For Black women, the journey to motherhood comes with unique challenges. One in 10 babies in the US are born preterm. Black mothers are 50 percent more likely to experience preterm birth—one of the leading causes of infant mortality—compared to non-Hispanic white mothers. This disparity reflects long-standing systemic inequities in healthcare access, quality, and outcomes. But there’s hope: advances like the PreTRM® Test are equipping Black women with the tools and knowledge to safeguard their pregnancies and demand the care they deserve.
BlackDoctor.org spoke with Dr. Barbi Phelps-Sandall, a board-certified OB/GYN who runs a practice in Mountain View, California, to discuss how the PreTRM® Test works, why it’s especially important for Black women, and what you can do to protect yourself and your baby during pregnancy.
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Why Black Women Face Higher Risks
The reasons behind the racial disparity in preterm birth rates are complex and multifactorial:
- Systemic Healthcare Inequities: Black women often receive less comprehensive prenatal care compared to their white counterparts. Implicit biases within healthcare systems can lead to delayed or insufficient interventions.
- Stress and Racism: Chronic stress, including the effects of racism, has been linked to adverse pregnancy outcomes. Prolonged stress impacts the body’s ability to sustain a healthy pregnancy.
- Economic Barriers: Limited access to quality healthcare and nutritious food can affect maternal and fetal health.
- Medical Conditions: Black women are more likely to experience pregnancy complications like hypertension and diabetes, which are risk factors for preterm birth.
Despite these challenges, tools like the PreTRM® Test and proactive care can help level the playing field by identifying risks early and enabling targeted interventions.
What is the PreTRM® Test?
The PreTRM® Test is a simple, non-invasive blood test designed to predict the risk of spontaneous preterm birth in singleton pregnancies. It’s available to expectant mothers between 18 and 20 weeks and six days of pregnancy.
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Here’s how it works:
- What It Measures: The test analyzes levels of two proteins—Insulin-like Growth Factor Binding Protein (IBP4) and Sex Hormone Binding Globulin (SHBG)—in a blood sample.
- How It Helps: By combining these protein levels with other factors, the test provides a personalized risk score for preterm birth. If your risk is high, your healthcare provider can take steps to reduce it.
This early detection tool is a game-changer, especially for women who don’t have obvious risk factors but are still at higher risk due to systemic challenges.
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Why the PreTRM® Test is Vital for Black Women
Early Risk Detection
Many preterm births occur without warning signs. The PreTRM® Test helps identify risks before symptoms arise, giving you and your doctor more time to act.
“The PreTRM Test is critical for all expectant mothers, because half the time, women don’t have any known risk factors when they deliver their baby preterm,” Dr. Phelps-Sandall says. “By identifying pregnancies that are at higher risk for a premature delivery, we’re able to offer patients and their providers the potential to intervene with treatment and improve outcomes. Knowing a pregnancy is at risk for spontaneous premature birth allows you and your doctor to plan accordingly and implement preventative measures. Every day counts.”
Proactive Care
Once you know your risk, you can collaborate with your healthcare provider to create a care plan. This might include more frequent check-ups, medications like progesterone, or lifestyle adjustments.
“Since up to half of all women who experience preterm deliveries have no known risk factors, the ability to independently seek testing can lead to earlier awareness and preparedness. Early detection is pivotal in deploying preventive strategies that could significantly mitigate the risks associated with preterm births,” Dr. Phelps-Sandall adds.
Protecting Yourself and Your Baby
Preterm birth isn’t always preventable, but there are steps you can take to reduce your risk and protect your health:
1. Get Tested Early
Ask your provider about the PreTRM® Test or order it directly online. Knowing your risk empowers you to take control of your care.
2. Prioritize Prenatal Care
Regular check-ups are essential for monitoring your baby’s growth and catching any complications early. If you feel your concerns are being dismissed, don’t hesitate to seek a second opinion.
