Babies Are on an Uneven Playing Field Before They’re Even Born: Here’s Why

With the medical advances made in the US within the last 100 years, one would imagine that everyone would be able to benefit from those advances. Improvements such as the creation of fetal ultrasound and the decline in the maternal mortality rate due to more sanitary techniques being used and the introduction of antibiotics would lead one to believe that all pregnant moms should be on a level playing field and their children have the same chance of survival after birth. Most people would guess that there is no way one newborn baby, seconds after they are born, is better off than another newborn baby. That only seems fair, but it is not the truth. The truth is that even before a baby is born, the future of its health is already determined by its mothers race and socioeconomic status. The race and socioeconomic status of a baby’s mother plays a major role in the health outcomes of the baby. Socioeconomic status (SES) is the status that someone has because of how long they have been going to school, how much money they make, and what kind of job they have. Usually, someone that has finished high school and college, makes a lot of money, and has a good job is of high SES, while someone who didn’t complete high school, doesn’t make a lot of money, and doesn’t have a good job is considered to be of low SES (Baker, 2014). In addition to SES, race also plays a big role in the health of a baby after it is born. Being a Black woman of low SES in the United States means that their baby will be the most likely to be born early or not weigh enough when it is born, compared to a White woman of high SES (or low SES) (Salm Ward et al., 2010). Most would agree that with the medical techniques and improvements that exist, there should be no such disparity. 


When adverse birth outcomes are mentioned in this blog post, they are referring to low birth weight and preterm birth. Preterm birth means that a baby is born before 37 weeks of pregnancy (with the average length of pregnancy being 40 weeks). It is the leading cause of death of babies after birth in the United States, and accounts for 60% to 80% of infant deaths in those without illnesses that they were born with (Palmer, 2009). As for low birth weight, this means an infant being born weighing less than 2500 grams or 5 pounds, 8 ounces. Preterm birth is the biggest cause of low birth weight. (Goldenberg and Culhane, 2007).

Race and Birth Outcomes

If a baby is born too early, it can have major health issues for the rest of its life. So why are poor Black babies more likely to be born this way than poor White babies? It doesn’t have to do with biology. There is nothing biologically different between Black and White people that makes Black people give birth to babies too early or that weigh too little. So why is this happening? Recent studies have shown that it is most likely due to the stress caused by everyday racism experienced by Black women. When stress builds up over time, it can have really bad effects on someone’s body. For example, high levels of stress have been shown to cause preterm labor, which is when a woman goes into labor before the baby is ready to be born. The only way to address this problem is to fix the institutionalized and personally mediated racism in the US, and to educate doctors and healthcare providers about the fears and needs of Black women before and during their pregnancies (Dominguez, 2008). 

Socioeconomic Status and Birth Outcomes

Why do babies with parents of low SES have worse outcomes after they are born? This one might be easier to guess. A lot of people with low SES don’t have good access to health insurance, and when someone doesn’t have health insurance, it is harder for them to see a doctor. If someone doesn’t see a doctor often, their body might not be as healthy as it could be, which could cause them to not have a healthy pregnancy. When a pregnancy is not healthy, it is likely for a woman to give birth too early to an unhealthy baby. Also, people of low SES usually live in neighborhoods that have higher levels of crime, not a lot of sidewalks to walk on, and bad access to healthy food. Sidewalks are important because when people are able to walk around their neighborhood more, they can get more exercise and be healthier. Access to healthy food is also important because eating healthy food long-term contributes to better health, which would cause a healthy pregnancy. 


While all of the results above from a variety of studies study slightly different things that may have an effect on birth outcomes, most of the articles come to the same conclusion that birth outcomes are largely impacted by the socioeconomic status and the race of the mother. SES and race can have independent effects on the prevalence of preterm labor and low birth weight, but most of the time they work together. In almost all cases, Black women of low SES had the worst birth outcomes, but even when socioeconomic status was accounted for, Black women still had the worst birth outcomes. Most of the current and emerging research suggests that this is because of the daily toll that racism takes on a Black woman’s body, and this stress leads to preterm labor and birth, which usually brings with it low birth weight. All of these factors now need to be researched in terms of how to even the playing field. In a country with such innovative medical advances, the playing field should have been evened out a long time ago. So far, current research has mostly aimed to determine what the disparities are for different races and SES. It has only started to look into why these factors have an impact on birth outcomes. Because of this, these factors need to be investigated in more detail to truly figure out how and why they have such a great impact on the birth outcomes of babies in the US. It is unacceptable that a country with so many resources and so much knowledge has such a great gap in the health of infants after birth, solely based on race and SES.


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