Pregnancy is a universal language all moms speak. It doesn't matter what culture or country a woman is from, she will always have that special connection as a mother with other mothers. That knowing smile women with swollen bellies give one another just says so much that words would be inadequate.
The tiny little kicksThe worriesThe lively sonogramsThe bodily changesThe changing family dynamicsThe surprisesThe sheer terrorThe exhaustionThe undying loveThe miracle of it all
Moms are able to share all of these experiences in one simple smile. The universal language.
Even though the language of pregnancy is universal, pregnancy can actually be very different among different races. Some women have shorter pregnancies while others have higher C-section rates, simply due to heritage and genetics.
Scientists have been busy studying these fascinating pregnancy differences between races in order to personalize care for pregnant women. Knowing if one woman might be more prone to high-risk challenges while another might have trouble with her pelvic opening allows doctors to approach each pregnancy with more customized care. Knowing these differences also helps give moms a better idea of how their race might affect their pregnancies or their perceptions of pregnancy. Heck, some of this is just fascinating to learn about, whether adjustments need to be made or not.
This article takes a closer look at some of the differences in pregnancy among black, Asian, white and Hispanic women in the US.
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For most women, 40 weeks is considered a full-term pregnancy. Anything beyond 41 weeks is considered post-term. But these guidelines are based on the average woman and not delineated by race, although it might be beneficial to base pregnancy progression on race. In studies, researchers have found that black and Asian women may actually have shorter pregnancies which would make them full-term at 39 weeks. Allowing their pregnancies to progress past 41 weeks might prove dangerous.
One of the signs that marks a baby's readiness for birth is meconium in the amniotic fluid. Researches noticed meconium was present earlier in the fluid of black and Asian women, which means that their babies are ready to be born sooner. It also suggests that the pregnancies of black and Asian women actually tend to be shorter.
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Because of their shorter pregnancies discussed above, South Asian women are allowed to progress past full-term pregnancy which increases the percentage of stillbirths. This is yet another reason why Asian women's pregnancy should be treated differently because the rate of stillbirth rose rapidly after the 40 week mark. Another problem that south Asian women face is their tendency to carry smaller babies. Birth weights under 4.4 lbs, which were more common with South Asian women, increase the likelihood of infant loss.
The rate of mortality for babies born to South Asian mothers were high for every other common cause also including congenital abnormality, fever, maternal BMI, and placenta abruption. Greater care and monitoring may be needed for South Asian mothers.
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Gestational hypertension is more common with black women and least common with Hispanic and Asian Pacific Island first-time mothers. It's difficult to determine exactly what causes this risk, but it would seem that genetics and environmental factors play a role. Narrowing down those risk factors would make it a whole lot easier to create a plan for early intervention for both pre-eclampsia and later cardiovascular disease.
Moms that are diagnosed with pre-eclampsia during pregnancy later have a 1.7 times higher risk of dying from cardiovascular disease in later life. It seems that the same risk factors that predispose a woman to pre-eclampsia during pregnancy also predispose them to cardiovascular disease later in life.
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Not only does mom's heritage affect pregnancy risk, so does dad's! For some reason, an Asian mom carrying a white dad's baby has a higher risk of developing gestational diabetes and will then be at a higher risk for C-section than an all-white couple. Genetics seems to contribute to this risk, and just knowing about this risk factor makes it easier for doctors to provide more targeted care.
Asian couples tend to have smaller babies than white couples. So, researchers guess that an Asian woman's pelvis might not be able to accommodate a a baby the same size as a white woman's. Since Asian women have an underlying predisposition to gestational diabetes and an increased risk for C-section, health care for pregnant Asian women requires some different considerations.
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Although the risk of maternal mortality is low in the United States, it is four times higher for black women than white women. Even if you control for age, socioeconomic status and education, the risk is still four times higher. African American women are 9.9 times likelier to die from pre-eclampsia complications than white women. Does that mean black women have a genetic predisposition to risk factors for death or is something else at play here?
It seems that poorer healthcare and higher-risk pregnancies leave black women vulnerable to complications, and even death. Since up to 40% of those maternal deaths were likely preventable, it would seem that healthcare quality is a likely factor for the increased risk of maternal death. It seems that the women with the highest risk for complications get the lowest quality care. Obviously something needs to be done to equalize care for pregnant women to lower this unequal mortality rate.
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Statistically speaking, you might think that the chances of having a girl or a boy is about half and half. However, there seem to be several factors that contribute to slightly skewed gender outcomes. For one, every time a woman gives birth, she is less and less likely to have a boy with each subsequent birth. Second, black women tend to give birth to more girls than boys.
Studies of birth records show that black women tend to give birth to more girls, and non-black women tend to give birth to more males. The birth ratio in sub-Saharan Africa, in particular, reveals more female babies than males. In the rest of the world, more males are born overall. Part of the reason for this skewed birth ratio is a higher birth rate among black sub-Saharan women. Since the more a woman gives birth, the less likely she'll have a boy, the number of pregnancies a black mom has may be favorable for more girls.
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White women are more likely than black, Asian, and Hispanic women to get an epidural at birth. Even when researches adjusted for demographics and insurance coverage, they found that white women had more epidurals. The rates of epidural were even the same for black women with private insurance and white women with no insurance.
Researchers were trying to determine if pain was just under-treated in minority women or if minority women just tolerated pain better. Epidural rates vary by age, race, number of births, geographic location and education level. Epidural rates are also lower for births assisted by midwives than physicians. So, it's hard to pinpoint the exact underlying factors that cause disparities among races and epidural rates. However, it does appear that minorities are under-treated for pain.
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Black women are more susceptible to preterm birth, which is birth before 37 weeks. Infant death rates are also 2.4 times higher for black infants than white infants, which preterm birth being one key factor. It's unclear exactly why this happens, but there appears to be an association between environment factors and preterm birth rates.