3. Manage Stress
Chronic stress can increase your risk of preterm labor. Practices like mindfulness, meditation, and prenatal yoga can help. Surround yourself with a supportive community and consider seeking counseling if needed.
4. Focus on Nutrition
A healthy diet supports your baby’s development and strengthens your body for pregnancy. Aim for meals rich in fruits, vegetables, lean proteins, and whole grains.
5. Track Your Baby’s Movements
After 28 weeks, pay attention to your baby’s kick patterns. Reduced movement could signal a problem, and contacting your provider immediately can make a difference.
6. Advocate for Yourself
Don’t be afraid to ask questions, request additional tests, or push for referrals to specialists. You are your best advocate, and your voice matters.
How the PreTRM® Test Can Reduce Risks
Studies like the AVERT PRETERM Trial show that early risk detection, combined with targeted interventions, can lead to:
- Lower neonatal mortality: Up to 18 percent fewer severe complications or deaths.
- Extended gestation: Particularly for high-risk pregnancies, every additional week in the womb improves outcomes.
- Shorter NICU stays: Reducing the financial and emotional toll on families.
These outcomes are especially critical for Black families, who often face greater hurdles in accessing high-quality postnatal care.
“This translates into less emotional and financial stress for families and better health outcomes for newborns,” Dr. Phelps-Sandall notes.
Having the Conversation with Your Doctor
Advocating for yourself is crucial during pregnancy, especially if you feel your concerns aren’t being taken seriously.
“With the results from the PreTRM Test, expectant mothers can engage in more informed and productive conversations with their healthcare providers. This fosters a collaborative approach to developing personalized care plans aimed at extending pregnancy and improving neonatal outcomes,” Dr. Phelps-Sandall says.
Use these tips to discuss the PreTRM® Test with your healthcare provider:
1. Be Direct
Ask, “Can we discuss my risk for preterm birth? I’ve heard about the PreTRM® Test and want to know if it’s right for me.”
2. Share Your Concerns
Let your doctor know if you’re worried about preterm birth, especially if you’ve experienced complications in previous pregnancies or feel unsure about your care plan.
3. Ask Questions
- How would this test change my prenatal care?
- Are there any risks associated with taking this test?
- What steps will we take if my results indicate a higher risk of preterm birth?
4. Be Prepared to Advocate
If your provider isn’t familiar with the PreTRM® Test or dismisses it, ask for a referral to a specialist or maternal-fetal medicine (MFM) doctor.
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Who Should and Shouldn’t Take the Test
The PreTRM Test is an excellent tool for many pregnancies, but it isn’t suitable for everyone. You should not take the test if:
- You are pregnant with multiples (e.g., twins, triplets).
- You have a known or suspected fetal anomaly (a condition affecting the baby).
- You are on progesterone therapy after the first trimester.
- You are outside the 18 to 20 weeks and six days window for specimen collection.
“For patients who miss the window for the PreTRM test, I typically recommend a repeat cervical length check by ultrasound before 24 weeks. Care is individualized and counseling done, based on those results,” Dr. Phelps-Sandall shares.
Proactive Steps to Protect Yourself
Even if your test results indicate a low risk, taking steps to safeguard your pregnancy is always a good idea. Here’s how:
- Get Regular Prenatal Care: Attend all your appointments and report any unusual symptoms.
- Track Your Baby’s Movements: Pay attention to kicks and patterns, particularly after 28 weeks.
- Manage Stress: Incorporate mindfulness practices, exercise, or seek therapy to reduce stress levels.
- Prioritize Nutrition: Eat a balanced diet to support your baby’s growth and overall health.
- Stay Informed: Learn about preterm birth risks, and don’t hesitate to ask your provider for resources.
- Speak Up: If you feel your concerns aren’t being addressed, seek a second opinion or advocate for additional care.
Remember: Knowledge is Power
By understanding your risk, advocating for equitable care, and adopting preventive strategies, you can give your baby the best possible start in life. Together, we can work towards reducing preterm birth rates and ensuring healthier outcomes for mothers and babies across all communities.
