Health Disparities and Stillbirth – S1 E17

[00:00:00] Jessica Stewart-Gonzalez: Welcome back to The Parenting Brief. I’m Jessica Stewart-Gonzalez, an Arizona working mom and Program Director for the Maternal, Infant, and Early Childhood Home Visiting Program at the Arizona Department of Health Services. Parenting can be tough. But don’t worry, that’s why we’re here. So if you have questions about pregnancy,

[00:00:24] raising a newborn, and navigating the toddler years, you’ve come to the right place.[00:00:30]

[00:00:38] We’re so glad you’re here for another episode of The Parenting Brief. On one of our previous episodes, “How to Count Your Baby’s Kicks,” we talked about a technique to prevent still birth. By counting fetal movement, pregnant mothers can identify what patterns are normal and when to be concerned and seek medical advice.

[00:00:56] In my conversation with Emily Price of Healthy Birth Day, [00:01:00] we looked at the alarming statistics surrounding stillbirth. While one out of every 167 pregnancies ends in stillbirth, the number is worse for Black mothers. One in every 96 pregnancies ends in stillbirth for Black parents. We’re continuing this conversation today on health inequities, why they exist and what we can do to support women of color during pregnancy.

[00:01:25] Plus how to empower expecting parents to advocate for themselves, their health, and the [00:01:30] health of their unborn babies

[00:01:36] To shed some light on the health disparities facing mothers from minority populations is Stephaney Moody, the Health Equity Coordinator at Healthy Birth Day. Stephaney, thank you so much for joining us today.

[00:01:48] Stephaney Moody: I am so glad to be here. Thank you for having me.

[00:01:52] I

[00:01:52] Jessica Stewart-Gonzalez: wanted us to start by picking up where we left off from the count the kicks episode. We had mentioned earlier that stillbirth is [00:02:00] much more prevalent among Black mothers with one in 96 pregnancies ending this way.

[00:02:05] Can you tell us why this number is so high?

[00:02:08] Stephaney Moody: Statistics show that in America, one out of every 167 pregnancies end in stillbirth, and the rate is double for Black women. As you mentioned, the stillbirth rates for Black women are one in 96. So that’s double what the national average is. Some of the reasons that this actually [00:02:30] exists,

[00:02:30] research points to several reasons including systemic racism. And that’s when the systems, the institutions, policies, practices, representations all work together to perpetuate racial inequity. So like a heartbreaking example of systemic racism is that health outcomes for Black women are dismal compared to their white counterparts.

[00:02:54] In 2015, there’s a study from the Department of Health and Human Services that reported that a [00:03:00] baby is more than twice as likely to die during childbirth if the birth mother is Black. A Black mother is three to four times more likely to die during childbirth than a white mother. A 2016 study reported that Black people were significantly less to receive adequate pain management medication because there’s this false belief that’s held by almost 75% of medical professionals that participated in this study that Black people have a higher pain tolerance than other [00:03:30] races.

[00:03:31] Now, Black people are going to the same hospitals as their white peers, but yet COVID-19, they were disproportionately affected by it in communities across the country. So systemic racism still exists. This results in what’s called toxic stress. Research shows that years of being treated equally and or unfairly, essentially being an African-American woman in a systemically unjust system

[00:03:56] and all that comes with it has led to real pervasive health [00:04:00] issues for Black women. There’s also epigenics and those are your physiological variations that are caused by external or environmental factors that switch your genes off and on. And it affects how the cells read genes instead of being caused by changes in the DNA sequence.

[00:04:17] Another issue is predisposition to certain conditions that may lead to stillbirth, such as gestational diabetes, preeclampsia, or high blood pressure, which are all linked to maternal [00:04:30] stress. Experts say that Black women are less likely than other races to receive early treatment for these conditions.

[00:04:37] Jessica Stewart-Gonzalez: It just is painful to think about those experiences and experiencing a loss of stillbirth, but then being treated a certain way or having somebody downplay that trauma and that loss just because of the color of your skin just has to be one of the most painful experiences.

[00:04:59] Stephaney Moody: Definitely [00:05:00] a very painful experience. Our family, and this is what launched me into taking this role in this position and even taking this stance against stillbirth and racial disparities that exist, our family experienced the loss that comes with stillbirth when my sister Angie she lost her baby in the early nineties to stillbirth and the difficulty in it is not being able to prove it.

