Maternal Health in the United States

Maternal Health in the United States

Each year in the United States, several hundred people die during pregnancy or within one year following giving birth. Thousands of others experience unexpected complications during labor or delivery which can lead to serious short-term or long-term health conditions for both them and their newborn children. Greater than 80% of these deaths have been determined to be preventable. According to a recent report by the Commonwealth Fund, the United States has the highest infant and maternal mortality rates compared to similar high-income countries. At the same time, the U.S. has the highest spending on health care among those same countries. If the majority of these deaths were proven to have been preventable and the United States are spending more than other countries on their health care, what is causing morbidity rates to become so high?

Maternal Health in Communities of Color

These severe complications in maternal health disproportionately affect communities of color. Pregnancy related deaths among Black women are over three times higher compared to the rate for white women. Similarly, American Indian and Alaska Native women face pregnancy-related mortality rates more than twice as high compared to white women. These women also face increased rates of preterm birth, low birth-weight births, and a lack of prenatal care when compared to white women.

All these factors increase the risk of mortality both for the child and the mother. This increased risk faced by women of color remains present even when controlling for level of education. In fact, according to the American Society of Anesthesiologists, ‚”Black women have a 53% increased risk of dying in the hospital during childbirth, no matter their income level, type of insurance or other social determinants of health.,” Controlling for these factors demonstrates that it is not their race which is impacting their maternal health, it is a structure of racism built within our healthcare system.

To understand why these rates are so different between women of color and white women, we must first understand the racism and bias which informs our healthcare system. The disparity between these rates are symptoms of broader systemic inequities that are rooted in racism. One of these systemic inequities includes limited access to insurance coverage. People of color are more likely to be uninsured prior to their pregnancy. In addition, people of color have limited access to providers and hospitals. Many people of color also are unable to receive care in a way that is responsive to their culture or their primary language.

A study found when Black mothers were treated by physicians who were also Black, outcomes for the newborn improved. This demonstrates the importance of people of color having access to care from people who are similar to them. These barriers are only more pronounced in rural areas, which have been facing a rise in closures of hospitals, further limiting access to care.

People of color face not only limited access to care, but also considerably lower quality of care when it is received. One study found that people of color were significantly more likely to report mistreatment by hospital staff who were supposed to be providing them with care. This included being yelled out, or even being ignored when requesting assistance. Many also reported that they were frequently not believed to be telling the truth when describing their experiences or levels of pain and were refused treatments, tests, or medication for pain. Furthermore, in the United States post the Dobbs Decision it has become even more challenging for people of color to receive access to quality maternity care. The Commonwealth Fund found that access to maternity care providers in states with abortion bans is worsening. With policy decisions such as this being made, access to quality care is becoming even more challenging.

There are some efforts being made in recent years to raise awareness in this disparity of care and come to a solution. However, before maternal health can improve in the United States there is a great deal of work to be done. While this is a systemic issue that will take tremendous efforts to resolve, it will take all of us working together to enact a positive change.

If you have…

5 Minutes	and	15 Minutes	and	20 minutes
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Check out this article from the CDC on possible solutions	and	Watch this TEDx talkfrom Dr. Ndidiamaka Amutah-Onukagha	and	Check out this in-depth article  on potential policy changes to support maternal health

Sources

• Systemic racism plays role in much higher maternal mortality rate among Black women – American Society of Anesthesiologists
• Racial Disparities in Maternal Health – BlueCross BlueShield
• Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017‚Äì2019 – CDC
• Working Together to Reduce Black Maternal Mortality – CDC
• Access To Obstetric Services In Rural Counties Still Declining, With 9 Percent Losing Services, 2004‚Äì14 – Health Affairs
• Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them – KFF
• Physician‚Äìpatient racial concordance and disparities in birthing mortality for newborns – PNAS
• The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States¬†- Reproductive Health Journal

Equity for All 2024 – April 25th

To learn more about maternal health in communities of color, join us on April 25th for Equity for All!

This an annual, progress-minded event that includes courageous conversations to provide us with an opportunity to broaden perspectives, learn new tools, and connect with a diverse community of citizens passionate about eliminating racism in our community. You can attend this event virtually, in person, or watch the recording after the event.

REGISTER TODAY!