February 22, 2002

For Mexicans, A Heavy Baby is a Healthy Baby

By Magin McKenna
Scripps Howard Foundation Wire

In the pediatric clinic of Midland Memorial Hospital, folklore stands even ground with science.

Traditions carried generations ago across the border from Mexico often end up here, as all the charms, the curanderos, the old world rituals bump up against medical opinion that says otherwise.

To ward off birth defects, soon-to-be mothers dangle keys and safety pins on chains against their hearts. They rub lotions over their bellies, creating barriers between them and anyone who wishes to do their babies harm.

And they eat for two, accepting food from family members and friends who are obligated to offer, heeding age-old warnings that if an expectant mother eats too little her baby will emerge from the womb with its mouth open, hungry and deprived.

"It's two helpings for everything," said Christina Gonzales, a resident physician. "There's a belief that a heavy baby equals a healthy baby." They call it the Mexican paradox.

For years it has mystified doctors, epidemiologists whose jobs are to find out why certain ethnic groups fall susceptible to illness, and others, those standing in the face of mammoth odds, do not.

Despite higher levels of poverty, lower levels of education and lack of access to doctors, Mexican-Americans have heavy, seemingly healthier babies than other ethnic groups living in the United States. National data released early this month in a Washington-based study that tracked birth records of every child born in the United States between 1990 and 1999 further fuels the paradox debate, sending a mix of signals to those who shape public health policy in the United States.

One researcher says the study, which has been mailed to every state legislature in the United States, misrepresents the facts, showing just a tiny blip on a giant radar screen.

"There's a tendency to oversimplify," said Edie Kieffer, a research scientist at the University of Michigan Ann Arbor's Department of Health. "They haven't done studies that follow health of babies in Mexican population that are born too large."

The study, "The Right Start for America's Newborns: A Decade of City and State Trends," sponsored by the Baltimore-based Annie E. Casey Foundation, culled birth records across the United States to find out which states and which of the 50 largest cities by population have healthier babies.

Corpus Christi was not included in the report because it is not classified as one of the 50 largest cities by population in the United States. Data released on Corpus Christi by the National Center for Health Statistics was available and is comparable to national findings. The study tracked the number of births in eight categories: teen births, repeat teen births, births to unmarried women, births to mothers who did not complete high school, late or no prenatal care, low birth weight and preterm births.

"There were substantial differences within cities that had large Hispanic populations," said William O'Hare, one of the study's six authors. "They had better outcomes in terms of birth-weight and mothers who did not smoke or use alcohol when pregnant."

The authors, O'Hare said, did not chart heavy birth weights, despite indications that babies born above 9 pounds place mothers at risk for diabetes.

For years Kieffer has studied the link between heavy birth weights, maternal obesity and diabetes risk, finding hidden dangers often underscored within Mexican-American, American Indian and Hawaiian communities.

"The biggest babies were born to mothers who weren't diagnosed, who didn't yet have gestational diabetes," Kieffer said. "The importance in a Latino community where there is so much diabetes and the complications are so devastating with pregnant women is that they need prenatal care."

Low birth weight - classified as below 5.5. pounds - in Corpus Christi was found to be 8.1 percent. The national average is 7.6 percent. Texas came in as one of the top five states with the lowest rates of prenatal care, as did Arizona and New Mexico.

El Paso, which is 78 percent Hispanic, had the lowest rate of prenatal care out of all the cities.

The average of women receiving prenatal care in Corpus Christi was also slightly below the national average. The percentage in Corpus Christi is 4.1. The national percentage is 5.2.

But the picture isn't completely clear, as communities with large Mexican-American populations as the low rate of pregnant women smoking cigarettes and drinking alcohol reduces awareness of the need for prenatal care.

The percentage of pregnant women who reported smoking was 7.6 in Corpus Christi. The national average is 12.6 percent.

"Promoting awareness of prenatal care among Mexican-American communities is always a problem," said Gonzales, the daughter of Mexican immigrants who two months ago gave birth to her second child. "There's a lot of `My mom didn't see a doctor, my grandmother didn't see a doctor' or `This is my third kid. I know what I'm doing.'"

And then, there is hunger. Mothers find a voracity for food that they never knew before. If they turn down plates heaped with food from relatives, they are seen as impolite, or, even, bad mothers.

"You're hungrier during pregnancy," Gonzales said. "Everyone is telling you it's `O.K, you can eat what you whatever you want. If you don't get what you want the baby will end up with a defect.'"

Gonzales knows she should have known better.

Still, throughout her pregnancy with her first child two years ago Gonzales wore a key on a chain around her neck.

"It's something my mother told me that my grandmother told her," she said. Gonzales knows this story probably carries little truth, but it symbolizes the precious, often precarious, nature of pregnancy. And it's a story she sees repeat itself each day in her clinic.

Mexican-American women stop working, stop lifting heavy objects - including other children - until a baby is born.

Gonzales worries that Mexican women are unknowingly placing themselves at risk for diabetes by succumbing to family pressure to overeat.

Still, as diabetes remains the fifth leading cause of death in Corpus Christi during the past three years, doctors scratch their heads and try to scale hurdles placed in their paths by centuries-old traditions.

"I tell my patients even though it's been done the old-fashioned way for generations, it's really important we seek prenatal care," Gonzales said.

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