[00:05:28] She had [00:05:30] baby number five and usually she would go in give birth pretty quickly. She would labor very quickly and give birth. This time with Jasmine it was very. She labored for days. And she’s speaking to her doctor, she’s talking, she’s saying something’s not right. Now this is before there was a Count the Kicks app.

[00:05:53] And she’s explaining to the doctor that there’s something off she doesn’t know to count fetal movement. The [00:06:00] doctor’s telling her to lay on her left side, drink more water and do all kinds of things. Yet if they would have listened to her, would have monitored her, they would have known that there was definitely an issue with the cord. OrHercord was too short.

[00:06:15] And so, as she was trying to pass through the canal, her cord stretched and it cut off the oxygen and the circulation. And unfortunately Jasmine was born still. And so we know the pain of it. [00:06:30]

[00:06:30] Jessica Stewart-Gonzalez: So that then it takes me into my next question. For those moms listening, who identify as a person of color, these numbers and your story

[00:06:39] is probably very alarming for them. So can you speak to them and tell us how these moms can advocate for themselves during their pregnancy journey? You’ve talked about the app and that really helps track that fetal movement and can be used as a way to learn and indicate whether or not something is wrong.[00:07:00]

[00:07:00] So how can using that app or what information is needed, how can we help women advocate for themselves during the pregnancy, especially if they are already walking into a situation where their voice may not be heard as much as

[00:07:18] it should be.

[00:07:19] Stephaney Moody: Well, one of the good things about it with Count the Kicks app, you are able to put notes in the system.

[00:07:27] It tracks how long it takes for your [00:07:30] baby. Once you know the average amount of time that it takes for your baby to get to 10 kicks or 10 movements, those can be rolls, jabs, anything but a hiccup because I hiccup is involuntary. So the app is going to track it. You’re going to have a number. You’re going to have an actual chart

[00:07:47] that’s going to show that it usually takes baby this amount of time to get to 10 kicks. Let’s say 15 minutes. So now if all of a sudden it takes an hour, don’t be afraid to speak up and you [00:08:00] can email or even text your kick counting history to your provider and have that conversation. If you don’t feel like your provider is listening, they’re not hearing what you’re saying,

[00:08:12] the hospitals are open 24/7, and they are there to help you. Go in, show them your history and let them know. That’s exactly what my daughter-in-law did because the doctors actually told her lay on her left side, drink more water. She was a first time mom and she went on and she [00:08:30] went into the hospital and she was able to show them that information.

[00:08:34] Statistics don’t lie. So that way you have another advocate or another way to be able to speak up by giving them the information, your statistics, your kick counting history, so that they can look at it themselves and determine what are the next steps, what tests need to be ran after that.

[00:08:53] Jessica Stewart-Gonzalez: So what can we do as a community, as a society to improve health outcomes for Black [00:09:00] mothers and their babies?

[00:09:01] We can’t just rely on ourselves that we can’t rely just on changing for somebody to advocate on their own. So how do we really make that systemic changes you talked about earlier, how do we do that?

[00:09:16] Stephaney Moody: I believe that we can do several things. One of the things is what we’re doing right now, educating everyone on the statistics.

[00:09:24] We’re broadcasting through this podcast and sharing information that is [00:09:30] correct. That they can actually go and look up the statistical data from the CDC. You can get more up-to-date information from the CDC. It’s not quite right in time, but 2019 statistics so that people know the truth about what’s going on.

[00:09:47] No one likes to talk about stillbirth. It’s just one of those taboo things, but talking about it and letting people know that it’s a real threat, it’s something that does exist. And if we [00:10:00] empower moms by letting them know the importance of counting and tracking their baby’s movements in the third trimester, we can save babies because what happens is they know if something’s wrong now, not every stillbirth is preventable, but those that are, we want to do something about.

[00:10:27] Jessica Stewart-Gonzalez: Want to learn more? Head to the links in the show notes. [00:10:30] We also have more episodes on the way that you don’t want to miss. So make sure you give The Parenting Brief a follow on your favorite podcast app. And because we can all use a little parenting help, go ahead and share the show on social media. Until next time,

[00:10:44] this is Jessica. You’ve got this,

[00:10:46] Mom[00:11:00]