Who's Caring for Our Babies?

What expecting black mothers need to know about infant mortality.

Last year I came across a New York Times story about increasing levels of infant mortality among African Americans. It stated that deaths of children in the first year of life, on the decline in previous years, were rising steadily. A few months later, another New York Times article discussed the declining rate of infant mortality around the world, primarily in African and South Asian countries, as a result of international campaigns . As a mother of two who has been blessed never to have experienced the tragic loss of a child, I asked myself, "Who is caring for our African-American babies?"

The term "infant mortality" refers to babies born alive who die before their first birthday. The cause of death can range from complications of premature birth and low birth weight to SIDS (sudden infant death syndrome) and accidents. Infant mortality has declined in the U.S. over the past 50 years, but our country still has the second worst newborn rate in the developed world. And the rates for infant death among African Americans remain alarmingly high.

In 2004, the national average was 6.78 infant deaths per 1,000 live births.But for African Americans, the rate was double that—13 infant deaths per 1,000 live births—and in some states, rates among African Americans were as high as 20 deaths per 1,000 live births.

This disparity is not simply related to poverty. Yes, being poor is hazardous to your health and increases the risk of troubled pregnancies and births. But statistics show that infant mortality strikes African Americans at higher rates regardless of socioeconomic status. In fact, a highly educated, middle-to upper-middle-class black woman still has a greater risk than an uneducated, poor white woman of losing her babybefore the baby's first birthday.

Just as puzzling, the disparity may be not just about race, but also about culture. Studies show that African immigrants in the United States have the same infant mortality rate as the general U.S. population. But after one generation, their rates plummet to the level of other African Americans.

Medical experts are hard at work to understand racial and cultural disparities in infant mortality. The most obvious area of research is around the availability of quality health care. But there are likely other factors at play as well. Some studies have shown that African-American babies are more likely to sleep in the same bed as their parents and older siblings, increasing the risk of death from rollover suffocation. There is also some evidence that African-American women have less frequent prenatal carein their first and second trimesters, relying more on care and advice from relatives than from doctors. Scientists are also beginning to look at the role of stress as it relates to race, and its impact on having healthy babies.

The impact of these deaths is monumental. Our country is losing important contributors to our society. We need the heart, souls and minds of African-American children to continue to push America to be the country it must be. And the pain and suffering that women and families endure as a result of losing their children is devastating. When a woman is pregnant, she bonds with that baby in her womb. Her family prepares to receive the new life. The pain, sorrow, depression and helplessness of losing a child affects not just the woman, but also her entire family and her community.

As scientists, doctors and social workers continue their work to try to determine the root causes of this terrible disparity, I have committed to working with the Office of Minority Health in the U.S. Department of Health and Human Services to remind women that, as vessels of the future, we must take care of ourselves. Healthy women create healthy babies, which create healthy communities. With the fast pace of life, we can all get caught up in our day-to-day lives and forget one of our most important contributions as women. We can also forget that pregnancy and childbirth are incredible biological and medical phenomena that should not be underestimated or taken for granted.

There are some simple things we can do to better support our babies, our families and our communities:

• We must forget the myths of our ancestors squatting in the fields, having babies then continuing to work in the hot sun. Yes, many of us survived and thrived through difficult circumstances. But many—countless others, too many to allow ourselves to comprehend—died.
• We must trust that our doctors can help us. If we have questions, it's up to us to speak up.
• We must accept that we need preconception care, prenatal care, healthy diets and exercise.
• We must not drink or smoke while pregnant.
• Once our children are born, we must put them to sleep on their backs, in cribs, with nothing nearby that could smother them. We cannot have our infants sleeping in beds with parents or siblings. The statistics related to deaths by rollover suffocation are staggering, and this kind of death is preventable.

Yes, we can do everything right and still suffer a tragic outcome. But doing things right will greatly reduce the chances that our babies die. Black babies in America matter. Black children matter. We can do something to make sure healthy babies prosper in America. Spreading the word is at least a start.

Tonya Lewis Lee is a writer and author in New York.