The World Health Organization defines a maternal death as the death of a woman during pregnancy or within the first 6 weeks of the end of pregnancy “from any cause related to or aggravated by the pregnancy or its management,” including a condition that developed before or during pregnancy and was worsened by the physiologic effects of pregnancy. According to Joan Stephenson, PhD, maternal deaths have been increasing in the US since 2000, according to a 2020 report from The Commonwealth Fund. That report also noted that the US maternal mortality rate is double or more the rates of 10 other high-income countries.
According to Michael C. Lu, MD, MS, MPH, “Every year in the United States, more than 700 women die of complications related to pregnancy and childbirth and more than 50 000 women experience a life-threatening complication (severe maternal morbidity).” In the same article Dr. Lu states, “Large racial/ethnic, socioeconomic, and geographic disparities persist. For example, African American women are nearly 3 times as likely to die of complications related to pregnancy and childbirth compared with white women (56.3 vs 20.3 maternal deaths per 100 000 live births in 2013-2014), a gap that has not narrowed in decades”. These sobering findings emphasize the urgency to address health inequity with regard to racial and ethnic disparities in maternal mortality. According to the CDC, “Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias”. The CDC also states that two in three cases of maternal deaths are preventable which makes it all the more tragic. According to Samantha Artiga of the Kaiser Family Foundation, the leading cause of pregnancy-related deaths overall is caused by cardiovascular conditions, although there are other causes linked to specific races and ethnicities. According to Geraldine I Oribhabor, an OBGYN, at the California Institute of Behavioral Neurosciences & Psychology, African Americans are at a poverty rate of 20.8%, which is more than double that of Non-Hispanic whites at 8.1%. This economic disparity, combined with other racial constraints and hardships, limits the quality of prenatal care received by Black mothers which puts them at significant health risks. Dr. Oribhabor also states that women belonging to racial and ethnic minorities deliver in inferior quality hospitals than white women, and if the same care was given to black women, maternal mortality for women of color would decrease from 4.2% to 2.9%.
Several measures need to be taken to fix health inequity relating to maternal mortality, including improvement of quality of care during maternity, pre and post maternity, sufficient funding to educate healthcare providers and physicians on eliminating implicit biases, improved healthcare facilities in minority communities, and educating healthcare providers on certain conditions specific to ethnic groups, making care more patient-centered. These measures can be ensured through collaboration between patients, families, communities, healthcare providers, and hospitals and healthcare systems.
References:
Joan Stephenson “US Maternal Mortality Rate Rose Sharply During COVID-19 Pandemic’s First Year” JAMA Health Forum 16 June 2022 online.
Michael C. Lu “Reducing Maternal Mortality in the United States” JAMA Health Forum 16 June 2022 online.
CDC “Working Together to Reduce Black Maternal Mortality” JAMA Health Forum 16 June 2022 online.
Samantha Artiga “Racial Disparities in Maternal and Infant Health: An Overview” KFF 16 June 2022 online.
Geraldine I Oribhabor, Maxine L Nelson, Keri-Ann R Buchanan-Peart, and Ivan Cancarevic “A Mother’s Cry: A Race to Eliminate the Influence of Racial Disparities on Maternal Morbidity and Mortality Rates Among Black Women in America” NIH 16 June 2022 online.
