Maternal Health

Mamas on Bedrest: The Myth of the Missing Black Father Debunked

May 19th, 2015

Greetings Mamas!!

Seldom do I revert to childish gloating, but occasionally I just have to go there. Such is the case as I am gleefully reading the report put out by the US Centers for Disease Control and Prevention utilizing data from the National Center for Health Statistics which shows that Black fathers are just as engaged-if not more so-in the rearing and support of their children than fathers of other races. 

Excuse me while I take a moment to gloat.

Yeeeeeeeee haw!!!!!

Yaaaaaaaahoooooo!!!

“Ha! Told yaaaaaaa!!”

“Na na na na na, you were wrong!!!!!”

Now you may be wondering why I am so over the moon about this research? Well, there are several reasons.

1. I am sick to death of hearing how black men are no good, they “hit it and quit it” and don’t take responsibility for the children that they help create.

2. I am sick and tired of hearing that all the ills of the world are because of black men.

3. I am thoroughly done with the portrayal of black men-black people actually-as uncivilized and bringing down the status of US culture globally.

4. And I am beyond through with this nation feeling that it is okay to kill a black male simply because he is present in time and space!

Now you all may be wondering, “What in God’s name does any of this have to do with high risk pregnancy and bed rest??” Well, it has everything to do with it. As I have often reported, African American women and infants have the worst birth outcomes of any other race or ethnicity in the US, with 2-4 times the morbidity and mortality of women and infants of other races and ethnicities. An African American infant is more than twice as likely to die before its first birthday than infants of other races and ethnicities and this is due primarily to preterm birth!!!

Are you following me yet?

Let me continue. Ever since I can remember and at least for my adult professional life “the party line” regarding the black family has been,

“It’s the breakdown of the black family, and the absence of black fathers in particular, that is the cause of the high maternal and infant morbidity and mortality that exists amongst African Americans.”

As an African American, and now as a divorced single mama, I knew that isn’t at all the case but had no way of substantiating what I knew to be true. Now there is concrete data obtained by one of the most reputable scientific bodies in the United States that has shown what many of us African Americans already knew. Yes, many more African American children are born to  and/or raised by “single” mothers, but what this study has shown is that while the parents of a child may not be married, they may in fact be together (co-habitating) and even if they are not living together, African American fathers are intricately involved in the rearing of and support (and here I do mean financially) of their children, in many cases more than White or Latino fathers.

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My son and his dad reading at the library.

 

So again you may be asking, “What does this have to do with preterm labor and infant mortality?” Stay with me.

There is a lot going on in the United States as regards race and quite frankly none of it is good. We have all seen and heard the news reports of police shooting unarmed African American men, racial profiling of both African American men and women, disparities in discipline for African American School Children and so on and so on and so on. These are daily facts of life, daily stressors for African American women, and daily stressors for the infants they are carrying. Additionally, poverty for all families is reaching heights not seen since the great depression and other times in our history. The unemployment rate is still teetering on the high side and looms highest amongst African American men. More depressing is the fact that people of any race with higher educations are now just as likely as those with little to no education to endure a prolonged time of unemployment, and those numbers are again higher for African American men. This amounts to markedly elevated stress for African American men and African American women, their partners. Stress, as well as poverty, is not good for anyone, but particularly not good for pregnant African American women and the infants that they are carrying. We know that stress is an independent risk factor for preterm labor, prematurity and low birth weight all areas in which African Americans have the highest rates. So I think that it is safe to say that poverty, unemployment and racism are far strong predictors and stressors on maternal and infant morbidity and mortality in African Americans than “absentee dads”.

Now I know that many of you are going to come right back at me and say, “But what about black on black violence? What about the crime rates in predominantly black neighborhoods? And we know that many African American men abandon their family responsibilities.” Agreed. But the data from this study, which was broad and the study well constructed, shows that despite all these negative influences, African American men continue to be hands on fathers, and at greater rates than white or Latino fathers.

I wholeheartedly admit that there is much that needs to be done within my culture to heal it. But let’s not look astray too much to lay blame. Much of what we see in these urban, depressed areas is poverty; boarded up buildings, non-existent stores and services, poorer schools and no revenue coming into these areas. Add to that no jobs, no way for people in these areas to support themselves and their families, no money, leads to crime and yes, homicides. Is it okay? No. Is it an excuse? Of course not. But let’s consider the fact that if people in these areas had jobs, income and ways in which to support and sustain their families, then, according to data from the CDC again, crime rates would in fact go down and quality of life would go up.

But I myself have veered a bit off topic. The bottom line is this-even in depressed economic times, even in economically depressed communities, even when jobless, even with the threats to their lives black men are taking care of their children. Contrary to the sensationalized news reports and the stereotypic depictions on television and in movies, black men are taking care of their children-their families. The question now becomes, how can we as a culture, as a nation give them a hand so that this can continue? What are we as a nation, as a culture doing to reduce poverty, increase jobs, increase opportunities for education so that not just black men, but all men, can have the means to raise and support their children?

Finally, we have to ask the question, “Have we too narrowly defined “family”? We know from this work that there are men and women living together and raising their children but not married, or married and helping to raise their spouse’s children. Aren’t they still a family? What about blended families? Large extended families? This is all data that is yet to be analyzed-or even obtained. We know that African Americans being of the African diaspora are a “tribal” people. Migration and dispersion-both voluntary and involuntary-has also played a role in the depressed socioeconomic status of African Americans resulting in decreased community support for families. How are we as African Americans going to re-establish our communities and our families going forward?

