A Healthy Pregnancy: Health Disparities Revealed

There are plenty of pregnancy complications that affect minorities in higher proportions. Some of these include high blood pressure, preterm delivery, excess weight gain, and gestational diabetes. The complications during pregnancy that are higher in minorities are not limited to pregnancy but are preexisting health disparities that are simply magnified during pregnancy. The highest percentage of preterm babies is in non-Hispanic Blacks (17.1%). These preterm births could likely be due to hypertension (high blood pressure), gestational diabetes, and lack of prenatal care. All ethnicities, other than non-hispanic white, have a higher risk of gestational diabetes. Asian and Pacific Islander are at the highest risk, followed by Hispanic, black, and American Indian. Much of this stems from health disparities pre-pregnancy. For example, with blacks (51% higher obesity rates than whites) and Hispanics (21% higher obesity rates than whites) already at a much higher risk for obesity, this already places these women at a higher risk of hypertension and gestational diabetes during pregnancy. Once diagnosed with hypertension (or even pre-eclampsia), preterm delivery is much more likely. It’s a vicious cycle.

There are many reasons these ethnic groups have higher risk for these pregnancy complications. Genetically, black women are at a higher risk for hypertension and Hispanic women are at a higher risk for insulin insensitivity, or diabetes. Traditional cultural foods in both of these groups tend to be higher in fat and calories, which contributes to weight gain. Also, both of these weight groups tend to have a different perception about body image and obesity. Many cultures believe that being “plump” or having fat on your body is a sign of health, rather than a risk factor for these conditions. Also, access to health care, especially when pregnant, is difficult for those of lower socioeconomic status. Early and frequent prenatal care is important when diagnosing hypertension and gestational diabetes. It is also important for these women to receive prenatal and preconception education about weight gain and healthy lifestyle choices.

 

Initiatives need to be focused on preconception education, and providing tools for women to be the healthiest they can be before they get pregnant. Also, encouragement of frequent prenatal care once they are pregnant is crucial to diagnosing conditions that can be corrected or maintained to prevent preterm delivery. As health educators, we also need to promote a health environment in the workplace, advocate for easier access to health care, and access to healthy food. Many individuals in rural areas or lower socioeconomic neighborhoods live in “food deserts” where access to fresh and nutritious food is hard to come by.

 

There are several national and state initiatives out there that are focusing their energy on preconception education, but also prenatal education. Some of these initiatives include health departments, Women Infants and Children Supplemental Nutrition Assistance Program, Medicaid, CHIP Perinatal, and the Show Your Love Campaign. One free program that is available to any mom with a phone and text message service is Text4baby. This program sends messages three times a week that include tips for a healthy pregnancy, breastfeeding information, emotional wellbeing, and reminders about important checkups. With a society moving more and more towards technology, a cell phone is not necessarily considered a luxury item but a necessity. This makes communicating with busy women much easier and more convenient. To learn more or sign up for Text4baby follow this link: https://www.text4baby.org/.

 

Resources

Centers for Disease Control and Prevention (2010). CDC Features: Compared with whites, Blacks had 51% higher and Hispanics had 21% higher obesity rates. Retrieved from http://www.cdc.gov/features/dsobesityadults/index.html

Centers for Disease Control and Prevention (2013). Women’s Health: Become a Text4baby Partner. Retrieved from http://www.cdc.gov/women/text4baby/index.htm

Hedderson et. al (2012). Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care 35(7): 1492-1498. doi: 10.2337/dc11-2267

The Henry J. Kaiser Family Foundation (2012). Preterm Births as Percentage of all Births by Race/Ethnicity. Retrieved from http://kff.org/other/state-indicator/preterm-births-by-raceethnicity/