Introduction

In 2017, a travel ban targeting people from countries that were predominately Muslim was instituted through an Executive Order signed by the President of the United States.  A newly published paper indicates that this Executive Order can be associated with an increase in preterm births for pregnant people from the seven targeted countries who were living in the United States at the time.

Investigators hypothesized that the Muslim ban was associated with greater than expected levels of preterm birth among gestations exposed in utero to the initial Muslim ban, which was signed by the president on January 27, 2017. The researchers from Columbia University Mailman School of Public Health found that xenophobic (a dislike of or prejudice against people from other countries) and racist policies impacted the health of pregnant parents and their newborns. Their findings published in November 2020, in Social Science & Medicine, found that the racism and xenophobia that was expressed as a direct result of the Executive Order travel ban is a determinant for the adverse health outcome of premature birth.  Preterm birth is a sensitive marker of temporally acute stressors including sociopolitical threats. (Alhusen, et al, 2016)

How was the research conducted

The researchers evaluated national birth data from the U.S. National Center for Health Statistics (which identifies birth country) for pregnant people who had come to the United States from the seven countries impacted by the 2017 travel ban: Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen.  A baseline rate of premature births was determined from historical data, from the years 2009 through to prior to the ban in January 2017 for both people from the banned countries as well as the prematurity rate of native born white pregnant people in the USA.  This was compared with the prematurity rate documented in those same groups after the 2017 travel ban was implemented.

What did the researchers find

Prior to the ban, the prematurity rate for parents from the travel ban counties was 8.5% and for native born White people the prematurity rate was 8.6%.  After the ban was implemented, the researchers found that the rate of premature birth for the pregnant people from the banned countries increased by 6.8% while the rate of premature births for the white population did not change.

Discussion and conclusion

According to the researchers, “The results indicate that even for populations that historically experience positive birth outcomes, anti-immigrant and Islamophobic policies are associated with abrupt and detrimental shifts in health outcomes.”  Prenatal exposure to environmental stressors impact birth outcomes.  Additionally, pregnant people from the targeted countries may fail to seek out or continue receiving prenatal care out of concern and fear.  This may also contribute to the increase in premature births as problems that contribute to this rate go unidentified and untreated.

Premature birth comes at a great expense to both the individual and society.  Children who are born prematurely face life-long impact from their premature birth.  The March of Dimes states that “babies born prematurely may have more health problems at birth and later in life than babies born later.  Premature babies can have long-term intellectual and developmental disabilities and problems with their lungs, brain, eyes and other organs.”

Governmental policies such as the 2017 Executive Order implementing a travel ban for people from seven predominantly Muslim countries was racist and xenophobic.  This racism and xenophobia increased stress on pregnant Muslim people and resulted in an increased rate of premature births in the impacted people.

References

Alhusen, J. L., Bower, K. M., Epstein, E., & Sharps, P. (2016). Racial discrimination and adverse birth outcomes: an integrative review. Journal of midwifery & women's health, 61(6), 707-720.

Samari, G., Catalano, R., Alcalá, H. E., & Gemmill, A. (2020). The Muslim Ban and preterm birth: Analysis of US vital statistics data from 2009 to 2018. Social Science & Medicine, 113544.