New research shows that in the U.S., the black-to-white disparities in maternal mortality or deaths related to childbirth or pregnancy might be higher than previously reported. However, closing the gap includes addressing structural racism. It’s necessary to look into the aspects of political, economic, social, and healthcare systems responsible for reinforcing inequity, according to researchers.
Pregnancy is riskier for women’s health than abortion. State initiatives restricting abortion may lead to an increase in deaths, specifically 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 heart muscles) than white women.
Researchers thoroughly reexamined the death certificates from 2016 and 2017. Their findings?
Researchers learned that the maternal mortality rate among non-Hispanic black wames was 3 ½ times that of non-Hispanic white women. It’s an incredible increase from the previous analysis, based on standard medical codes, which found that black and brown women faced a maternal death rate of 2 ½ times of white women.
This new analysis revealed the disparities were concentrated, with only 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 for black women. Pregnant and postpartum black women were over two times more likely to die of hemorrhages or embolisms.
A further look into the analysis showed that embolism, preeclampsia, and eclampsia were all tied as the leading cause of maternal deaths across all ethnic and racial groups during pregnancy or within six weeks postpartum. The abovementioned issues were followed by hemorrhage, cardiomyopathy, and complications with obstetric surgeries, like c-sections, as other causes of death.
This study found that late maternal deaths occurring between six weeks and a year postpartum were about 3.5 times more likely among black and brown women than white women. Postpartum cardiomyopathy was found to be the leading cause of late maternal death in all races, with black and brown women experiencing a risk that’s six times higher than white women.
The fact that cardiovascular conditions such as preeclampsia are among the leading causes of maternal death, especially for black and brown women, highlights how importantly increased vigilance is to improve early diagnosis and treatment of these complications.
Elevated risks of maternal mortality for black and brown women from multiple causes reflect the impact of structural racism on healthcare and health in the US.
More in-depth research into experiences people of color face can inform efforts to improve the healthcare system and women’s birthing experience. It all boils down to needing new models of care throughout the entire pregnancy process during all stages to address the inequities faced.
Equity In Women’s Health Requires Fundamental Changes In The Approach
Addressing the evident racial differences requires fundamentally reorienting the current approach to health care. Research and action need to be grounded in the understanding that racism is at the very root of health inequities.
Before anything changes, we have to ask specific questions:
How do policies, systems, and social structures combine to create these conditions for poor health?
What is wrong with people of color that’s making them die younger, at higher rates, and suffer from more illnesses?
As sad as this sounds, black newborns’ in-hospital death rates were a third lower when the newborns were cared for by black or brown physicians instead of white physicians.
We need a model parental 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 a pregnancy instead of pathology or a problem. We need a care plan that includes regularly available parental classes on nutrition, gestational diabetes, and various topics pregnant women should know about. Black and brown women need more extended and frequent than typical prenatal and postnatal visits.
Pregnancy and childbirth are killing black and brown women too often. More often than not, the issue isn’t the growing baby or the mother. The problems are with the lack of proper healthcare and information available.
