Nationally and locally African American women and infants have higher rates of infant and maternal death than any other ethnic group in our country. According to the New Mexico Department of Health's 2015 Health Equity Report, African American infant mortality rates in NM are the highest of any ethnic group. In New Mexico, Hispanic and Native American women also suffer from high rates of poor birth outcomes. I believe that we have a right and responsibility to change this.
During the 2014 Legislative session the Office of African American Affairs (OAAA) took leadership on this issue. Senate Bill 69, Sponsored by Senator Ortiz-y-Pino, directed the Office of African American Affairs to address this issue, and Governor Susana Martinez allocated funding for the Office to pilot it's efforts. The result of this legislation, which passed unanimously on the House and Senate floors, and the funding from our Governor resulted in The Office of African American Affairs being able to offer a new prenatal care model in Bernalillo County that has been shown to improve birth outcomes for women of all ethnicities, and African American women in particular.
The prenatal care model, CenteringPregnancy, is a group care model that gives patients up to 10 times more time with their provider. The average prenatal visit is 3-10 minutes. This model provides pregnant women with a 2-hour visit with their provider. The model is unique because it works to consciously change the power dynamics between providers and patients and it provides patients with a lot more time to have their questions answered and concerns addressed. Patients become active experts in their own care and providers become active partners. Women are also encouraged to learn from each other in this group care model.
The prenatal care model chosen by OAAA, works to improve birth outcomes for women and their children by actively addressing stress, relationships, breastfeeding, nutrition, smoking cessation and a host of other topics. The model is designed to support all pregnant women wholistically. Anyone can enroll in the Centering prenatal care program.
The role of race/ethnicity in poor outcomes among African American women is thought to come from generational and personal experiences of racial discrimination and hardship over one’s life, including psychological factors. Unlike most health disparity areas, when it comes to African American infant mortality, an increase in income and education in pregnant African American women’s lives can actually increase the likelihood of infant mortality. Preterm birth and/or low birth weight is the primary causes of infant mortality for infants born to African American mothers. CenteringPregnancy and provider cultural humility can help to address these factors.
Providers must keep in mind that African American mothers have an elevated risk, regardless of maternal report of stress, and should be monitored and listened to with extra care during pregnancy. The following facts are important for providers to keep in mind when caring for African American mothers during pregnancy:
- African American women routinely have more than double the risk of infant mortality of their White/Caucasian counterparts
- When examining national data, NO LEVEL of education or income has been shown to reduce the African American infant mortality rate lower than that for the poorest, least educated White/Caucasian mothers
- The following factors should be considered when assessing neonatal mortality risk for African American mothers:
- Family (especially maternal) history of preterm birth/complications/infant mortality, as daughters tend to reflect their own maternal outcome
- Family history of low birth weight
- Personal history of miscarriage, previous preterm birth
- Stress level
For more information on this initiative or to learn how you can help, please use the "contact" page on this site.