Introduction
High rates of infant mortality remain a severe problem on the current health care agenda, reflecting the failure of the clinical system to deliver high-quality services or the low availability of medicine and related knowledge among mothers. Infant mortality is a highly sensitive societal threat affecting not only the well-being of mothers but also the population health of communities. Meanwhile, infant mortality rates among black American mothers remain consistently high compared to mothers of other races (March of Dimes, 2020). There are several reasons why infant mortality rates can be so ethnically imbalanced. These include the presence of infections, low availability of medicine, genetic or physiological complications during childbirth, or the prevalence of unhealthy habits among pregnant women (NHS, 2021). Consequently, any one of these causes, or even a synthesis of them, can lead to the problem of the current birth agenda. The purpose of this research project will be to examine this phenomenon sociologically using a statistical tool.
Literature Review
In preparing the current study, academic and public thematic materials were used to demonstrate the nature of the stillbirth problem. Stillbirth should be defined as intrauterine fetal death for a variety of reasons occurring after the twentieth week of pregnancy (Carter et al., 2019). It is clear that stillbirth is a critical problem in maternity practice because it leads to the most undesirable outcome and potentially threatens the health of the mother. As such, the threat is increasingly important; studies report preventive practices targeting vulnerable populations (Ishak & Khalil, 2021). Working with potentially stillbirth-prone mothers seems reasonable as it will minimize stillbirth rates and improve the community’s public health agenda, including psychological health.
The outlined strategy is an appropriate practice to identify potential trends among Black mothers who are susceptible to stillbirths. Villarosa (2018) reports psychological and consequent physical abuse of such mothers; in other words, Black women are found to be more likely to live in a more dysfunctional relationship with the child’s father than women of other races. In addition, research reports a higher prevalence of infectious diseases and defective conditions in Black infants (Singh & Stella, 2019). However, there has been a lack of knowledge on quantitative trends in such infant mortality. Thus, the study of this phenomenon will contribute positively to the theoretical study of this public health threat.
Research Question
What are the trends in infant mortality, including stillbirths, among American black mothers?
Methodology
Conducting the Study
The methodological basis for this study was a survey questionnaire administered to Black women attending maternity hospitals. The experimental design was based on quantitative data collection, with further transformation into statistical patterns and relationships revealed through analysis. Preliminary estimates suggest that between 350 and 400 black women between the ages of 18 and 50 should participate, but the actual survey may expand these boundaries slightly. The survey is administered in the ten states in the United States with the highest demographic representation of blacks, namely Mississippi (38.77%), Louisiana (33.71%), Maryland (31.55%), Georgia (31.42%), Alabama (27.09%), South Carolina (26.40%), Delaware (23.00%), North Carolina (21.84%), Virginia (20.64%), and New York (17.58%) have the highest black resident population (World Population Review, 2022). The sample is of the cluster type, in which the clusters are several maternity hospitals in the regions described. Volunteers randomly ask black patients at these clinics to participate in the study, obtain informed consent, and describe the goals of the project so that the respondent accurately understands her role.
Ethical Assumptions
Conducting the present experiment is closely related to the ethical issue of maternal participation, as the topic of infant mortality is compassionate. For mothers, experiencing this experience can be associated with the development of depression and emotional instability (Trimiar, 2020). As a consequence, the additional reminder of this issue can be traumatic for these women, which is not in the interest of this study. Nevertheless, the strategy described seems best for forming a reliable representative sample, so it is critical to train volunteers to present information to patients in a way that is not perceived as painful. In addition, the identity of each respondent is anonymized, so there is no means of identifying a particular patient.
The research project takes approximately one month to complete, with the bulk of the work being done on the statistical analysis. The survey questionnaire should take less than one week to complete, after which all files are sent to the researcher for processing. About three weeks will be needed to complete the statistical analysis, have them peer-reviewed, process and visualize the results, and prepare a formalized progress report. It is expected that at the end of one month, the work will be fully completed, resulting in the report’s scientific publication.
