Why Do Black Women Experience More Pregnancy Loss?

Research has shown that Black women experience all types of pregnancy loss more often than white women. This includes miscarriage as well as stillbirth, preterm birth, and infant death.

The reasons why have baffled scientists for decades. We do understand that Black women have higher rates of the risk factors associated with pregnancy loss, such as diabetes, tobacco use, obesity, and low socioeconomic status. But even studies that control for these variables find higher rates of pregnancy loss among African Americans.

The reasons why Black women are more susceptible to these risk factors is complicated and related to various issues of racism and systemic inequality in healthcare. However pinpointing the exact reasoning behind higher rates of diabetes, high blood pressure, and many other chronic illnesses is not clear cut.

Preterm Labor

One of the major contributors to the higher rate of infant death is an increased rate of preterm labor in African American women and in premature birth for their babies. Because prematurity and low birth weight are leading causes of death in infants, it’s logical to conclude that more babies born early will ultimately equate to more infants dying from those factors. However, these facts don’t explain why African American women are so much more likely to go into early labor than white women.

One study out of Virginia Commonwealth University identified a small variation in the gene SERPINH1 in Black women. This gene is essential in the production of collagen, which is one of the components of the amniotic sac (bag of waters).

This collagen defect is three times more common in African American women than in white women, which may account for some of the incidents of preterm labor among Black women. Because the gene was only found in 12% of the population studied, however, the collagen defect can’t be the only contributing factor to pregnancy loss in Black women.

Late Pregnancy Loss

Another study sponsored by the National Institutes of Health found African Americans were more than twice as likely to experience late pregnancy loss, including stillbirth.

That study attributed the difference to the higher rates of pregnancy complications like diabetes, high blood pressure, premature rupture of membranes, uterine bleeding, placental abnormalities, and problems with the umbilical cord in labor.

Structural Racism in Healthcare

While our instinct might be to point to socioeconomic factors, several studies have found that the risk of pregnancy loss is the same, even among educated, affluent Black women.

This discovery reveals an uncomfortable truth about structural racism in the healthcare space and how prenatal care is administered differently to white vs. Black mothers. In other words, there is a much higher likelihood that white women will receive more effective medical care and social service assistance than Black women. Black women are also less likely to have access to prenatal education, which can affect how they eat and behave during pregnancy.

Ultimately, it has become broadly accepted that the continuous, low-grade stress caused by racism and inequality, is a key factor contributing to disparities in infant and maternal deaths.

What Can Be Done?

Programs like Life Course aim to tackle the problem holistically, offering everything from job assistance to transportation to prenatal care visits, which have shown some success.

Those programs aim mostly at alleviating the socioeconomic factors that contribute to perinatal mortality, but they can’t completely close the gap until we understand what causes the health disparities, even among women who aren’t economically disadvantaged.

In the meantime, there are things African American women can do in an effort to improve their chances of having a healthy pregnancy. The following are some steps they can take:

A Word From Verywell

Although some of these statistics related to African American women and pregnancy loss may scare you at first, it's ultimately in your best interest to be informed. Don't be afraid to bring up any potential concerns with your doctor. You may ultimately not have anything to be alarmed about, but it’s always okay to call with questions and concerns.

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  1. Mukherjee M, Edwards D, Baird D, Savitz D, Hartmann K. Risk of miscarriage among black women and white women in a U.S. prospective cohort study. Am J Epidemiol. 2013;177(11): 1271–1278. doi:10.1093/aje/kws393

  2. Wang H, Parry S, Macones G, et al. A functional SNP in the promoter of the SERPINH1 gene increases risk of preterm premature rupture of membranes in African Americans. Proc Natl Acad Sci USA. 2006;103(36):13463-7.  doi:10.1073/pnas.0603676103

  3. Anum EA, Springel EH, Shriver MD, Strauss JF. Genetic contributions to disparities in preterm birth. Pediatr Res. 2009;65(1):1-9.  doi:10.1203/PDR.0b013e31818912e7

  4. Centers for Disease Control and Prevention. Smoking during pregnancy. Updated January 2018.

  5. Centers for Disease Control and Prevention. STDs during pregnancy - CDC fact sheet. Updated March 2016.

  6. Brigham and Women’s Hospital. 12 ways to stay healthy during pregnancy

  7. National Institutes of Health. What is prenatal care and why is it important?. Updated January 2017.

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