African-American mothers more likely to have pregnancy-related complications, research shows

JACKSONVILLE, Fla. — The Neonatal Intensive Care Unit at UF Health in Jacksonville takes care of our area’s most vulnerable babies, born well before their due date.

More than half of its patients are African-American.

Shawana Brooks, a local mom, gave birth to her baby, Roosevelt, at UF Health at 26 weeks. Brooks' pregnancy journey was not easy. She had two stillborn babies before Roosevelt.

"Never was I prepared to take care of a child that wasn't going to be fully developed," Brooks said.

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She's not alone. Black women from all over began to tell her their stories of close calls, loss and birthing premature babies.

"That strong black woman is always a perception, is always out there and yes, we are strong, but strength still comes with vulnerability," Brooks said.

The pre-term birth rate in Florida among black women is 54% higher than all other women.

Duval County received an F grade from the March of Dimes, a nationwide nonprofit organization that works to improve the health of mothers and babies. The county led the state in the number of pre-term babies, and black women are three to four times more likely to die from pregnancy-related complications than white women.

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Action News Jax anchor Letisha Bereola asked NICU Medical Director Dr. Josef Cortez why the numbers are so high. He said studies show there are racial and social factors at play.

"Their conclusion was, yes there is race and ethnic disparity in safety, quality and outcomes, but those are modifiable -- which means that doctors, researchers, clinicians - can affect outcomes by rigorous quality improvement projects," Cortez said.

Research from Northeast Florida Healthy Coalition shows access to care, poverty and unstable housing all play a role in the health of the baby and mother.

However, there can be an additional factor for black women -- implicit bias in the medical industry.

Dr. Cortez said unintentional racism doesn't exist in his NICU unit because there are systems in place to make sure each baby gets equal care.  But he told Bereola --  he's seen it throughout his career.

"Personally, it's pervasive. We talk about all of that, we talk about it. It's always kind of sensitive and difficult to talk, but you hear things," Cortez said.

UF Health said it has multiple quality improvement projects in place to ensure the best outcomes.

"UF Health Jacksonville has put systems in place to constantly improve care for all pregnant women and their babies. It is this systematic, systemic, robust process and quality improvement that curtail some of the disparities. In our NICU, we have put in place quality improvement projects applicable to all of our babies, whether they are inborn (born in UF), or referred to us from other hospitals. To prevent common complications among preterm infants, we have care bundles derived from evidence-based best practices. One project I would like to highlight is the impact of a care bundle to prevent intracranial hemorrhage among preterm infants that had intended consequences of improved temperature upon NICU admission, decreased mortality, and overall improved outcomes. Another project is the creation of a Milk Lab where human milk (both donor and mothers' own milk) are stored and dispensed have increased our breastfeeding rates. Historically, African-American women have one of the lowest breastfeeding rates, and this is also true for us. With our hospital leadership's support, we have hired certified lactation consultant who is dedicated to the NICU since 2014, and combined this with promoting breastfeeding with the use of donor milk for the most premature infant, we have increased the rates of exclusive human milk usage in the last 5 years. Yet another project is the use of telemedicine for mothers to be able to view their children on a smart phone device has increased bonding, and we hypothesize that this will also increase human milk usage. Imagine viewing your baby while you are pumping at the bedside to produce milk – a good surrogate would be viewing the baby (if she's at home at 2 AM in the morning) on a smart phone device via an app. Lastly, we have established a dedicated unit for infants who have been exposed to opioids and other substances prenatally. While this may not be strictly a race/ethnic disparity issue, this project still addresses a disadvantaged group who have struggles that may also have been brought by other societal factors."

Brooks is hoping her story inspires more women to open up about their pregnancy complication -- so they can support each other and help eradicate all disparities.

RESOURCES:

Maternal Child Health | Florida Department of Health in Duval (floridahealth.gov)

Association of Maternal & Child Health Programs

Every Woman Southeast

Cox Media Group