Statistical Data Analysis
Data Preparation
The primary step for statistical analysis, even before the survey questionnaire is implemented, is to examine the validity of the questionnaire created. For this purpose, a focus group of women who fit the characteristics of the population can be assembled to complete the pilot test questionnaire. Based on the results of this questionnaire, Cronbach’s alpha, a measure of the consistency of the test items, would be determined (Zach, 2021). Values of this parameter at a confidently high level will indicate a well-designed questionnaire; if not, the survey should be edited, and a second pilot test conducted.
Descriptive Statistics
Since the results of the survey will be presented in the form of a spreadsheet with 350-400 rows, the initial preparation of the data is the first step for its analysis. Specifically, any incomplete rows where respondents or volunteers missed responses must be removed – such data can distort the statistical picture and introduce errors in the conclusions (Gitlin, 2018). Once the data is prepared, the next step is to conduct descriptive statistics procedures, which include compiling a sample mean image and determining trends in responses to questions. Frequency distribution tables would be ideal tools to describe such statistics and identify key characteristics of the collected sample. For example, one result might be the following “X% of women indicated that they have experienced infant mortality in their experience.”
Inferential Statistics
However, descriptive statistics cannot detect significant research findings because they are limited to a superficial examination of them. Inferential statistics will use Spearman’s correlation analysis to determine patterns between various variables. Specifically, the correlation will be used to look for a relationship between respondents’ unhealthy habits and infant mortality parameters. Any differences in subgroups of the sample will be assessed using the chi-square test; this metric assesses the statistical validity of differences between observed characteristics and expected values. Finally, because one of the questions was related to the identification of causes of stillbirth from a list of potential causes, visualizing responses using histograms is a good strategy for describing them. Moreover, causes can be related to the age of the patient at the time of the failed delivery through regression analysis to determine whether a relationship exists between the variables.
Conclusion
Contribution of the Study
This study will make a positive contribution to the study of infant mortality among black mothers in the United States. The project will not only cross-sectionally identify the characteristics of such a threat for ten regions of the country but also predict key tactical measures to reduce mortality rates. Specifically, identifying the critical causes of stillbirth combined with identifying age-specific patterns will allow planning potential prevention strategies for pregnant black women. Moreover, the study will contribute to the problem of studying ethnic differentiation in infant mortality and will demonstrate consistency or inconsistency with the detected agenda.
Limitations and Directions for Future Work
In the meantime, the research conducted will have several limitations that will be part of future academic practice. Moreover, only women from ten U.S. states were invited to participate in the survey, which would not allow the results to be extrapolated to the entire country. In addition, the survey included only female patients who went to clinics on their own; hence, it did not include physically challenged mothers and women who did not attend clinics during pregnancy. For this reason, expanding the geographic scope, increasing the sample size, and using additional sociodemographic variables are essential objectives for further research work.
References
Carter, E. B., Stockburger, J., Tuuli, M. G., Macones, G. A., Odibo, A. O., & Trudell, S. (2019). Large‐for‐gestational age and stillbirth: Is there a role for antenatal testing? Ultrasound in Obstetrics & Gynecology, 54(3), 334-337.
Gitlin, J. (2018). Survey data cleaning: 7 things to check before you start your analysis. Survey Monkey. Web.
Ishak, M., & Khalil, A. (2021). Prediction and prevention of stillbirth: dream or reality. Current Opinion in Obstetrics and Gynecology, 33(5), 405-411.
March of Dimes. (2020). Mortality and morbidity. March of Dimes: Perinatal Data Center. Web.
NHS. (2021). Causes – stillbirth. NHS UK. Web.
Singh, G. K., & Stella, M. Y. (2019). Infant mortality in the United States, 1915-2017: large social inequalities have persisted for over a century. International Journal of Maternal and Child Health and AIDS, 8(1), 19-31.
Trimiar, D. H. (2020). Understanding grief in stillbirth: A phenomenological study of African American women [PDF document]. Web.
Villarosa, L. (2018) Why America’s black mothers and babies are in a life-or-death crisis [PDF document]. Web.
World Population Review. Black population by state 2022. WPR. Web.
Zach. (2021). How to report Cronbach’s Alpha (with examples). Statology. Web.