We know that environmental exposure to smoke, lead, and air pollution influences preterm birth and black moms have more exposure to those things than white moms. So environmental factors seem to play a role in preterm birth rates. We also discussed earlier about how black women may actually have shorter pregnancies than white women, so perhaps the classification of "preterm" is inaccurate for black women. Learning as much as we can about the factors that lead to preterm birth are instrumental in prevention and proper maternity care.
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Black women carrying around extra baby weight can totally blame genetics on their predisposition to hang onto the weight. Black women tend to hold onto a considerable amount of weight gained during pregnancy. A staggering 63% of black women report a BMI that makes them overweight or obese after the birth of a child. A variety of factors contribute to this weight conundrum including diet, exercise, body image, postpartum mental health, sleep, social support, and health education.
Although black moms have a harder time getting rid of the baby weight, statistics show that black women actually tend to not gain the recommended amount of weight during pregnancy. They tend to gain less during pregnancy! If we consider the normal recommended 25-35lb weight gain for pregnancy, Hispanic and black women tend to weigh in shy of the recommendations.
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Spanish-speaking Hispanic moms have greater intentions to breastfeed, actually start breastfeeding and continue breastfeeding than other moms in the US. These moms are followed closely by English-speaking Hispanic moms. The Hispanic culture seems to play a pivotal role in breastfeeding success. With stronger family histories of breastfeeding and pro-breastfeeding demographics, Hispanic women have a culture of breastfeeding support that makes it normal and natural to breastfeed.
On the other hand, black women are least likely to start or continue breastfeeding, and many don't even intend to start. The lack of family breastfeeding history and the introduction of in-hospital formula feeding seem to inhibit black mothers from carrying out a breastfeeding routine. Cultural perceptions of breastfeeding may also play a role. Black mothers may need more continued support to breastfeed.
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White women have the widest pelvises of all when compared to black women and Asian women. White babies also tend to be longer and heavier and have larger heads than babies of other races. Because of this, birth outcomes are quite different among different races. For one, C-section rates are highest among minority women in the US and lowest among white women. White women have the biggest babies and larger pelvises to push through.
These statistics poke all kinds of holes in the birth charts our healthcare system uses to assess fetal size and due dates. The standard charts the doctors refer to, to figure out baby size and percentiles, are based largely on the averages of a group of middle-class white women in the 1980s. It's probably time to put together some new charts since the 1980s are long gone and the women giving birth in the US are much more diverse than middle-class white women.
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Black and Latina girls are twice as likely to become pregnant during their adolescent years than white girls, according to Pew research. Although the rate has been on a steady decline in the last decade, the rate is still alarming. The factors that play the biggest role in teen pregnancy rates are geography and poverty. Teens that live in poorer cities, especially in the southern United States, have much higher rates of pregnancy than elsewhere.
The lack of opportunity these teens face plays the biggest role in teen pregnancy rates. Their race doesn't have anything to do with it except for the fact that black and Latina populations are more prominent in those places. Many lack access to proper healthcare, contraception, and quality education. Family history seems to amplify the effect too. If a young teen's own mother had her in her teens, then the teen is three times more likely to have a baby in her own teens.
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Black and Asian women seem to be less afflicted by morning sickness in the first trimester than white women. However, the differences end there. The incidences of hyperemesis gravidarum are about the same among different races, even among moms in Eastern and Western populations. There aren't any other statistical differences between race and morning sickness. Morning sickness doesn't discriminate! Morning sickness might be reassuring though considering the more morning sickness you have, the less likely you are to miscarry.
One interesting fact to note is that Native Americans and Eskimos report a really low incidence of morning sickness. There are also 27 traditional societies in the world that that report not suffering from morning sickness at all. Researchers surmise that the diets of these traditional societies, high in maize and low in animal products, cause the most dramatic effect on morning sickness, more than genetics even!
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When asked about their exercise habits, diet, stress management tactics and sleep habits, black women were most likely to agree that they were able to maintain a healthy lifestyle during pregnancy. Compared to 54% of black women, only 39% of white women and 29% of Hispanic women thought they maintained a healthy lifestyle during pregnancy. Black women were also most likely to report doing "extremely well" at taking care of themselves.
Black women seem to have stronger feelings of health and well-being during pregnancy and after. They also report having less overall support around them, especially during labor. It makes one wonder if black women report better well-being because they actually practice better self-care, if they have higher self-perception, or if they face higher expectations of self-sufficiency and autonomy than white and Hispanic women.
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Although we'd like to think the rates are lower, a small percentage of pregnant women do admit to alcohol and illicit drug use during pregnancy. Hispanic women report the lowest rates of drug, alcohol and cigarette use during pregnancy compared to white and black women. Pregnant white women reported the highest incidence of cigarette smoking (21.8%) within the preceding 30 days than black (14.2%) and Hispanic (6.5%) women. Those numbers are probably much higher than you might expect!
Illicit drug use was highest among pregnant black women and lowest among pregnant Hispanic women. Alcohol consumption (12.2%) was the same for black and white women. Meanwhile, only 7.4% Hispanic women reported consuming alcohol within the last month. As you've likely been warned, alcohol, drugs, and cigarettes have many adverse affects on fetal development, including mental and physical defects. Most doctors urge pregnant women to completely abstain from all three. Intervention and education would be beneficial for populations more prone to use and abuse.
Sources: Childbirth Connection, Pew Charitable Trusts, Journal of Epidemiology, Softpedia, National Library of Medicine, Stanford Medicine, Newsweek, Bioline, Advances in Nutrition, American Academy of Pediatrics, Journal of Perinatology, Pregnancy Sickness Support, Addiction Pro