Death of a child
Mamas on Bedrest: A Call for Compassion, Not Crucifixion
October 10th, 2012
On October 5, 2012 Jeanne Faulkner, R.N. posted on theFitPregnancy Blog about Tragic Teen Pregnancies. Seems yet another young teen aged girl hid her pregnancy and gave birth alone and scared in the bathroom. She subsequently killed the baby and disposed of it in a garbage bag. The baby was later discovered and the girl arrested.
From time to time we hear of such tragedies. I happen to know of one personally, and saw a few others working as a PA in a teen health clinic. It’s a really difficult situation. Those on the outside looking in are appalled by the young mothers’ actions. The media is crucifying them. And many want them punished to the full extent of the law.
But I like Faulkner’ take on the situation. These are young girls, often as young as 14 or 15, having babies. Babies are having babies. For whatever reason, the girls choose not to tell their parents (a question for a whole other post!), friends or teachers. They hide their pregnancies, childishly hoping they’ll go away. But what can we expect-THEY ARE CHILDREN!!! I could go on and on about the first grievous mistake being that they are sexually active in the first place, why is this happening and where are the parents/guardians? But that is all water under the bridge. The more important question is how do we help young girls who are caught up in such situations get the (mental/emotional and physical) help that they need so that they can recover, grow up, become productive adults and eventually have children of their own?
Jennie Joseph, CPM, was quoted in the article and I think that her words bear repeating. Joseph describes “labor madness”, a trance-like state many women enter into during labor, a sort of primal defense mechanism from the pain and overwhelm of the situation.
“Women from all walks of life disappear into an inner place (during labor). They retreat from the fear and pain and the overwhelming nature of what their body is doing. They don’t really know what’s going on and without help some panic. When a woman is supported by a caring midwife, nurse, doctor, doula and family we can call her back from that place. We can support her, help her and get her through the experience. But when a woman is alone the terror, pain and hormones kick some women into autopilot where they panic and do whatever they have to do to save themselves from this life-threatening situation.”
“And if it’s a young teenage girl, all alone, in pain, not fully understanding what’s going on, terrified of what will happen when her parents find out…that’s a recipe for labor madness right there.”
Labor madness. I like that term and I believe that it is fitting. We all like to believe that pregnancy, labor and childbirth are these ethereal states in which a woman experiences her truest feminine self. This occurs for many women. But for many of us, pregnancy, labor and childbirth can be fraught with hellacious complications, fear, chaos and at their worst, catastrophic if not deadly complications.
As mamas on bed rest, we’re on the front lines of complicated pregnancy. Yet most of us are grown women. Many of us are married or at least with a partner in the picture and if not, we have family, friends and a support system. We’re on the internet, reading websites, chatting with other mamas and gathering information in order to best prepare ourselves for whatever may lay ahead. This is the difference between pregnancy in a woman and a girl. As women, if we don’t have a support system, we know how to find one.
Young girls aren’t necessarily that savvy. Yes, many have grown up women’s bodies, but not the wisdom of age. Think back to your teen years. Were you fully equipped to manage all the feelings and emotions you were experiencing? Now add pregnancy, and all its physiologic (hormonal) changes, and you can readily see that trainwreck poised to happen.
I am not saying that what this young girl did was right. It absolutely wasn’t. But there are so many levels at which things went wrong I would find it difficult to prosecute her for a crime. I highly doubt that her actions were premeditated or that she acted out of malice or guile. She was afraid. It’s that simple. And she’ll be further traumatized by the criminal justice system. Will she ever receive counseling? Will she ever heal? I mean really heal???
I see this story as another reminder that women of all ages need support and compassion during pregnancy. For young girls, they need not only support but also caring and compassionate guidance-preferably before they become pregnant but most certainly after-to help them understand the complex physical changes they’ll experience as well as the myriad of emotional changes. Oh what a different story this would have been if this young girl had been able to talk to someone about what was happening! Oh what a difference it makes forMamas on Bedrest to have this support network!
I don’t know what will be next for this young girl or others like her. What I do know is that rather than crucify her in the media, we all need to show her compassion. She needs help so that she can heal. And we as a culture need to be thinking about what we can do to help end this type of tragedy in teen pregnancies.
Mamas on Bedrest: Standing for Little Brown Babies by Supporting Their Mamas
September 18th, 2012Welcome to the Third Edition of the Black Birth Carnival. Hosted by Darcel of The Mahogany Way Birth Cafe and Nicole of Musings From The Mind of Sista Midwife.
The Topic: Infant Mortality Awareness: Saving OUR Babies.
