The Buzz This Week
Black Maternal Health Week is a critical initiative observed annually April 11 to 17. Black women in the US face a disturbing reality with pregnancy: They are three times more likely to die from pregnancy-related complications than their white counterparts, despite the preventable nature of most of these deaths. The maternal mortality rate for Black women remains consistent across various socioeconomic statuses and educational levels. A study from 2007 to 2016 revealed Black women with a college degree or higher are five times more likely to suffer pregnancy-related mortality compared to their white counterparts.
Black women are more likely to develop preeclampsia, experience cardiovascular issues during and after pregnancy, suffer postpartum hemorrhage, and encounter discrimination and disrespect within healthcare settings. Factors such as inadequate healthcare access, underlying chronic conditions, structural racism, and implicit bias contribute to perpetuating these disparities, which impact maternal mortality rates. The American Medical Association (AMA) has identified other contributing factors, including inadequate insurance coverage during the perinatal period, a lack of adequately trained interprofessional teams, and the closure of maternity units in both rural and urban areas.
In response to these challenges, Black Maternal Health Week was founded in 2018. The theme for 2024 is “Our bodies STILL belong to us: Reproductive justice NOW!,” which highlights the urgency for reproductive justice and rights. The landscape of reproductive rights has become increasingly complex following the decision of the Supreme Court of the United States to overturn Roe v. Wade on June 24, 2022. This decision, followed by abortion bans or restrictions in 21 states, has ignited fear and activism, particularly among marginalized communities. Data from the Pew Research Center shows that Black women constituted the largest demographic seeking abortion services in 2020 (39%).
A survey by the Kaiser Family Foundation (KFF) indicates that the Dobbs decision has exacerbated racial and ethnic inequities in maternal health. The report found that the majority of obstetrician-gynecologists surveyed believe the decision has also worsened pregnancy-related mortality (64%) and exacerbated racial and ethnic inequities in maternal health (70%). A concerning correlation emerges as many states with the most restrictive abortion bans also exhibit higher maternal and infant mortality rates. These states often lack supportive social welfare and family support programs, compounding the challenges Black women and birthing individuals face.
Why It Matters
The stark reality of being a Black birthing person in the US demands attention and concerted action. Ndidiamaka Amutah-Onukagha, Associate Professor in the Department of Public Health and Community Medicine at Tufts University School of Medicine said, “What we’re seeing in Black obstetric health is unnecessary and preventable deaths. It’s a failure of the obstetric system when it comes to prioritizing Black birthing people and making sure that their needs, their wishes, and their intentions are centered.”
Health systems, community partners, and policymakers play a critical role in improving Black maternal health outcomes. Accountability within health systems is vital to ensure equitable and culturally competent care for every mother.
Hospitals are adopting initiatives like midwifery support, remote monitoring of patient vitals, and educational resources to address the disproportionate risk of life-threatening conditions among Black obstetric patients. In addition, effective partnerships with community organizations (like launching a community-based program to train culturally congruent doulas) help expand the reach of maternal health initiatives. These initiatives can move beyond clinical settings, addressing social drivers of health and fostering community engagement.
Improving the Black maternal health experience requires a multifaceted approach that includes targeted interventions, collaborative partnerships, and policy reforms. These efforts are essential to ensure that every mother and baby has a fair and just opportunity to be healthy.
RELATED LINKS
Mayo Clinic Press:
Why are Black maternal mortality rates so high?
Modern Healthcare:
3 strategies that are improving Black obstetric outcomes
The Hill:
5 things to know about the maternal health crisis
USA Today:
Being Black and pregnant in the Deep South can be a dangerous combination
Editorial advisor: Roger Ray, MD, Chief Physician Executive.
