing claimed the benefits of breastfeeding for the offspring of white masters while denying or limiting those health advantages to slave infants. On the other hand, wet nursing required slave mothers to transfer to white offspring the nurturing and affection they should have been able to allocate to their own children," writes historian Wilma A. Dunaway, in the book The African American Family in Slavery and Emancipation, published by Cambridge University Press. And since breastfeeding reduces fertility, slave owners forced black women to stop breastfeeding early so that they could continue breeding, often to health detriment of their infants, Dunaway writes.

But there's more to our story than a stunted and complex breastfeeding experience at the hands of slave owners hundreds of years ago, though many may argue that some vestiges of slavery still exist in the mindset of the black community. Aggressive marketing by the formula companies in the 1930s and 40s made formula feeding the choice of the elite, "the substance for sophisticates" --white or black. And who doesn't want to be like the rich and famous. That marketing continues to this day, down to the formula company-sponsored bag of goodies you probably received on the way out of the hospital. Then there's something I call the National Geographic factor--that is, most of the images we see of black women breastfeeding are semi-naked women in Africa whose lives seem so far away from the African American lifestyle and experience.

To help remedy the global situation BAWA takes aim at hospitals and other maternity care providers. This year the campaign focuses on "Just 10 Steps--the Baby Friendly Way" showcasing the 10 steps hospitals need to do to encourage breastfeeding. Those ten points include:

• Have a written breastfeeding policy that is routinely communicated to all health care staff.



• Help mothers initiate breastfeeding within a half-hour of birth.




• Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.



• Give newborn infants no food or drink other than breastmilk unless medically indicated.



• Practice rooming-in -- allow mothers and infants to remain together -- 24 hours a day.



• Encourage breastfeeding on demand.



• Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants. (read all 10 points at www.worldbreastfeedingweek.org)

In our community, we need to talk and encourage each other more. And speak out. We still long for an African American role model in breastfeeding, like a Michelle Obama. In the meantime, if you are already on the breastfeeding bandwagon, tell others. Check out the "I Breastfeed Because . . . " campaign sponsored by Ameda, a leading breast pump maker. Mothers who are currently breastfeeding and or have in the past can log onto www.ibreastfeedbecause.com to upload 20-second videos that share the reasons why they chose to breastfeed.

Sharing My Story: Post-Partum Depression

A few weeks ago, I went to visit a girlfriend who has been showing some signs of post partum depression. I trekked all the ways to Queens, with dinner, two able hands for baby-holding and diaper changing and my trademark sense of humor, ready to be a supportive friend.

Turns out, I have a lot to learn. Because what she really needed from me was the truth.

My truth.

And my truth (that I somehow nearly forgot) was that I struggled with my own frightening bout with post partum depression. One that led me to get professional help.

Today I am talking candidly about my own bout with post partum depression in the hopes of starting an open conversation among black women and more personally, to help my girlfriend. To show, there's no shame in my game. If one more of us openly talks about post partum depression, I'm hoping that more of us will keep talking and helping each other. And so I start with the mama in the mirror. Here goes:

I'm pretty sure I had some sort of post partum after both of my children. But with my daughter, it was actually a little scary. Very scary. At first, I didn't really think it was post partum because I wasn't having dramatic crying spells or feeling sad or hopeless. In fact, as you may know of my personal story, if the circumstances of my pregnancy didn't tip me over into clinical depression, then I figured I was straight. During the daytime, I was happy and proud. I had a lovely 3 bedroom, 2 bath apartment, my freelance career was doing well, I was proudly breastfeeding and staying at home with my newborn.

But at night I was gripped with fear. Like seriously, irrational fear. I remember vividly thinking someone was in my bathroom waiting to kill me. I remember hearing noises all night. At first, I thought, well, I'm in a new place. It's a big apartment and I'm all alone with a helpless baby, of course you are afraid.

But then my fears got out of control.

I started having keep-me-up-at-night fears of a fire. Once I packed a "fire" backpack for me and the baby and left it underneath the window I designated as our escape route. At the height of it, my brother or father had to come over every night and sleep at the apartment with me. I couldn't sleep on my own. The fear took over my nights and my sleep. My dreams were violent. Someone was always hurting me or my baby. My daydreams and night dreams were vivid. I saw it all playing out. It seemed so real. I was afraid to sleep. And remember frequently staying up all night to avoid the violent dreams.

Something was wrong. I kept thinking it would pass. But it didn't.

I was too ashamed to tell my friends. I thought I was going crazy.

And the strangest thing about my fear was that, true to who I am, I always had an action plan. I was never just a victim. When fears of fire consumed me, I packed a backpack with essentials and carefully plotted the best escape route. When I thought someone was breaking into my house, I crafted the most ingenius, homemade, home security devices. Some of which, now make me laugh. One of which is in my current home today.

One night, at my lowest point, I was so afraid and yet so sure that someone was going to break in that nigh and hurt us, I slept with a spray bottle full of bleach in my hands. That was my self defense plan.

I've never told anyone that.

The next day, I knew I needed to talk to somebody. And I did. My doctor gave me a referral.

In just a few sessions with a therapist, things really turned around for me. By talking to a stranger, I felt surprisingly free to be open, vulnerable and honest. Short version: One day, something clicked for me and I felt better. In the end, I did what I needed to do to get in the right mind to take care of my baby. And I'm hoping that any woman who reads this and is battling with any sort of anxiety or depression post baby or at any time in her life will do the same.

And that's my story. Do you have one? There's a girlfriend out there who needs to know.

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.