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Tragedy in the delivery room

African Americans have high rates of infant and maternal mortality. No one knows exactly why.

VALLEJO - The day the child was born, to a woman who would have loved her for life, was the last time their eyes met.

Minutes after Alexandria Robinson was born, the 5-pound, 7-ounce baby was placed on her mother's chest. Lisa Patrick Robinson, a 39-year-old black woman, beamed proudly at her only child as her husband, Michael Robinson, and mother, Arlene Patrick, gazed in awe.

Michael was floating in that new world of fatherhood, he said.

The events that followed Nov. 11, 2006, however, betrayed the normal birthing experience for a couple.

Minutes after Michael and Arlene stepped into the hall, Lisa was whisked to the operating room.

Patrick, holding back her tears, still replays the memory.

"I was there every moment. I walked down the hall next to her as she went to the operating room and Lisa said to me, 'Mama . . . I'll be right back,' " Patrick recalled all too vividly. "Those were her last words. It's so emotional."

Patrick remembers dropping to the floor, screaming and crying minutes later. She prayed for her only daughter, her best friend and her confidante.

One week later, on Nov. 18, 2006, Lisa died with her family nearby. Her death certificate states the causes to be cardiac arrest, amniotic fluid embolism and vaginal delivery of infant. She would have turned 40 March 15.
"She left a sweet taste in everyone's mouth who met her. I just knew Lisa was special," Michael Robinson said of his wife of two years. He paused, stared at his little girl dressed in a pink outfit and said, "Here's an opportunity for Arlene to raise another girl with the same family structure as Lisa. She's blessed."

Maternal mortality

The United States is considered medically and economically advantaged worldwide. But rates of death, illness and injury are high for American women during pregnancy and after childbirth. The U.S. ranks below 20 other developed countries in rates of maternal deaths, according to World Health Organization.

Up to three women die in the U.S. every day from pregnancy complications and more than 30 percent of pregnant women experience some type of illness or injury during childbirth beyond what would be expected in a normal delivery, according to the Centers for Disease Control and Prevention.

Yet what raises eyebrows are the number of deaths among black women. They are four times more likely than white women to die from pregnancy-related complications, a gap that has persisted for more than 60 years, the CDC reported.

"It's a concern for the African-American community, especially pregnant women," said Norma Thigpen, Solano County Black Infant Health Program manager. "Maternal mortality is a concern and it's one of our objectives to have African-American women take care of themselves, even after pregnancies."

But maternal mortality rates aren't the only disparity blacks face county- and nationwide.

Infant mortality

Monique Sims, co-chair of the Black Infant Health Coalition, is shocked by the high number of black babies dying before reaching the age of 1 - known as infant mortality.

"It doesn't make sense to me. It's unacceptable," she said. "And I don't think the black population knows this is happening."

Between the years 2002-04, the infant mortality rate in Solano County overall was 5.2 per 1,000 live births, said Howard Friedman, political financial analyst for Solano County Health and Social Services. That was a slight decrease from the 2001-03 study, when the county was at 5.5.

But the numbers broken down by ethnicity tell a different story - the infant mortality rate among blacks was 8.7 compared to 5.0 for non-Hispanic white in 2002-04.

"When you look at other groups, this is a problem," Thigpen said. "I think a lot of attention has been directed to this problem and we are seeing numbers dropping. In about 15 years, the numbers have dropped in half but there is a lot more work that has to done."

Dr. Rich E. Bell is a medical director for the neonatal intensive care unit at NorthBay Medical Center. He believes the reasons often cited for this disparity - ranging from stressors in the black community to low birth-weight babies - are causes, but not the main factor.

A higher percentage of premature births among blacks is the single most important driver of this higher infant mortality rate, he said.

"It's not driven by socioeconomic factors and it's not just a matter of prenatal care. It would be easier to lump them together and say that African-Americans experience poverty, are single-parent families or say that their drug abuse rates are higher. But that's not the case," he said. "The biggest cause for infant mortality is a complication of prematurity and with prematurity, more babies die."

"No one knows what causes prematurity but the rate is going up," Bell added. "No one understands why it happens more to African-American women. It's completely unknown."

Prevention

Medical advocates advised black women to understand the risk and find the best care possible during their prenatal and postnatal time.

"I think the data about higher prematurity rates and higher mortality rates among the African-American community is an invitation to get the best care and address the disparity," Bell said.

For this reason, Sims, along with the Black Infant Health Coalition and First 5 Solano, are hosting a "Community Baby Shower" for Solano County pregnant black women and their partners, with classes that emphasize breastfeeding and nutrition.

"Formula-fed infants are 1.5 times as likely to die than breast-fed infants," Sims said. "In Solano County, we're doing good work but we're trying to increase breastfeeding among African-Americans. It protects childhood illnesses and mortality."

The Black Infant Health Program, part of Solano County Health and Social Services and dedicated to helping black women, is also an option for pregnant black women.

Alexandria

The cooing sound of Alexandria Robinson fills the well-furnished room as she lays nestled in her grandmother's arms, the same arms that held her mother almost four decades ago.

"Alexandria gives me the strength and the family will make it," she said. "I just look forward to the day we all get to heaven and meet again."