Repeated exposure to trauma and multiple stressors may be behind Black women giving birth early more than white women.
A new study published by the Journal of Health Disparities Research and Practice connects racial discrimination and post-traumatic stress disorder to preterm births.
PTSD affects African-Americans more than any other group, and more African-American women than men.
“When we talk about racial disparities in health outcomes, we have to think about how we construct mental health, the role of PTSD and how different racial and ethnic groups experience it,” says Amelia Gavin, an associate professor in the University of Washington School of Social Work and co-author of the study.
PTSD isn’t just always from one event. And multiple studies show Black women have reasons to be traumatized more than anyone.
Black children and men are being killed by police at an alarming rate.
Higher poverty, especially in red states with lower GDPs, are synonymous with policy racism. These same states have higher rates of premature births.
Mississippi has the highest rate of premature births at 13.6 percent and the lowest GDP in the country. The CDC reported in 2016, that the preterm birth rate for Black women was 14 percent and 9 percent for white women.
Blacks and Latinos are still among highest numbers of uninsuredin the country, and Trump’s aim at dismantling the Affordable Health Care Act, and stripping away reproductive rights could mean even less access to health care. Screenings, equitable care and access are also a point of contention when it comes to the healthcare as studies show disparities in quality of care exist.
“Pregnancy is a stress test for the body. If you’ve been stressed during your life through discrimination, poverty, and residential segregation, then the likelihood of having a healthy birth outcome has been compromised,” said Amelia Gavin, an associate professor in the University of Washington School of Social Work.
Previous studies have shown that women, who suffered a new stress or trauma during pregnancy, had increased PTSD symptoms during and post-birth problems.
The stats are alarming post-birth as well: Black mothers are three to four times more likely to die, suffer from postpartum depression close to twice as much as non-Black mothers (38 vs 19 percent. And rates of recovery for PTSD are much lower than in Blacks than whites.
Gavin and coauthors recommend health-care providers start screening all pregnant women for prenatal PTSD, in order to spot those at risk for preterm birth. Screening for PTSD is not common, however.
Hospitals and doctors have cited inability to be reimbursed by Medicaid for screenings, even for people who are gunshot victims. If they can’t get reimbursed, they have to come out of pocket, and in poorer areas, that’s less likely to happen.
Gavin’s report also highlights the need for action to mitigate the impact of policies that purport discrimination and racism experienced by Black women.
“Federal and local governments must make investments to increase the amount of and improve access to affordable and livable housing, healthy built environments, equitable funding for K-12 public education, and affordable health care.”
In 2017, a congressional briefing on Black maternal health focused on encouraging policy action by Rep. Bonnie Watson Coleman of New Jersey, Rep. Robin Kelly of Illinois and Rep. Yvette D. Clarke of New York, and several advocacy organizations. But more is dialogue in those rooms is needed.
The study concludes that Black women’s mental health and preterm birth rates will improve as a result of policy change.