COMING TOGETHER TO ADDRESS MATERNAL HEALTH DISPARITIES

By Lase Ajayi, MD, FAAP

Maternal Health Is In A State Of Crisis

in the United States. Maternal mortality has been steadily increasing since 1997. Despite a brief plateau phase in 2008, it continues to increase to present day. This mortality rate is particularly pronounced in non-Hispanic blacks, and Indian/ Alaskan Natives. There are many factors driving the inequity in care. They include access and coverage gaps, social determinants of health, and structural racism. In some cases, women don’t have a way to physically get the proper care they need. For example, facilities equipped to care for them simply don’t exist where they live. Consider these factors, along with implicit biases of caregivers and a systemic lack of cultural competency. With this, we can see why the system is failing women of color far more than their white counterparts.

Many women express fear of advocating for themselves. They feel that they do not have the power to make decisions about their pregnancy. There is also mistrust between patient and doctor. It is layered in race, class, education, and lived experiences. Certainly, this creates a dynamic that can prove dangerous for Black women and their babies.

These are big problems that cannot be solved overnight, or with one singular approach. It will take open sharing of information, wide partnership, and more creative thinking. The PowerMom research team is approaching this challenge through innovation, crowdsourcing, and community outreach. PowerMom is an app-based research platform that allows pregnant people to share health data through surveys, electronic health records, and wearables. By involving pregnant people from diverse communities throughout the United States, PowerMom aims to help achieve equity in maternity care — for all pregnant people. PowerMom is committed to uncovering patterns in healthy pregnancies. We are working together with community organizations, advocacy groups, healthcare institutions, technology companies, payers and many others to discover answers to questions moms (and soon-to-be-moms) have about their bodies and their growing babies.

Some of these questions include:

— How does healthcare access in different parts of the country influence health outcomes?

What preexisting conditions lead to early birth?

— How does the support pregnant people receive influence mood disorders and postpartum depression across a diverse population?

One solution is not enough. One organization cannot fix the system alone. We know that without a commitment to partnership, we will never see change. Without reaching out and working directly with the people affected by these outcomes, we won’t make progress.

Dr. Ajayi is a San Diego pediatrician, palliative care physician, and the president of SDCMS. She is a faculty member and director of clinical research at the Scripps Research Translational Institute, where she is the lead researcher on PowerMom.

California

POLITICS AND PUBLIC POLICY