Written by Leah Hairston, MSSW
Senior Health Equity Consultant
Black Infant and Maternal Health Task Force
Too often, low birth weight (LBW) among Black infants is treated like a sad mystery or an unfortunate outcome of personal behavior. But let’s be clear: LBW is not a biological fate. It’s a political outcome, driven by systems that have failed Black families for generations.
LBW refers to babies born weighing less than 5.5 pounds. It’s one of the most widely used indicators of infant and community health because “it is a clearly measurable outcome that captures racial disparities, and its root causes are intertwined with intersecting systems of oppression” (Hairston et al., 2025). Babies born with LBW face a higher risk of medical complications throughout their lifespan —both short- and long-term (Brown et al., 2020), including developmental delays, chronic illnesses, and even infant mortality.
Research consistently shows that Black babies are more than twice as likely to be born with low birth weight compared to other racialized groups—even when their mothers have college degrees, stable incomes, and access to prenatal care Hairston, 2025; David & Collins, 1991. This disparity is not about individual choices; it’s about systemic exposure to stress and harm.
This is where the concept of weathering comes in. Coined by public health scholar Dr. Arline Geronimus, weathering describes how chronic exposure to social, economic, and political stress—especially racism—literally wears down the body over time (Hairston, 2025; Geronimus,1992). The stress hormones that surge every time a Black woman is overlooked, disrespected, or denied proper care have real, measurable effects on pregnancy outcomes.
We must stop treating LBW and other birth inequities as unfortunate but unchangeable – especially when 84% of pregnancy-related deaths are preventable (Hairston, 2025; Smith- Ramakrishnan, 2025) So are many cases of LBW. The science is clear. The lived experience is undeniable. What we lack is political will.
It’s time to shift from blaming individuals to demanding accountability from systems. That means fighting for policy changes that ensure:
- safe, stable, and affordable housing
- equitable access to respectful, high-quality healthcare
- protection from environmental toxins
- an end to discriminatory policing and community violence.
Low birth weight is not inevitable. It is the predictable result of choices our society makes every day. Let’s choose differently. Let’s choose justice.
Call to Action
Join NBCDI in demanding upstream, structural reforms that address root causes, protect Black babies, and support Black families. Advocate for policies that honor our dignity and affirm our right to thrive — because every baby deserves to be born healthy, not despite the system, but because of it.
Despite the harmful passage of the so-called “Big Ugly Bill,” which plans to roll back vital programs like Medicaid and SNAP, NBCDI’s commitment to Black families is unwavering. We continue to stand with and act alongside our National Village Network by co-creating policy, advancing advocacy, and building movements around birth equity.
Here’s how you can help:
- Contact your local and state elected officials to oppose cuts to healthcare, nutrition, and maternal health funding.
- Champion proactive policies that support Black maternal and infant health.
- Support Black-led birth justice organizations through donations, partnerships, and volunteering.
- Share your story and raise awareness about how policy choices impact Black birthing experiences.
Every action counts. Every voice matters. Together, we can build a future where Black babies are born into a world that cherishes and protects them from the very start.
