Jessica Dotson is described by her coworkers as “the girl who’s always smiling.” But underneath the glow of her grin, Jessica grapples with a severe case of depression, stemming from the loss of her infant child only days after he was born.

“They [the medical staff] told me he died from a respiratory infection,” Jessica explained while choking back tears. “He was also extremely underweight. I could practically hold him in my hand. It was like holding an apple.”   

Shortly after graduating from high school, Jessica discovered that she was pregnant and contacted her boyfriend to give him the news. “But he questioned whether the baby was even his,” Jessica explained coldly. “I was only a few weeks pregnant, and I didn’t want to rely on the government to help me take care of my baby, so I got a job as quickly as I could. I was prepared to raise a child alone.”

Jessica’s entering her third year of employment at one of many Target locations throughout the Los Angeles area, and her warm and inviting demeanor casts a bright light everywhere she goes. “It’s a mask I wear,” she says. “I smile so that I won’t cry. I guess it’s a defense mechanism. I’m afraid that people won’t wanna be around me if I’m sobbing all the time. But when I’m at home, the mask comes off, and I break down.”

“The death of my child consumes me,” she added.

In 1850, when the death of a baby was commonplace, infants succumbed so often that parents avoided naming their children before their first birthdays, the United States began keeping records of infant mortality by race. That year, the reported black infant-mortality rate was 340 per 1,000; the white rate was 217 per 1,000. This Black-White divide in infant mortality has been a source of both concern and debate for over a century. In his 1899 book, “The Philadelphia Negro,” the first sociological case study of black Americans, W.E.B. Du Bois pointed to the tragedy of black infant death and persistent racial disparities. He also shared his own “sorrow song,” the death of his baby son, Burghardt, in his 1903 masterwork, “The Souls of Black Folk.”   

From 1915 through the 1990s, amid vast improvements in hygiene, nutrition, living conditions and health care, the number of babies of all races who died in the first year of life dropped by over 90 percent — a decrease unparalleled by reductions in other causes of death. But that national decline in infant mortality has since slowed.

In 1960, the United States was ranked 12th among developed countries in infant mortality. Since then, with its rate largely driven by the deaths of black babies, the United States has fallen behind and now ranks 32nd out of the 35 wealthiest nations. Low birth weight is a key factor in infant death, and a new report released in March by the Robert Wood Johnson Foundation and the University of Wisconsin suggests that the number of low-birth-weight babies born in the United States — also driven by the data for black babies — has inched up for the first time in a decade.

Black infants in America are now more than twice as likely to die as white infants — 11.3 per 1,000 Black babies, compared with 4.9 per 1,000 white babies, according to the most recent government data — a racial disparity that is actually wider than in 1850, 15 years before the end of slavery, when most black women were considered chattel. In one year, that racial gap adds up to more than 4,000 lost black babies. Education and income offer little protection. In fact, a black woman with an advanced degree is more likely to lose her baby than a White woman with less than an eighth-grade education.

The healthcare disparities in the Black community are vast. The lack of quality healthcare access combined with hereditary factors are the reasons why many believe Black women are suffering so greatly from this problem. Venus Standard, a certified nurse midwife (CNM) and  lamaze certified childbirth educator, says the answer to problem has many layers.

“The health care challenges of an African American woman are multifaceted. The sequelae of complication can increase drastically when pregnancy is added into the equation. While some challenges are a result of their inability to access quality health care, others are a direct result of lifestyle choices, i.e., obesity, hypertension and diabetes or toxic substances abuse such as smoking, alcohol or drugs,” Standard explained to “There’s not a whole lot you can do about your hereditary challenges, and while socioeconomic restraints can limit your ability to change your physical environment, we all have the ability to make conscious lifestyle choices.”

Conscious lifestyle choices during pregnancy are what experts like Standard believe are key for a healthy baby, including proper dieting, regular exercise, blood pressure and blood sugar management, and the avoidance of toxic substances.