A low birthweight baby weighs less than 5.5 pounds at birth. Low birthweight
is more prevalent among African-American women, regardless of marital status,
age, or whether or not the mother smokes. The rate stays constant even across
income levels, from extreme poverty to wealth. "Either way, that black woman
still has a 2-to-1 chance of having a low birthweight baby," says Gail Gibson,
head of Maternal Child Health for the Medical Center for Louisiana, which encompasses
University and Charity hospitals and is the birthplace of 70 percent of this
city's babies.
In the state of Louisiana, one in 10 babies are low birthweight -- the second-highest
rate of low-birthweight babies in the nation, according to the 2002 Kids Count
data book. (Mississippi, which ranked last, had a low-birthweight rate only
0.3 percent worse than Louisiana's.) The Kids Count book, compiled and published
annually by the Annie E. Casey Foundation, ranks states from 1 to 50 on factors
that affect child and family well being. Locally, the group Agenda for Children
compiles a similar book, Kids Count Louisiana, which breaks down this data for
each parish in the state.
Louisiana typically falls near the bottom of the Kids Count rankings, and
2002 was no exception. Overall, Louisiana ranked 49th (once again, just barely
ahead of Mississippi). Our state came in at or near the bottom in four key areas:
percentage of low birthweight babies; percentage of children in poverty; percentage
of children living in families in which no parent has full-time, year-round
employment; and percentage of families headed by a single parent.
Reports such as these are troubling and raise an obvious question: "What can
we do?" When it comes to the problem of low birthweight babies, the unfortunate
answer is that in at least half the cases we don't yet know. According to the
National Institutes of Health, one of the greatest research challenges before
us is deciphering "the underlying reasons for ethnic variations in low birthweight
and preterm delivery."
It's a mystery that affects Louisiana every day. Low birthweight babies have
extremely high infant-mortality rate. Survival is also costly -- some of the
tiniest babies require more than a half-million dollars worth of care before
they leave the hospital for the first time. There are long-term effects as well.
Low birthweight babies are more at risk for a number of problems, including
chronic lung disease, brain damage, mental retardation, cerebral palsy and blindness.
Some will grow up with trouble learning, and some will suffer numerous health
problems into adulthood.
Half the babies born at low birthweight have known, traceable causes. To help
these infants, the Louisiana Office of Public Health (OPH), with local advertising
and public relations agency Keating Magee, launched a noteworthy campaign called
Partners for Healthy Babies. The project, started in 2001, features a designated
24-hour helpline (800-251-BABY) and a distinctive television spot produced by
Keating Magee that promotes early prenatal care for teens and young women.
In addition, OPH emphasizes early detection of infections, proper weight gain,
and spacing between children -- all factors known to be connected to low birthweight.
Yet there are many women of all classes, colors and ethnicities who have done
everything they should for the health of their newborn and still go into labor
months before their due date. Nearly one in five New Orleans babies were born
as a result of labor that started preterm, or before 37 complete weeks of gestation.
Preterm labor is connected closely to low birthweight babies.
Prenatal care is vital for the overall health of a newborn child. But some
researchers, such as University of Michigan professor Dawn Misra, contend that
the idea of prenatal care has been oversold as a solution to low birthweight.
They note that prenatal-care rates have risen appreciably nationwide and yet
the rate of low birthweight babies hasn't budged since the 1960s. Nationwide,
Healthy Start agencies -- including the local group Great Expectations -- have
begun to look at other factors that can affect women. Most experts in low birthweight
babies now believe that stress is a key component. Perhaps, they suggest, daily
stresses faced by African-American women in America cause higher rates of low
birthweight.
Recognizing this possibility, some cities have discussed the
idea of providing comprehensive medical care and other support services to women
of childbearing age -- specifically those women who have miscarried within the
past year. This is an idea worth considering here. We can't expect healthy,
full-size babies from mothers who have been in poor health for the rest of the
year. The cause of many low birthweight babies remains elusive, but increasing
efforts to provide greater care for women and their unborn children would be
one way to help ensure happy, healthy babies.