There are many unanswered questions and I am sure that many more studies will come about, but what we do know is this: African American men are supporting their children and its time to toss out the stereotypes of them as “absentee fathers” and do what we can to support their efforts and the efforts of all men who want to be active parents to their children.

References:

Jo Jones, Ph.D., and William D. Mosher, Ph.D., “Father’s Involvement With Their Children: United States, 2006–2010”. National Health Statistics Report, Number 71, December 20, 2013

The Causes of Infant Mortality-The US Centers for Disease Control and Prevention

African-American Women and Their Babies at a Higher Risk for Pregnancy and Birth ComplicationsThe US Centers for Disease Control and Prevention

Black Unemployment Rate 2015: In Better Economy, African-Americans See Minimal GainsInternational Business Times.

Murry, V. M., Brown, P. A., Brody, G. H., Cutrona, C. E. and Simons, R. L. (2001), “Racial Discrimination as a Moderator of the Links Among Stress, Maternal Psychological Functioning, and Family Relationships.” Journal of Marriage and Family, 63: 915–926. doi: 10.1111/j.1741-3737.2001.00915. x

The Absent Black Father Myth Debunked-by CDCThe Daily Kos

Mamas on Bedrest: Does Pregnancy Protect Against Cardiovascular Disease?

April 6th, 2012

My grandmother, Holly Alston Turner had 13 pregnancies and 15 children. Yes, you read correctly, 15 children! Born in 1897, she had my Aunt Candace, her first born in approximately 1917 and my dad, her youngest in 1940. In between she had a child about every 18 months to 2 years. She had 2 sets of twins, boys born after Aunt Candace and girls who are 4 years older than my dad. Unfortunately the boys died of childhood illnesses before the age of 3. My grandmother died in the summer of 1967 just before her 70th birthday in December from a stroke.

When I saw the article title from Medscape, “More Pregnancies, Longer Life? I immediately thought of my grandmother. In this study, researchers sought to determine the association between reproductive history and all causes of cardiovascular (heart disease and stroke) death. This is what they found:

“This study searched for an association between gravidity/parity and overall mortality from cardiovascular disease (CVD), including coronary heart disease (CHD) and non-coronary heart CVD, in 1294 middle-class women (the Rancho Bernardo cohort). Clinic visits, questionnaires, physical examinations, and laboratory testing were used for data collection. Gravidity/parity was used to divide the cohort into 5 groups (0, 1, 2, 3, 4 or more). The average age of the participants was 70.6 years; both the median gravidity (number of pregnancies) and the median parity (number of live births) were 2. The average age at menopause was 46.5 years, and the average duration of menopause was 23.7 years. During follow-up, 707 of the 1294 women died, with 46.5% of the deaths attributed to CVD (20.5% to CHD and 26% to non-CHD CVD).

Women with higher gravidity/parity were older at menopause, spent fewer years in menopause, had slightly higher body mass index, were less likely to be current users of estrogen therapy, and were more likely to be receiving diabetes medication.

Multivariate analysis controlling for age and other known risk factors found that women with 4 or more pregnancies had lower risks for overall CVD mortality (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.38-0.96) and non-CHD CVD mortality (HR, 0.48; 95% CI, 0.26-0.90) in comparison with nulligravid women. Trend analysis showed reduced risk for overall CVD mortality and non-CHD CVD mortality with increased gravidity.”

The findings from this study did not match findings from similar studies seeking answers to the same question. While one study reported a slightly increased risk for cardiovascular disease and coronary heart disease among women with 6 or more pregnancies, another found an increased risk for myocardial infarction (heart attack) in women with 5 or more deliveries. This study had different observations. Women with high gravidity (4 or more pregnancies) had lower risk for overall CVD and non-CHD CVD mortality.

But the authors of this study recognize that many factors play into a woman’s mortality. One has to look at ability to conceive-did she have problems and utilize fertility treatments, for example. What is her overall socioeconomic status? Many women of lower socioeconomic means have fewer children. Women who have many pregnancies, especially those without complications may in fact have better overall health to begin with, so would have lived longer and would have been less likely to develop cardiovascular disease anyway. It’s a fascinating subject that will clearly have to be researched further before any definitive answers are obtained.

As for my grandmother, I think many factors contributed to her reasonably “young death”. Raised in the south, she had what many of us would call the “southern palate”, a high fat high salt diet which we know contributes substantially to cardiovascular disease-especially in African Americans. Two months after giving birth to my father, my grandfather died, so she was left to raise the 10 children she had at home on her own. She was definitely of low socioeconomic means which we know contributes to higher rates of morbidity and mortality for all diseases across all ethnicities. She was an African American woman in this country when segregation and racial discrimation was the norm and was not at all challenged. She would be a diffiicult study participant in that there are so many confounding variables in her history it would be hard to know what really caused anything.

And I believe that is the conclusion these researchers came to. It would be nice to say that having several pregnancies is protective to women’s health, but as we see with my grandmother, it clearly had little to no bearing. One could argue that my grandmother had an excessive number of pregnancies that stressed her body and her heart. Possibly. Her southern upbringing and dietary habits certainly didn’t help her health. True. Stress?? We can’t even go there. I think in time we will be better able to assess the effect that pregnancy has on a woman’s overall health long term, but we’ll also have to find a way to factor in a woman’s environment and the role it also plays on her health.