US Infant and Maternal Mortality: A National Disgrace

According to the Centers for Disease and Prevention ( CDC ) US infant and maternal mortality failed to improve between 2000 to 2005. This plateau represents the first time since the 1950s that infant mortality has seen no improvement. The US spends more than any other country in the world on health care and yet is only 33rd in the world in infant mortality. A baby born in Cuba, Slovenia, the Czech Republic or South Korea has a greater chance of living for the first year than a baby born in the US. In fact, a baby born in Singapore has twice the survival rate of a US baby.

The infant mortality among non-Hispanic black women is 2.4 times what it is among non-Hispanic white women. One of the chief contributing factors to infant mortality is premature birth. In 2005, 36.5 percent of all infant deaths in the US were due to preterm-related causes; among the non-Hispanic black community nearly half (46%) of infant deaths were related to prematurity.

Global health care worker, Oya Kali, MPH, presented compelling research on the underlying causes of prematurity and infant mortality at the 7th International Black Midwives and Healers Conference. Her research at the University of California at Berkeley focused on the effect poverty has had on generations of African American families and how the trauma of generational poverty becomes biologically embedded in African American women.

To illustrate this embedding, Kali cited the concept of “weathering” as defined by Arline T. Geronimus, Sc.D, professor and senior researcher at the University of Michigan School of Pubic Health. The concept “weathering” suggests that the health of African Americans is subject to early deterioration as a consequence of social exclusion. In fact, as a race, African Americans suffer prematurely from poor health outcomes.

Kali talked of the cumulative health impact of socioeconomic disparity, cultural marginalization, and chronic psychological and biological stress. Since the 1990s we have had new tools to measure the high cortisol levels that indicate chronic stress. Many studies support the link between maternal stress and preterm labor. The baby’s hormones respond to the mother’s stress hormones and trigger early birth. According to Kali, fifty to 100 percent of women who birthed early describe themselves as being stressed.

Examples of the chronic stress caused by institutional racism were reported by both Kali and by Eleanor Hinton-Hoytt, president of the Black Women’s Health Imperative. Kali said, “My people accept the fact that the doctor does not want to touch you.” Hinton-Hoytt told of black women who reported that their white doctor would not touch them or look them in the eye.

Infant mortality for white college educated women is 4 in 1000; for black college educated women it is 12 in1000, worse than for white women who have not graduated high school.

Overall, 32 percent of mothers live in poverty; 40 percent for African American moms. Poverty affects where you live, your access to food, your social support and the health care available to you. It affects whether or not you feel safe walking down the street with your newborn baby. Social isolation further adds to the stress of poverty. Kali suggests that one solution is increasing social support to pregnant women and new moms; she calls this “sisters supporting sisters.”

When it comes to saving our babies, we are all sisters.

Peggy O’Mara  (101 Posts)

Peggy O’Mara founded in 1995 and is currently its editor-in chief. She was the editor and publisher of Mothering Magazine from 1980 to 2011. The author of Having a Baby Naturally; Natural Family Living; The Way Back Home; and A Quiet Place, Peggy has lectured and conducted workshops at Omega Institute, Esalen, La Leche League International, and Bioneers. She is the mother of four.

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3 thoughts on “US Infant and Maternal Mortality: A National Disgrace”

  1. Your title refers to maternal mortality but unfortunately your article did not touch on this very troubling aspect of US perinatal outcomes. One of the leading causes of infant mortality is maternal morbidity (severe injury) and maternal mortality. The US is 41st in the world in terms of maternal mortality (

    For over the past 5 decades, African American women in the US have consistently experienced a 3 to 4 times greater risk of death from pregnancy complications than white women. (Tucker, AJPH, Feb 2007) This increase appears to be independent of age, parity or education (OB/GYN, 2003 and MMWR 1995). In addition, for five conditions with known rates of high pregnancy-related mortality, African American women did not have a higher prevalence, but did have a higher case-fatality rate than white women (Tucker, AJPH, Feb 2007). In 1940, African-American women were 2.3 times more likely than White women to die from pregnancy-related causes, while in 2004-2006, African-Americans were 3.3 times more likely to die from these causes.

    In California, we are working on this issue and welcome your involvement. Please see and click on maternal mortality to see the trend of maternal mortality by race/ethnicity in California.

    When it comes to saving our babies, we are all sisters, yes, and we must work to save our mothers from preventable injury and death during pregnancy and childbirth.

  2. I don’t even know why you are bringing up race. I am white and live in the suburbs and my baby was killed by an incompetent black doctor. It is not a race issue. Bad medical care is everywhere and happens to anyone, regardless of race. Babies and moms dying as a result of bad prenatal and medical care in the USA is a huge issue. I begged and pleaded to not be forced in to a csect, but was threatened that I did not love my own child and CPS would be called on me if I did not consent. My child died and I almost died.

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