Birthing Beautiful Ideas

At the end of last month, Courtroom Mama wrote a chilling post on the even-more chilling film, “Crisis in the Crib: Saving Our Nation’s Babies.”  A 2009 documentary by Tonya Lewis-Lee, “Crisis in the Crib” focuses on the striking racial disparities found in U.S. infant mortality rate data.

Specifically, it focuses on the fact that as of 2006, black infants in the United States are more than twice as likely to die in their first year of life as white infants are.  The most frequent causes of these deaths are (in order from most frequent to less frequent): 1) low-birthweight, 2) congenital malformations, 3) sudden infant death syndrome (SIDS), and 4) maternal complications.

tonya lewis-lee, director of "crisis in the crib" and spokesperson for "a healthy baby begins with you"

Notably, the infant mortality rate is higher for black infants even when one compares babies born to highly educated white and black mothers.

It is higher despite the fact that the smoking rate among white pregnant women is higher than it is among black pregnant women.

And it is higher no matter what the ages of the mothers in the comparison groups.

I have neither the skills nor the education to analyze this data–that is, the numbers themselves–in any meaningful sort of way.  Nonetheless, one does not need such skills in order to feel the deeply sobering effect of the data and the stories described in “Crisis in the Crib.”

And I, for one, felt very much like Courtroom Mama did after watching the film:

Watching “Crisis in the Crib,” I could see the water I swim in for a moment and realized that I sometimes have “birth blinders” on.  I care so much about unnecessary interventions and evidence-based care that it’s tempting to look at our flagging position in rank for maternal and infant health and say “see! It’s the unnecesareans and the pitocin and the EFM!” But the truth, as the documentary shows, is more complicated. The truth is a story that is so big and so awful that it crushes blogs under its tires and we can’t look at it for fear of turning to stone: we live in a nation where the legacy of slavery and segregation is a permanent invisible underclass. Mothers and babies are dying, and I, for one, am not caring enough about it. (emphasis added)

I’m not caring enough about it.

I’m not caring enough about the injustice of a society in which adequate access to transportation, affordable and nearby fresh produce and whole foods, employment options, childcare options, and prenatal care often play out as privileges and luxuries rather than absolute human rights.

I’m not caring enough about the outrage we all should feel over the fact that the stress of racism not only creates chronic stress for many (if not most) African-American women but also puts mothers and babies at greater risk for adverse pregnancy and birth outcomes.

I’m not caring enough about the fact that I’ve often failed to take into consideration the complexities and nuances of the injustices in the U.S. maternity care system in my own analyses and critiques of this system–that I’ve focused on the institutional sexism and ignored the institutional racism of this system.

And it’s certainly time to care more.

The Office of Minority Health (OMH) has a number of resources to get people caring more about the racial disparities in the infant mortality rate in the United States.  I don’t know if any of us can care enough about it, but caring more (and possibly doing something) is better than caring for and doing nothing at all.

• Do you have 30 minutes to spare? You can watch “Crisis in the Crib” and download relevant posters and brochures on the OMH website.  (And then you can send a link to this short film to all of your friends!)
• Do you represent a news outlet or other relevant media? A number of infant mortality experts are listed on the site and are available to do interviews on the topic.
• Do you have the time and the means to host a large event? OMH is seeking health professionals to hold A Healthy Baby Begins With You events in their communities.
• Do you have any interest in becoming a preconception peer educator? OMH is enlisting college-age minority students to serve as preconception peer educators to discuss everything from disparities in minority health to preconception health to HIV and STIs on college campuses and in the community at large.

(Many, many thanks to Courtroom Mama and Jill from the Unnecesarean for reminding me and many others just how much we should be caring about this issue.)