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It’s common knowledge that black babies in the United States die at twice the rate of white babies. Higher rates of infant death were found to occur in counties with rural, poor and minority populations, especially in the Mississippi Delta - a longstanding situation. Even when age, income and education level are taken into account, blacks still have a higher rate of infant mortality than whites, researchers say.

There are many explanations for poor birth outcomes among African American women; they include psychological and social factors that surround the pregnancy, birth, and the months after the birth of the baby. One obvious reason for this inequity is the unequal share of social deprivation borne by pregnant black women and by women in socially isolated geographic locations like those in the Mississippi Delta. These socially excluded women tend to have less access to jobs or jobs with pregnancy benefits; they lack positive social supports or peer networks; they are excluded from some services , and they are often recipients of negative attitudes from people in their local communities – all of which can be associated with poor pregnancy outcomes. The socially deprived may experience "a deprivation of basic capabilities due to a lack of freedom, rather than merely low income." This lack of freedoms may include reduced opportunity, little or no political voice, or little or no dignity.

Explanations for the poor birth outcomes among African American women are complex. In recent years, researchers, have focused on high maternal stress levels as a key ingredient among the complex factors contributing to African American women’s poor birth outcomes. There is increasingly more research that examines the impact of stress and stress mediators on pregnancy outcomes for African American women.

We are social beings, born with the need to feel connected to others in order to be healthy and happy; we depend on others for our survival. For most women, pregnancy is a time of positive expectation, but may also be a time for psychological and physiological challenges for women who are socially isolated. Feeling isolated causes us to experience longstanding stress. When we are feeling disconnected from others, the body perceives this as a risk to our survival. Social stress is often worsened when people have less capability of changing their own circumstances. Thus, individuals feeling cut off from their group will naturally be in a state of high anxiety or feel highly stressed.

Excessive stress exposures during the woman’s entire life course have been demonstrated to have an impact on her birth outcomes. When the number of stressors exceeds the capacity to cope, negative emotional and physical responses are likely to occur. Reactions to stressful situations are tied to the biological factors which governs physiological reactivity to stressors. In pregnancy, higher and more prolonged levels of stress, (i.e., perceived stress, social isolation, worry about jobs, relationships and –depressive symptoms, racial discrimination, stressful life events, and pregnancy-specific anxiety [for black women- giving birth to a male child] and therefore cortisol in the bloodstream has been associated with preterm birth, low birth weight, risk of gestational hypertension, and negative health and behavioral outcomes for both mother and baby.

Social support is considered the interaction between a person and the environment, which reduces stressors. Friends are a natural sounding board ; interactions with them provide us with feedback regarding our thoughts and feelings. Without friends who will give us honest feedback, we can easily become lost in the maze of our own thoughts. Having the means to communicate our thoughts to others engages the part of the brain required to have an effect on our thought processes which in turn helps us to see things more clearly, making us feel empowered, stronger, more capable. Birthing Project’s “Sister-Friend” concept hinges on the extended family social support concept.

( Tune in next month for a continuation of this article)

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