More Black women than White women are dying from pregnancy and childbirth-related causes. Could surviving being hit as a child make pregnant women mortally ill?
Do the lives of Black babies matter?
What about Black mothers, irrespective of educational or financial background, who are more likely to die from childbirth than White women?
Apparently not. How else can we explain the deafening silence about the fact that Black infants are 2.2 times more likely to die in their first year of life than White babies?
There are decades of research citing myriad reasons for the tragic racial disparities in birth outcomes. But scientists may be overlooking a potential connection between trauma suffered by mothers during girlhood and deadly maternal outcomes later in life. And some of that trauma might be caused by having been hit during childhood.
Last week NPR reported that Black expectant and new mothers are “243 percent more likely to die from pregnancy or childbirth-related causes” than White women. Public-health professionals still want to understand why so many American women, especially Black women are dying from complications of pregnancy and childbirth.
Black women are also 49 percent more likely than Whites to deliver prematurely, while Black infants are twice as likely as White babies to die before their first birthday. According to an article published last spring in The Nation examining racial disparities in infant mortality, previous research has focused on the theory that Black mothers are doing something wrong, such as “eating poorly; being overweight or diabetic; smoking or drinking during pregnancy; not going to the doctor; not being married; getting pregnant too young; or smothering their newborns in their sleep.” Replicating widespread stereotypes that criminalize and pathologize Black mothers, these narratives ignore the many devastating costs of racism.
It is also important for researchers to look more deeply at childhood trauma and stress, considering Adverse Childhood Experiences (ACEs) as potential factors in these medical imbalances. ACEs are strongly related to the development and prevalence of a wide range of health problems throughout a person’s lifetime, including those associated with substance misuse. These experiences include physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, intimate partner violence, whether the mother was treated violently, substance misuse in the household, mental illness in the household, parental separation or divorce, or a household member being incarcerated.
There’s a growing body of literature that has examined the long-term impacts of ACEs on poor adult health outcomes like early puberty, diabetes, heart disease, stroke, cancer, and even a lowered lifespan. More recently, researchers have been pushing to add spanking a child to this list as a form of early adversity.
But researchers have largely ignored this. Instead, data points to how Black women (alongside the entire community) routinely receive lower-quality medical care and pain management, how access to healthy food and water is shaped by racism and segregation, and how Black women are less likely to have their complaints and symptoms taken seriously by medical professionals or treated appropriately, so it’s not hard to see why more Black mothers are falling victim to maternal mortality.
Experts also cite these “unconscious biases” inherent in the medical system. NPR and ProPublica recently interviewed more than 200 African-American mothers who shared their experiences of being devalued and disrespected by medical providers.
Yet, recent scholarship has found that many health disparities, including infant and maternal mortality, are not only about access to health care or poverty—these issues persist across class lines and when access isn’t the central issue. Research has revealed that racism is literally making Black people sick. It causes chronic stress, which not only takes a physical toll on women during pregnancy and childbirth, but also speeds the aging process at the molecular level. This stress-induced wear-and-tear on the body, known as “weathering,” makes women more susceptible to inflammation, causing chronic diseases and leading to higher rates of maternal and infant mortality.
Even the popular notion that “Black don’t crack,” referring to how Black women often look younger than their age, is challenged by research showing that telomeres (chromosomal markers of aging) of Black women in their 40s and 50s have health profiles seven-and-a-half years older on average than White women.
When we ask why these numbers are so bad and are getting worse, it’s easy to assume that the Black women in question are dying due to poverty, lack of health insurance and/or medical care, or the endless list of chronic health conditions—including higher rates of high blood pressure, hypertension, and diabetes—that generally put their health at risk.
On top of all these factors, “It’s the discrimination that Black women experience in the rest of their lives—the double whammy of race and gender—that may ultimately be the most significant factor in poor maternal outcomes,” NPR reports. Even education, money, better environments, and higher standards of living don’t protect Black women from negative birth outcomes. The chronic stress of simply living as Black in America wears a body down.
The heartbreaking case of Shalon Irving, as told in the NPR piece, illustrates this horrible disparity. Irving, 36, was an epidemiologist at the Centers for Disease Control and Prevention, researching how people’s health was harmed by the structural inequality of racism, as well as trauma and violence. Her work was driven by wanting to move the conversation around health disparities beyond the victim-blaming that can often happen with Black and poor victims. As her Twitter bio states, “I see inequity wherever it exists, call it by name, and work to eliminate it.”
Irving was thrilled to become pregnant with her first child, and to give birth to Soleil, a healthy baby, earlier this year. Then, just three weeks after her daughter’s birth, Irving died from complications related to high blood pressure after repeated visits to doctors who misdiagnosed or did not take her alarming symptoms seriously.
In a twist of bitter irony, the Black woman whose career was devoted to studying and eliminating health disparities between Black and White women, Irving had become a devastating casualty of the very thing she was fighting to erase, while working at the leading federal agency that studies the very issues impacting Black women.
