The Starting Gate: Birth Weight and Life Chances provides its readers with thought provoking information on the intermingling of biological and sociological factors impacting birth weight. Ultimately, however, I found the book to fall a bit short on some of its research and its suggestions for lowering LBW births. A recent health article in the New York Times states “in 2008, about half of all pregnancies in the United States were unplanned.” The article explicates that women with unplanned pregnancies are far more likely, when made aware of the pregnancy, to continue behavior detrimental to the fetus such as drinking, smoking, and drug use. They were also likely to put off or neglect prenatal care altogether. As a result, babies from unintended pregnancies are seriously at risk for either premature birth or low birth weights (or presumably both.) Conley, Strully, and Bennett never mention this pretty simple but overarching concept as a factor contributing to LBW babies. Better access to [free or subsidized] birth control or family planning education would make a huge impact and potentially lower the correlated pattern between low-income families and low birth weight babies. Without access to cheap birth control, low-income couples are far more likely to get pregnant unintentionally and produce underweight children.
On the subject of subsidies, another concept came to mind. The Starting Gate emphasizes the importance of adequate nutrition for pregnant mothers to make sure the placenta can adequately nourish the growing fetus. Without healthful and abundant nutrients, a child is likely to be LBW. The United States government subsidizes the growing/harvesting of certain crops (for example: soybeans, corn, wheat, and some potatoes) to ensure that various foods are kept at low cost. With these crops available at such low prices, fast food restaurants are capable of providing reasonably priced, extremely filling/caloric foods. Low income families are much more likely to buy a cheap hamburger and fries for a filling meal than a slightly more expensive but more nutrient dense food of vegetables, grains, and legumes at the supermarket. Not to mention the convenience of fast food. The Starting Gate touches several times on the subject of nutrition, but it seems some of the problems that could help combat LBW susceptibility are deeply entrenched in U.S policy. In order to change these sort of genetic and/or social susceptibilities and lower LBW rate, it is imperative we change poor policies which perpetuate the cycle.