Many birth workers are talking about the alarming infant mortality rates in this country, but none are talking about infant mortality in the Black Community. That’s where this Blog Carnival comes in. We will talk about statistics, try to figure out why, and most importantly what we can do to help lower our infant mortality rates. This post will be updated with live links linking back to the other participants posts
I have a real thing for little brown babies. Having had two of my own, I can honestly say that they are the most precious (and most beautiful) beings in the world to me. Having also lost two pregnancies, sadly I also know the pain of losing precious souls.
It’s hard to believe that the United States has one of the higher infant mortality rates in the world, with African American babies dying at nearly 2-3 times the rate of White and Latino infants. According to the Office of Minority Health, a unit within the US Department of Health and Human Services,
African Americans have 2.3 times the infant mortality rate as non-Hispanic whites. They are three times as likely to die as infants due to complications related to low birth weight as compared to non-Hispanic white infants.
- African Americans had twice the sudden infant death syndrome mortality rate as non-Hispanic whites, in 2008.
- African American mothers were 2.3 times more likely than non-Hispanic white mothers to begin prenatal care in the 3rd trimester, or not receive prenatal care at all.
- The infant mortality rate for African American mothers with over 13 years of education was almost three times that of Non-Hispanic White mothers in 2005.
The OMH website goes on to list all the data from the US Centers for Disease Control and Prevention regarding infant mortality in the United States. At all indices, African American infants fare far worse than their White or Latino counterparts.
The statistics are alarming, yet I encourage you to read through them. I believe that change in the African American community-whether it’s regarding infant mortality, maternal mortality, health care delivery disparities, crime, homicide or anything else-is going to have to be an inside job. It is all well and good for university researchers to study what is going on in African American communities. It is fine if news outlets want to report on activities going on in African American communities. But little to none of these analyses makes one hill of beans difference if they are doing nothing to change the situation on the ground, and by my observations they aren’t doing much. Raising awareness is good but action is imperative.
I recently wrote a blog post called, Mamas on Bedrest: I’m Pro-Action! It engendered a lot of controversy because people felt that I was politicizing birth, bringing in the Pro-Life/Pro-Choice debate. I’ll admit that I chose the term “Pro-Action” as an attention grabber, but the meaning I’ve placed behind it is entirely different.
“Pro-Action” is a term that I believe we all have to embrace. So often in our culture, we vent “righteous indignation” over one thing or another, yet we fail to act on our beliefs. I believe failure to act is in large part responsible for the demise of our communities and our culture. Being “Pro-Action” means putting movement behind the lip service and working to effect change.
After reading the statistics on infant mortality in African American infants, you might sit back with a feeling of helplessness and hopelessness. It is a daunting problem and one that as individuals cannot possibly tackle effectively. But as individuals in collective, we can make an enormous impact. So how does one become “Pro-Action”? What does that look like when working to curb infant mortality?
- It’s working within your immediate neighborhood, community or congregation to assist mothers who are pregnant. Perhaps you give them a ride to their prenatal visits or watch their children so that they make it to visits unencumbered (we all know that even pregnant, you can move faster without the little ones along!).
- If mamas are on bed rest (my particular soft spot), it’s going by their homes and making sure that they have healthy meals and groceries, making sure that they are comfortable, talking to them, reassuring them, helping around their homes and with their children and family responsibilities.
- It’s talking openly and honestly to teenagers about sex and contraception. Let’s face it, the “sex outside of marriage is a sin” speech ain’t workin’ and hasn’t worked for decades. I think it’s time for a new approach (just my opinion here).
- It’s educating teen-aged girls about why teen pregnancy is not a good idea. Again, address not only the moral arguments, but also address the concrete data in the medical literature that clearly shows that teenagers have higher rates of maternal and infant mortality. Contrary to popular beliefs, pregnancy is not a benign condition. Many things can and do go wrong and they tend to go wrong in the extremes-amongst young girls under 20 and women over 40.
- It’s grassroots organization like Mamas of Color Rising here in Austin, TX. This group of low income African American and Latina mamas has come together to train birth attendants of color to be with mamas of color as they labor and deliver. They are supporting and training midwives of color who will attend births of low income mamas of color. They have lobbied for and are on the crest of seeing rules changes in the Medicaid laws of Texas such that Midwives will be able to care for and attend to pregnant women on Medicaid and be reimbursed for their services. And in just mere weeks, this dynamic group of mamas will see the grand opening of a free prenatal clinic for low income women of color who will be able to receive prenatal care in the midwifery model. Yes, these mamas are definitely “Pro-Action”!
I could go on and on, but I think you get the picture. Pick an area that pricks your heart and then Take Action! Get out and get involved. If each one of us becomes involved in each of our respective communities, soon, our efforts and our reach will coalesce and we’ll find that we are one large collective effecting change on a grand scale.
This Blog Carnival is once such example of change in action. Let’s keep the ball rolling and all be “Pro-Action” for our mamas, our babies and our communities.
