Philadelphia’s infant mortality rates have decreased, but the deaths among Black babies remain the highest in the city. The same trend has served true for maternal mortality rates among Black women, and the pandemic could make it worse.
Now, with vaccines available to the public, people remain skeptical about the virus and its treatment. For pregnant women this uncertainty is even higher, considering their unborn children. There is very little research on how COVID affects pregnant women and their children.
As for infant and maternal mortality rates, factors such as stress and medical conditions play a major role in the health of mothers and babies.
The 2019 Pew Report revealed that infant mortality rates (IMR) in Philadelphia have slowly decreased since 2007. In 2017, the IMR in Philadelphia was 8.4 per 1,000 births. However, Philadelphia’s rates remained well over the national rates recorded by the CDC. In 2018, the national infant mortality rate was 5.7 deaths per 1,000 live births. According to the Philadelphia Department of Public Health, the city had a goal of less than or equal to 4.1 deaths by 2020.
The CDC notes the IMR is defined as the death of an infant before their first birthday. The infant mortality rate is the number of infant deaths for every 1,000 live births. This rate is calculated by dividing the number of resident infant deaths by the number of resident live births and multiplying the number by 1,000.
In January, the World Health Organization (WHO) stated that pregnancy puts women at a higher risk of severe complications, but it did not recommend the vaccine for pregnant women “unless they are at a risk of high exposure” as essential workers.
With a wealth of misinformation and inconclusive data on COVID’s effects on pregnant women, Black women have expressed their past experiences maneuvering through the health care system.
Briana Graves, a former Philadelphia resident and mother of a one-year-old son, shared her experiences and fears dealing with doctors during and after her pregnancy.
Graves explained that at one point her son was experiencing breathing problems and was in the hospital for a week. During that time, Graves said she had additional concerns, but doctors ensured her that her son was fine. Graves said as a new mother she feels that doctors are trained to treat multiple patients but at times, they fail to make treatment individualized.
“There are times when doctors aren’t listening, I feel they’re trained to do their jobs, but do not go out of their way for people’s well-being,” said Graves. “No mother expects their child to pass away. In some cases, doctors tell mothers about conditions before they give birth, but other times the birth goes well, then comes the negligence,” said Graves.
Nicole Glover, who gave birth to her first child during the pandemic, said she also had some concerns about healthcare workers during her labor process.
Glover shared her labor story, explaining that she was asked to position herself on her hands and knees by a nurse, despite Glover and other doctor’s knowledge that the position made the baby’s pulse inaudible.“At one point, I kept telling the nurse I couldn’t hold myself up any longer. She insisted that I do. My child’s father began to yell at the nurse because I could have fallen on my belly and hurt the baby. This was a bad experience for me,” said Glover.
While dreading the delivery process, Glover said during the healing process she was treated well, but later discovered doctors failed to inform her of post-pregnancy health conditions.
During my healing process, I was treated pretty well. However, my blood pressure was high, and this was serious after the pregnancy. After 4 or 5 days, I was sent home, still with unpredictable blood pressures. During my time in the hospital, no nurse had told me or given me the nebulizer, which I was supposed to constantly use post-surgery to open my lungs and remove all the fluid from my system. I did not learn about this until my last day at the hospital when I told them I felt pressure on my chest. One week later, I was back in the hospital because I developed pneumonia in my lungs, due to their failure in the post-care process. I had to be away from my newborn baby, experiencing separation anxiety — not able to have anyone visit me because of COVID. It just was a lot.
Both Graves and Glover said they wished doctors and other healthcare workers did a better job listening, so their needs were better met. Unfortunately, they were not the only women who felt this way.
A 2018 study called Listening to Black Mothers in California reveals that almost one-third of Black mothers reported that they felt the delivery room staff did not encourage them to make decisions about their birth progression.
Philadelphia’s Response to Healthcare Trends
In 2020, a group of researchers including Children’s Hospital of Philadelphia’s Division of Neonatology and Center for Pediatric Clinical Effectiveness and University of Pennsylvania’s Perelman School of Medicine did a study focusing on the COVID antibodies in pregnant women. The team ran 1,293 serological tests on pregnant women.
The research showed that 80 of the 1,293 tested positive for the COVID antibodies. The rates among Black(9.7%) and Hispanic (10.4%) women were much higher than White (2.0%) women.
In 2019, Councilwoman Cindy Bass requested additional support for maternal services. Bass explained that the trends of maternal mortality were disturbing and required further action.
“Philadelphia is called a City of ‘eds and meds,’ so we should be especially alarmed, and vigilant, about this disturbing and deadly trend,” Councilwoman Bass said.
The City council noted that Black women represented 75 percent of all pregnancy-related deaths in Philadelphia between 2010 and 2012. In the United States, Black women are up to four times more likely to die from pregnancy-related complications than white women. Pew’s report also shows that 27% of Black women living in Philadelphia live in poverty.
During the 2019 proposal, The Committee on Public Health and Human Services analyzed why Black women were more likely to die during childbirth. State Representative Morgan Cephas and Philadelphia Commission for Women planned to introduce bills that helped combat the disparities within healthcare and provide more access to education for both mothers and healthcare specialists.
Maternity Care Coalition (MCC) is also involved in decreasing the IMR in Philadelphia, offering prenatal care, parenting and life skills education, school readiness support, and referrals to medical care for pregnant and postpartum women in underserved communities.
Vice-president, Kamala Harris said there is a need to address these disparities during her last visit to Philadelphia, explaining that inequalities are present in healthcare as well other areas like education. While health disparities are prominent, especially dealing with health insurance, other issues such as poverty play a role in the IMR statistics as well.
“I’m sure my experience is not the worst, but it hurt me as a Black woman and first-time mom having to go through this. I felt it would have been different had I been white,” said Glover.
According to the CDC, it is safe for pregnant women to get vaccinated, although the initial vaccine trials did not include pregnant women.
A new study published in the New England Journal found that the study did not show obvious safety signals among pregnant persons who received mRNA Covid-19 vaccines. However, regular follow-ups for women vaccinated earlier in pregnancy, are necessary to track maternal, pregnancy, and infant outcomes.