Irving didn’t fit the widespread stereotypes about Black mothers who have died during childbirth. She was college educated, with two master’s degrees, a dual-subject Ph.D., high-quality health insurance, in a loving two-parent family and with a strong support system. Yet none of this protected her from the deabilitating health effects of racism.
NPR reports that “even relatively well-off Black women like Shalon Irving die, and nearly die at higher rates than Whites … A 2016 analysis of five years of data found that Black, college-educated mothers who gave birth in local hospitals were more likely to suffer severe complications of pregnancy or childbirth than white women who never graduated from high school.”
While it is clear that racism is having a devastating impact on expectant mothers and our children, there are other factors that deserve attention as well.
Currently much of research focuses on the stresses experienced by adult Black women—ignoring the potential impact of a history of stress that dates back to childhood. The accumulation of chronic stress during childhood surely impact health and reproductive well-being of black women once they become adults.
Decades of research shows that parents who rely on spanking to control children’s behavior may be more likely to physically abuse their children. Additionally, spanking puts children at risk for experiencing other forms of maltreatment, including psychological aggression, sexual abuse and sexual problems as adults, physical and emotional neglect. Some 50 years of scientific studies show that the ways in which children are parented can rewire the structure of their developing brain’s actual physical structure, as well as their social and emotional functions.
When children are hit, the stress and pain can alter their hypothalamic-pituitary-adrenal (HPA) axis—the nerves and hormonal channels that control reactions to stress and regulate body functions such as digestion, immunity, moods, emotions and sexuality. Children who are exposed to mild early childhood stress can benefit from enhanced HPA functions and become more resilient to stress throughout their lives. But if they experience repeated stress—such as parents hitting them to correct their behavior—the HPA axis can become hyper-reactive.
Parents might not realize that hitting their children causes this biochemical reaction and can lead to emotional and physiological harm. It’s comparable to a child becoming obese or diabetic from a constant diet of junk food.
Given the body of research, it is not farfetched to wonder about the impact of spankings/whuppings on maternal and infant mortality. This child-rearing practice, alongside the impact of racism, needs to be part of the conversation.
Think about it: If a girl is threatened or hit in childhood, the part of her brain that causes arousal becomes hypervigilant and primed to respond to danger, which leads to a release of oxytocin, which places her at risk for early puberty and risky sex. If she is spanked over time, her developing brain is rewired by these hormonal changes and her nervous system stays in overdrive as she anticipates more threats.
So when you hit your daughter, threaten her, or subject her to verbal abuse, you trigger neurochemical responses in her body that contributes to an “allostatic load.” If you create an environment where she has to be hypervigilant or there is no emotional safety, these too play a part in building an allostatic load that could then add to the wear and tear on her body and make her vulnerable to negative birth outcomes.
Whenever I have discussions with Black folks about hitting children they love to invoke the phrase: “I was hit and I turned out fine.” But these heavily researched and scientifically documented racial disparities in health outcomes tell a very different story. Your parents may not have always left visible bruises or other injuries. But your brain and immune system were always keeping the score and eventually tell a different story about health. We often lament the anti-intellectualism and refusal to let science lead discussions as it relates to policy, yet when it comes to parenting and family we balk at truth for the sake of tradition.
On social media pages where the NPR story was shared, I saw commenters dismissing the science as racist propaganda designed to scare Black women into not having babies. Of course we have to understand Black people’s skepticism given the racist history of medical science, but denial of research isn’t empowering, liberating, or protecting us.
I’m not suggesting that spanking alone can cause women to have negative or fatal maternal outcomes. But we need to start connecting the dots to see how racism can impact harmful Black parenting practices like spanking—and how those practices impact our health as a people.
And given the higher rates of hitting children in our communities, this should be considered a driving factor in ALL of our health disparities. Black girls experience so many kinds of stress from attacks in school and in their communities, and we have to consider how harsh parenting plays a role in adding to that load of stress and the resulting hypervigilance, pain, and continual hormonal rushes that begin wearing down their bodies from an early age.
Much of the late Shalon Irving’s research focused on the link between childhood experiences and adult health outcomes. She studied how children’s lives might have damaged their wellbeing and looked at how to make them healthier and more resilient.
In honor of Shalon Irving and her baby girl, Soleil, in honor of all the lives lost in the birthing process, I want every person who raises their hand to strike a child to pause and think about what harm they might be causing to that child’s young body, emotions, and mind, and to their child’s future children. What seeds they might be planting for undesirable—or even tragic—outcomes that perhaps cannot be easily traced directly to that whupping, but that might result from the impact of violent discipline. I want parents to think about the stress and hormonal response and the damage to their child’s developing brain.
I especially need every Black adult to think about the long-term effects of hitting a child in the name of love, discipline, or responsible parenting. To consider that it’s time to find new and better ways to reduce—not compound—the stress that our children are facing as they struggle through their youth into adulthood.
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