Southeast

How trust and stress affect infant and maternal mortality in Southeast Fort Wayne

The year 2020 has been a rollercoaster of overwhelming and jarring experiences that have created new problems for some and hyperextended pre-existing problems for many.

What’s been virtually inescapable this year is talking about racism and the role it plays in the lives of every American. Whether it takes form in purposefully designed policies, casual microaggressions, or implicit bias, racism sets up and reinforces a structure that does not allow for equity or justice for all. This reality also takes a toll on the physical, mental, and emotional health of those who are oppressed.

However, for every whiplash-inducing current event in 2020 that results in frustration, loss, or hardship, opportunities for greater awareness, learning, and hope emerge.

Regardless of social-economic status, Black women face health disparities in the U.S. at higher rates than most other populations. Research on infant mortality and maternal health shows that “Black women experience the highest infant mortality rates among any racial or ethnic group in the United States. The Black IMR has been roughly twice that of the White IMR for over 35 years.”

Income and education levels do nothing to close the gap either. In fact, infant mortality rates are highest among Black women with doctorate or professional degrees and across all income levels, leaving Black women “243 percent more likely to die from pregnancy- or childbirth-related causes.”

These disparities hit all too close to home in Northeast Indiana where infant mortality rates in Fort Wayne are among the highest in the state and the country. Allen County has a consistently higher IMR than that of the U.S., as a whole, particularly among Black populations.

“From 2013 to 2017 in Allen County, African American births accounted for only 15.9 percent of live births, but 33.2 percent of the deaths,” reports Footprints Fort Wayne.

While the state’s IMR dropped in 2019, the numbers are still troubling—especially in the city’s 46806 zip code of Southeast Fort Wayne. This zip code was once redlined and now has a population that is roughly 50 percent Black. Its IMR is nearly three times the national average.

Data from the Indiana State Department of Health.

A Black woman herself, Fort Wayne OB-GYN Emmary Butler sees issues like limited access to care, a lack of clinics, transportation issues, late prenatal care, inadequate follow-up care, and comorbidities as major contributing factors to early deliveries and infant mortality in Black communities.

“Trust is also a huge issue,” Butler says. “We don’t have a lot of doctors around here who look like the people who are on the Southeast side of town. Me, being one of the only African American OBs, I hear all the time that patients are very comfortable when they come in. They don’t feel judged.”

Butler helps her Black patients feel at ease sharing their health concerns.

A recently published study in the Proceedings of the National Academy of Sciences found that Black babies are three times more likely to die in the hospital when their doctor is white. But that rate is cut in half when Black babies are cared for by Black doctors. The explanation could be any number of factors ranging from patient trust to Black doctors having a better understanding and higher level of interest in issues Black mothers and babies face to implicit bias impacting the ability for white doctors to adequately care for their Black patients.

Unfortunately, the risk of maternal mortality among Black women remains high, regardless of the race of the doctor.

In recent years, more attention has been paid to the concept of “weathering” as a possible explanation for the poor health outcomes of Black women. “Weathering” refers to the premature biological aging, chronic health conditions, and illnesses Black women’s bodies experience as the result of the constant stress of racism and discrimination. For Butler, preventing these stressors, which includes connecting people to resources, is the missing puzzle piece.

“I focus my change in the office with the girls that I see and try to make sure that they have the best outcomes and resources,” Butler says. “This is how I am contributing.”

Butler understands the challenge of "weathering" on Black women and their babies.

Despite the daunting nature of facing such largescale, systemic problems, Fort Wayne has a network of resources ripe for the sort of collaboration that could make a real impact on the health outcomes for Black women and babies. Under the leadership of Executive Director Meg Distler, the St. Joseph Community Health Foundation specifically focuses an area of its work on supporting programming aimed at helping pregnant women, new fathers, and infants have healthier outcomes—particularly People of Color and those living in 46806.

Through funding projects like Healthier Moms and Babies, the ECHO project, the Journey Birth & Wellness Community Doula Services program, a prenatal and infant care network, and extensive community health and prenatal and infant care resource directories, the Foundation serves as a vehicle for bringing people and resources together.

“Our goal is to lift awareness, get resources, and get people connected to the different projects, which, in turn, helps reduce the stress and weathering Black women experience,” Distler says. “We know that when people feel safe, stable, and nurtured, the pregnancy is better; the infant is healthier; it all starts better when women have access to resources.”

Meg Distler is Executive Director of the St. Joseph Community Health Foundation.

One such resource is Healthier Moms and Babies (HMB). The organization offers programs with case managers and nurses to work with families throughout their pregnancies until the baby turns two years old to address everything that goes into having healthy lives, including connecting mothers to therapy as a means of dealing with stress. HMB Executive Director Paige Wilkins says weathering has played into her organization’s work, too.

“Many of our moms have voiced concerns about the fears they have about bringing a child into this world the way it is—having a boy and being fearful of that boy growing up and being profiled by the police,” Wilkins says. “Those are real concerns of the families that we serve, and that creates so much stress, and stress impacts your body.”

HMB’s 9-week “Own Your Journey” program is designed specifically to build a support system and address the health and fitness, financial wellness, and mental health of women and teens before they conceive their first or next baby. It’s all a part of a focus on holistic health and dealing with the added trauma that Black communities face to help prevent health risks before they start.

“I would really love to see the Own Your Journey program take off,” Wilkins says. “Because the one thing you can do to help with infant mortality is to prevent it, and you have to prevent it by being healthy before you become pregnant.”

Wilkins

YoungLives, a program for teen moms that is supported by the St. Joe Community Health Foundation, also has programming that focuses on the health of teen mothers until age 21, providing them with mentors and a support system. For Elisha Catts, a Southeast resident and YoungLives Coordinator for Southeast Fort Wayne, making sure teen moms have someone they can trust in their lives who advocates for their health is critical. Making sure they have supportive relationships with people and services that can help them navigate their pregnancies is important, too.

YoungLives connects girls with resources like HMB, primary healthcare providers for them and their babies, before and aftercare for infants, and childcare services through the Early Childhood Alliance and Brightpoint as kids get older.

“We’re not necessarily the ones who are providing any health services, but we’re like the bridge or the hub that connects our girls to whatever they need,” Catts says.

Elisha Catts, center, is the YoungLives Coordinator for Southeast Fort Wayne.

Other resources around the city include the African-American Healthcare Alliance, the Eta Upsilon Zeta Chapter of Zeta Phi Beta Sorority, Women’s Care Center, Parkview Health, Footprints Fort Wayne, and more.

Even so, there is a noticeable absence of diversity among the leadership and staffs of the majority of the local organizations addressing such important issues that heavily impact Black women, highlighting the need for more Black leadership and Black-led programs in Fort Wayne. Having more Black people designing and implementing programs from a place of personal interest and understanding, supporting efforts to increase the numbers of Black people in the healthcare and medical fields, and intentionally recruiting more Black doctors to the city would help create the type of trust and care needed to better address the health disparities that plague Black women.

What’s also missing is a comprehensive network of care for moms and babies in Fort Wayne that brings the myriad of people and organizations in this space together to better serve the community.  

“I do think there is becoming an increasingly concerted effort to address maternal health and infant mortality in a unified way,” Catts says. “All of the organizations are coming together to say, ‘This matters to us.’ But it’s going to take all of the organizations coming together to really make an impact and to see, not the just the numbers change, but lives change and babies living.”

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