Other Posts in this Carnival
Health Programming and It’s Impact on Black Infant Mortality-By Amy Hereford
Black Infant Mortality and Your Responsibility. By Darcel of The Mahogany Way Birth Cafe
Stop The Talking…Implement Solutions! By SistaMidwife Productions
Mamas on Bedrest: How Embarrassing-The US Infant Mortality Rate
September 12th, 2012September is National Infant Mortality Awareness Month and there are numerous events, campaigns and activities taking place all designed to raise awareness about infant mortality. The United States has an embarrassingly high infant mortality rate in contrast to many other countries. But what is even more disturbing is the fact that according to an article published in The Lancet, May 2010, the country isn’t keeping up with global gains in reducing child mortality, despite significant health care spending.
Citing an article published on DOTmed.com summarizing The Lancet publication,
According to the World Bank, the U.S. has the highest infant mortality rate among 33 countries that the International Monetary Fund defines as having “advanced economies.”
At the time of the DOTmed summary, The U.S. ranked 42nd in the world in child mortality.
“What is surprising is that the U.S. continues to fall even farther behind, while other developed countries such as Australia and New Zealand have shown much better improvements in child mortality. If we look at progress over time, we see the U.S. was ranked 29th in the world in 1990 and has dropped to 42nd now (2010). What that tells us is that we’re not making as much progress as other high income countries.”
~Julie Rajaratnam, assistant professor with IHME and one of the study’s authors.
While our infant mortality rate is dismal and not readily improving in comparison to many other nations, researchers have found that there are some identifiable reasons for our high infant mortality rate. The leading causes of infant death in America are congenital defects, preterm birth and low birth weight and sudden infant death syndrome. They believe that if the US addresses those issues, the infant mortality rate will surely improve.
Birth Before Due Date
The US has an unusually high preterm birth rate in comparison to many other countries. According to a 2009 report by the National Center for Health Statistics, compared to Europe, America has a higher percentage of preterm births, likely the main cause of its higher IMR. (Preterm is defined as birth before 37 completed weeks of gestation.) Not only do we see many babies born before the recommended 37 weeks gestation, there are also thousands of babies born before 39 weeks gestation, the acceptable length of “term birth”. The March of Dimes has repeatedly advocated for education and policy changes within hospital and birthing centers encouraging physicians and families to do their best to allow babies 39 weeks without any sort of intervention (induction or cesarean section) unless absolutely necessary (i.e. mama or baby at risk).
Dr. Scott Berns, a pediatrician and a senior vice president with the March of Dimes Foundation reiterates that there is important development that occurs between 37 and 39 weeks gestation. Because we have gotten so accustomed to seeing “good” outcomes at 37 weeks, we’ve been lulled into a false sense of security. Dr. Berns notes that if we were to look at the overall numbers, we’d see the dip in positive outcomes in babies born before 39 weeks gestation.
The US also has a higher percentage of older mamas and mamas who have used assisted reproductive technologies. Mamas who become pregnant using ART are at increased risk of having a multiple pregnancy which carries with it an increased risk of preterm birth.
Socioeconomic Disparities
Many experts also draw links between America’s vast socioeconomic disparities and infant death. According to Dr. Gregory, half of U.S. births are to mamas on Medicaid. While both preterm birth and SIDS can happen to any family, these conditions are more prevalent among poorer families. Additionally, a 2008 NCHS report found that the infant mortality rate for black women was 2.4 times the rate for white women in 2005 (and this disparity exists today!!).
According to IHME’s Rajaratnam, looking at the U.S. child mortality rates by counties would likely identify areas that are performing just as well as Europe, and others on par with the world’s poorest countries.
“We are starting to do some of that local level research now and those results will help us get closer to putting our finger on what needs to change in order to save more lives.”
Both Dr. Gregory and Dr Rajaratnam admit that socioeconomic factors and access to care can’t account for the entire higher infant mortality amongst lower income ethnic minorities. However, they play a major role and must be addressed if infant mortality rates are to be lowered nationwide.
More Research
Both Drs. Gregory and Rajaratnam agree that there needs to be more research into the possible causes of infant mortality and both advocate that the National Institutes of Health, the National Institute of Child Health and Human Development and other research and policy organizations allocate funds and research efforts into infant mortality.
It must also be noted that advances in treatments, such as the use of progesterone injections for preterm birth, Magnesium Sulfate’s impact on protection of preterm infant brains, improvements in neonatal intensive care and improving access to perinatal health care will all improve infant outcomes.
References
Neonatal, postneonatal, childhood, and under 5 mortality for 187 countries, 1970-2010; a systematic analysis of progress towards Millennium Development Goal 4. Julie Knoll Rajaratnam PhD et al. The Lancet, Volume 375, Issue 9730, Pages 1988 – 2008, 5 June 2010. doi:10.1016/S0140-6736(10)60703-9
