New research shows that in the U.S., disparities in maternal mortality—or deaths related to childbirth or pregnancy—between Black and white women may be higher than previously reported. However, closing this gap requires addressing structural racism. According to researchers, it is necessary to examine the aspects of political, economic, social, and healthcare systems that contribute to reinforcing inequality.
Pregnancy poses a greater risk to women’s health than abortion. State measures restricting abortion may lead to an increase in deaths, particularly among Black and Brown women.
Black and brown women are about five times more likely to die from pregnancy-related cardiomyopathy (a chronic disease of the heart muscles) than white women.
Researchers thoroughly reviewed the death certificates from 2016 and 2017. What did they find?
Researchers found that the maternal mortality rate among non-Hispanic Black women was 3.5 times higher than that of non-Hispanic white women. This represents a significant increase from the previous analysis, which was based on standard medical codes and found that Black and Brown women faced a maternal mortality rate 2.5 times higher than that of white women.
This new analysis revealed that the disparities were concentrated in just a few causes of death. Postpartum cardiomyopathy and blood pressure disorders, including preeclampsia and eclampsia, were found to be the leading causes of maternal deaths among Black women. Pregnant and postpartum Black women were more than twice as likely to die from hemorrhages or embolisms.
A closer look at the analysis revealed that embolism, preeclampsia, and eclampsia were all tied as the leading causes of maternal deaths across all ethnic and racial groups during pregnancy or within six weeks after childbirth. These conditions were followed by hemorrhage, cardiomyopathy, and complications from obstetric surgeries, such as cesarean sections, as other causes of death.
This study found that late maternal deaths occurring between six weeks and one year after childbirth were about 3.5 times more likely among Black and Brown women than among white women. Postpartum cardiomyopathy was found to be the leading cause of late maternal death across all racial groups, with Black and Brown women facing a risk six times higher than that of white women.
The fact that cardiovascular conditions such as preeclampsia are among the leading causes of maternal death, especially for Black and Brown women, underscores the critical importance of heightened vigilance in improving the early diagnosis and treatment of these complications.
The higher rates of maternal mortality among Black and Brown women from various causes reflect the impact of structural racism on healthcare and health in the United States.
More in-depth research into the experiences faced by people of color can inform efforts to improve the healthcare system and women’s childbirth experiences. Ultimately, what is needed are new models of care throughout the entire pregnancy process, at every stage, to address the inequities faced.
Achieving Equity in Women’s Health Requires Fundamental Changes in Approach
Addressing these clear racial disparities requires a fundamental shift in the current approach to health care. Research and action must be grounded in the understanding that racism lies at the very root of health inequities.
Before anything changes, we need to ask specific questions:
How do policies, systems, and social structures combine to create these conditions that lead to poor health?
What is it about people of color that causes them to die younger, at higher rates, and suffer from more illnesses?
As sad as it may sound, in-hospital death rates among Black newborns were one-third lower when the newborns were cared for by Black or Brown physicians instead of white physicians.
We need a model maternal care program designed to reduce birth complications and maternal deaths. A model that treats a mother’s racial identity, culture, and background as assets during pregnancy rather than as pathologies or problems. We need a care plan that includes regularly available classes on nutrition, gestational diabetes, and other topics that pregnant women should be aware of. Black and Brown women need more frequent and comprehensive prenatal and postnatal visits than is typically provided.
Pregnancy and childbirth are claiming the lives of Black and Brown women far too often. More often than not, the problem isn’t the growing baby or the mother. The problem lies in the lack of adequate healthcare and information.
