Informed Communities: How COVID-19 May Be Hurting Black Mothers and Infants
COVID-19 disproportionately impacts black families, causing a wide range of concerns among people already facing racial unrest, bias in health care, and an infant mortality rate at least twice the rate of white infants statewide.
“Like I said, day care is not even an option for me at this point,” said Re’Ona O’Neal, who is having a rough morning at her Northeast Ohio apartment. Her 1-year-old daughter, Lindsey, demands attention as she leans against her mom’s swollen, pregnant belly.
Right now, O’Neal would normally be preparing to make calls from home for her work as an insurance agent, but after the virus struck both both her and her daughter, life became a minefield of challenges.
“[Lindsey] was diagnosed not even a month ago, so a lot of people aren’t comfortable watching her, not even, like today I may have to call off work because I may not have anyone that would watch her,” O'Neal said.
She said the problem began in July when she and her daughter posed for a photograph with extended family and then went to an indoor golf range. A few days later, after experiencing mild symptoms -- a sore throat, cough and loss of taste and smell -- O'Neal tested positive for COVID.
“I had to have my mom, somebody come get my child when I first got diagnosed because I was a mess. I couldn’t even talk without crying, you know. It was really hard for me to go through that and then you’re going through that alone,” she said.
O’Neal, who was newly single following a breakup with Lindsey’s father, lost needed income from her part-time job at a group home as she recovered alone. Later, her daughter also tested positive but was asymptomatic. With a high-risk pregnancy, O’Neal began taking her own vitals for telephone prenatal appointments with the director of fetal intervention at University Hospitals, Dr. Ellie Ragsdale.
“Our anticipation is that COVID won't have a long- term effect on her pregnancy and that she'll do very well. But that's an assumption and something that we don't have a lot of data for. And that's the goal of studies like ours is to give us that data,” Ragsdale said.
O’Neal is participating in a study of women who tested positive at some point in their pregnancies. OB/GYN Dr. Rachel Pope said that the group of 145 women, which is nearly half black, is 18 percent higher than the total African American population in Cuyahoga County.
“Sometimes I wonder, are there more African-American women working in health care, the food industry? Are they working multiple jobs? Are they not able to control those variables around them of who they are coming into contact with?," Pope said. "Why that has to do with their race, I don’t have the answers. But I do think it’s compelling, and it’s something that we do need to look at.”
The Cuyahoga County Board of Health, Cleveland’s three main hospitals and Case Western Reserve University are collaborating on the research study, which involves taking samples of the placenta, amniotic fluid, breast milk, and blood to see if the virus is transmitted during pregnancy or delivery. So far, 30 babies have been born from the group, with none testing positive for the virus.
The doctors advise women to isolate at home as much as possible three weeks before their due dates. Dr. Ragsdale said that, so far, they have had a good response persuading employers of the need to protect pregnant employees, especially toward the end of their pregnancies.
“The conversations are difficult when a woman is COVID positive, and she comes into deliver. And I want everyone to know that if you test positive for COVID, we’re not going to take your baby away from you. We’re not going to tell you you can’t breastfeed. We’re not going to do any of those things. We’re going to teach you how to safely take care of your baby and decrease the likelihood of spread of COVID,” she said.
Cleveland Clinic pediatrician Dr. Gina Robinson has treated two infants born to women who tested positive in delivery. Both babies do not have the virus. She said black parents are feeling more stressed these days, and their babies can sense it.
“It definitely can have an impact on sleep patterns, on eating, and it can have an impact on bonding,” Robinson said.
“That’s the number one reason why a lot of us don’t make it,” said O'Neal, referring to the negative impact of stress on the black community.
O’Neal is trying to maintain a positive outlook, encouraged that the study can help other pregnant women -- and herself and her own children. Her second baby girl is expected in December.