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Born prematurely – healthy women

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As if finding out that something was expecting her amid a global pandemic wasn’t enough, Merrick Smith said her surprise came to a shock last year when she later learned she was carrying twins on Christmas Day.

Her pregnancy started out fairly normally, and working from home, which many resorted to during the shutdown, proved to be a convenient advantage for the married mother of a then two-year-old daughter. That changed abruptly in her sixth month when she ended up in the emergency room of a nearby hospital because of profuse bleeding.

“[Doctors] I don’t know if it was … a blood clot that passed or some sort of placental detachment, but I spent about five days in the hospital, ”recalled Smith, 37, of Ypsilanti, Michigan, who was home about a week and a half before it actually went premature labor Blow. ”

Her medical team at the University of Michigan’s CS Mott Children’s Hospital at Ann Arbor monitored her progressively stronger contractions and her cervix continued to expand. Her maternal and fetal health specialist eventually concluded that Smith had to deliver her girls by emergency caesarean section.

Daughters Melliah and Merriah were born on October 14, 2020 at the age of 29 weeks and five days of pregnancy. Weighing 3 pounds, 5 ounces and 2 pounds, 8 ounces, respectively, they initially had difficulty breathing and feeding. The next three months were an exhausting blur for Smith and her family, which included daily hospital visits with both babies in the neonatal intensive care unit (NICU) and finally the added challenge of managing one at home while the other stayed in the hospital.

“I was very overwhelmed,” Smith recalled of what she calls her “NICU trip”. After 56 and 96 days respectively, their two girls finally made it home. Nine months later, she says they are both healthy weights and thriving.

Premature birth is very common, especially among black mothers-to-be. Black women in America, like Smith, experience premature births at a 50% higher rate than any other ethnic group across the country. Research confirms that black, Latin American, and indigenous women are more likely to experience pregnancy complications than non-Hispanic white women. They are also more likely to suffer maternal death and negative consequences after complications.

For the fifth year in a row, the premature birth rate has increased in the United States, accounting for 10.2% of births. Premature birth – when an infant is born before the 37th week – and its complications were the second largest contributors to infant mortality nationwide in 2019 Data from the Centers for Disease Control and Prevention. “

Based on these factors, the babies and the mothers can often have [many] long-term health considerations, “explains Dr. Anna Euser, Maternal and Fetal Medicine Specialist at UCHealth University of Colorado Hospital.

The Covid-19 connection

While it’s too early to be conclusive research, early data suggests Covid-19 didn’t help. For one thing, black people, including black women, are at increased risk of contracting the virus and dying from it. Early dates has also shown that pregnant women infected with the virus may be at increased risk of premature births and loss of pregnancy.

“Covid-19 has proven to be more serious in pregnant women. [they are] more likely to be hospitalized or admitted to intensive care, “said Jamille Fields Allsbrookwho oversees policy development and strategic planning for the Center for American Progress (CAP), which has several Reports about health differences in premature births.

Euser said the effects of Covid-19 are still unclear.

“Some studies show a higher rate of preterm birth with Covid … while other studies haven’t shown an increased rate of preterm birth,” she said. “The data is really mixed.”

Apart from the risks of Covid, premature birth is one of the leading causes of death in infants in the US, along with pregnancy-related complications. Almost two-thirds of infant mortality occurs in the first month after birth, often due to congenital abnormalities and complications in preterm birth, a 2019 CAP report complete, and the consequences are devastating for parents and families.

“It can be stressful for the mothers, especially when the mother goes home and the baby has to stay in the hospital,” said Euser, also a professor of maternal and fetal medicine at the University of Colorado. And that stress can also make postpartum depression worse.

Adding to the concerns for black mothers-to-be is that black women are three to four times more likely to die from pregnancy-related complications than non-Hispanic white women, regardless of income or background, and the death rate for black infants is three to four times more likely twice those of infants born to non-Hispanic white mothers.

Racial factors

“[Preterm birth is] no longer the problem that it was once among the general population, but it persists among blacks and indigenous peoples, and also among certain subgroups of the Latinx population; the prices are not comparable with [those] among whites, “said Allsbrook.

According to Euser, a growing body of research is finding that the effects of racism, such as conscious and unconscious biases against women of color in health care and the economic disadvantage of women of color, rather than race itself, are the driving force behind these disparate mothers-to-be. and infant mortality among blacks. In addition, researchers have found that chronic stress, which can also be caused by racism, can increase levels of the stress hormone cortisol and inflammation, which has been linked to an increased risk of premature birth.

Systemic solutions

Allsbrook said the need for solutions is urgent and needs to be addressed systemically.

That CAP report offers a range of potential solutions, including screening and treating women at risk of premature birth, eliminating deserts from maternity care, investing in community programs that provide comprehensive one-stop services, implementing standardized screening for mothers and babies, specialized screening and assessments, training providers to combat racism, provide culturally literate training, and build a more diverse healthcare workforce.

These steps can help reduce the risk of Long-term complications in premature birth which are often costly and stressful for families, including:

  • Cerebral palsy
  • Developmental delays
  • Vision problems
  • Hearing problems
  • Dental problems
  • Behavioral and psychological problems
  • Chronic health problems

Even if there is a happy ending, as in Smith’s case, premature birth can be economically and emotionally devastating for families. Finding long-term solutions and pushing preventive action at the political level will have far-reaching benefits for all.

Many advocates advise vulnerable pregnant mothers to be vigilant, hold their health care providers accountable, and not be afraid to stand up for themselves and their babies.

This resource was created with the assistance of Covis.


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