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Why are my sisters dying?

by Ngozi Osuagwu, MD | April 22nd, 2018

Why are my sisters dying?

When I decided to launch my website, the initial tag line was ‘Why are my sisters dying?’ I wanted to know why there was such a disparity in health outcomes between black and white women. The tag line did not have a positive feel so with the help of my sister I changed it to ‘Keeping my sisters alive and healthy’.

Reading the article that was published in the New York Times on April 11, 2018 titled Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis: The answer to the disparity in death rates has everything to do with the lived experience of being a black woman in America written by Linda Villarosa reminded me of my initial tag line. It is a long article but it is worth the read. The article helps answer the question –  ‘Why are my sisters dying?’

Below are excerpts from the article that I found pertinent:

Black infants in America are now more than twice as likely to die as white infants… a racial disparity that is actually wider than in 1850, 15 years before the end of slavery. Education and income offer no protection. A black mother with an advanced degree is more likely to lose her baby than a white woman with less than an eight-grade education.

The United States is one of only 13 countries in the world where the rate of maternal mortality – the death of a woman related to pregnancy or childbirth up to a year after the end of pregnancy is worse than it was 25 years ago. Black women are three to four times as likely to die from pregnancy- related causes as their white counterparts.

The reasons for the black-white divide in both infant and maternal mortality have been debated by researchers and doctors for more than two decades. But recently there has been growing acceptance of what has largely been, for the medical establishment, a shocking idea: For black women in America, an inescapable atmosphere of societal and systemic racism can create a toxic physiological stress…that lead to higher rates of infant and maternal deaths.

When a person is faced with a threat, the brain responds to the stress by releasing a flood of hormones, which allow the body to adapt and respond to the challenge. When stress is sustained, long-term exposure to stress hormones can lead to wear and tear on the cardiovascular, metabolic and immune systems, making the body vulnerable to illness and even early death.

Persistent racial differences in health maybe influenced by the stress of living in a race-conscious society. These effects may be felt particularly by black women because of the double jeopardy of gender and racial discrimination.

Why are my sisters dying? It would be easy to say it is because of poor eating habits, lack of exercise, poverty, obesity, etc. but we are learning it is much more than that.

What is the solution? The obvious solution would be to end racism. While we as a society work on this, there are some tangible things we can be doing.

We have to advocate for each other. Even if you are not considering pregnancy, you can share the information and be a health advocate.

Decreasing maternal mortality

  • Avoiding unintended pregnancy – using birth control until ready to become pregnant.
  • Seeking prenatal care early and going to your prenatal care visit regularly.
  • As the article suggested – getting a doula.
  • Do not be afraid to ask questions.
  • Listening to your body – if something does not feel right, get help immediately.
  • If you have a chronic illness like high blood pressure, diabetes or asthma, make sure you are managing it appropriately. The way that it is controlled during pregnancy maybe different from when you are not pregnant.
  • If you are high risk while you are pregnant, you should have your first visit postpartum in 2 weeks and then again at 4 – 6 weeks.
  • Go to your postpartum visit.

Decreasing infant mortality –

  • Knowing your history – if you have a history of preterm delivery (delivery of a baby before 37 weeks), it is important to have the length of your cervix checked when you are about 16 weeks pregnant (4 months pregnant) and starting on progesterone.
  • Listening to your body – if you have any abnormal discharge – inform your health care provider
  • Breastfeed
  • Know the ABCs of safe sleep – Baby should be alone in the crib, on their back, in a crib.

 

Eating a diet full of vegetables and fruits and exercising regularly are positive interventions for all of us.

 

 

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The book discusses common gynecological and women’s health issues in a series of witty and entertaining letters. These letters, all educational, offer suggestions on what approaches to take in tackling the medical problems that typically bring women to an ob/gynecologist. The letters are spiced with art, a poem and quotes. Although its emphasis is on gynecology and women’s health, it touches on some other medical issues that make women visit their doctors.

The second half of the book briefly discusses the most common gynecological conditions and also provides an overview of sexually transmitted infections. A list of annotated websites dealing with the different topics in the book is provided for the reader who wants to pursue each subject in depth.




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