The Effects of Health Disparities on Neonatal Outcomes

Racism is an embedded part of the history of the United States. Slavery was legal in North America for 246 years and dramatically altered the reproductive health of Black women and the well-being of their children. After the end of the Civil War, legal discrimination through segregation and Jim Crow policies remained enforced through political and legal power structures. Even after the Civil Rights era of the 1960s, the impact of hundreds of years of racism continues to be felt through deeply embedded structural racism. Health care is no exception to this legacy, through explicitly racist experiments such as the Tuskegee Study of Untreated Syphilis, continued teaching of insidious and disproven theories of intellectual inferiority or higher pain tolerances,52 or abuses of power such as the creation of the HeLa immortal cell line. These cells were taken from Henrietta Lacks, a Black woman being treated for an extremely aggressive cervical cancer, without her consent and are still widely used today in research.53 These deceptive practices have led to generations of mistrust and suspicion of the healthcare system for Black families, and it is imperative that health care professionals keep this in mind when trying to establish a trusting relationship. To move forward, health care professionals must acknowledge the past and commit to working together to eliminate health disparities. Access to health care in areas that were previously redlined, increased resources to hospitals that take care of high Black populations, improving local access to prenatal care, and more representative staffing would help to improve maternal health through a reduction in premature birth. For those infants still born prematurely, care focused on reducing disparities will continue to lower the rates of neonatal morbidities and mortality, increase breastfeeding rates, and promote healthy family experiences.