4 minute read
Breaking the cycle: Addressing health inequities in black maternal mortality
Research from the Centers for Disease Control and Prevention (CDC) shows that Black women in the United States have the highest mortality rate from birth-related complications, largely due to social determinants of health (SDOH) and health inequities.
The Office of Disease Prevention and Health Promotion defines SDOH as conditions in environments that affect groups of people across a wide range of health, functioning and qualityof-life outcomes. These groups often face challenges in achieving financial stability, accessing quality education and healthcare, securing safe housing and receiving adequate social support.
The World Health Organization defines health inequities as systematic differences in the health status of different population groups, exacerbated by factors like climate change, structural racism, substance abuse, pandemics and pre-existing health conditions.
SDOH and health inequities contribute to the high rate of high-risk pregnancies among Black women. According to a National Health Institute (NHI) study on Black maternal mortality, maternal mortality rates increased by 33 percent during the COVID-19 pandemic, with late maternal deaths increasing by 41 percent. Black and Hispanic women experienced disproportionately high maternal mortality rates during this time, with significant increases in causes of death related to viral diseases (2,374.7 percent), respiratory diseases (117.7 percent) and circulatory diseases (72.1 percent).
In 2021, the maternal mortality rate for non-Hispanic Black women was 69.9 deaths per 100,000 live births—2.6 times higher than the rate for nonHispanic white women—according to a study by Donna L. Hoyert, Ph.D., from the National Vital Statistics System. Despite achieving higher education, better jobs and improved housing compared to previous generations, Black women often face mental and physical health challenges that can complicate life goals, such as having children.
Monique Rainford, M.D., a Yale medicine obstetrician-gynecologist, notes that one example of a high-risk pregnancy factor for Black women is "allostatic load," which refers to the cumulative physiological effects of chronic stress. “Studies have shown that Black women’s biological age can be up to 10 years older than their white counterparts, likely due to allostatic load," Rainford explains. "This 10-year difference significantly increases the risk of maternal death, as the risk of maternal mortality rises with age."
Many pregnant Black women are giving birth later in life, during what are considered "geriatric" stages (age 35 and up), and are more likely to have pre-existing medical conditions. According to the CDC, they are also more prone to complications such as gestational diabetes, hypertension, preeclampsia, eclampsia, preterm labor, postpartum bleeding and having multiple births (twins or triplets).
Other contributing factors to the higher mortality rate among Black women include unnecessary C-sections, a lack of Black medical professionals, being uninsured or underinsured and inconsistent access to transportation.
Raising awareness of these health disparities is key to improving resources and outcomes for Black women and their babies. One important step for Black women who are pregnant or planning to become pregnant is to discuss potential high-risk complications with their doctors. While Black women face higher risks, there are still many successful births. An article published by Beaufort Memorial suggests asking relatives about pregnancy complications, as some may run in families and indicate potential risk factors.
It's also important for Black women to advocate for themselves during pregnancy. Because they are more likely to experience complications, it’s crucial to ask questions, listen carefully to medical advice and find a doctor who provides comfort and security. If necessary, switch to a different provider. After giving birth, continue with scheduled care for both mother and child.
Healthcare professionals and community organizations are working to break down barriers through research, education and advocacy. These efforts aim to reduce harmful SDOH and eliminate health inequities, fostering a culture of respect and humility in healthcare to create a more equitable system.
Megan Freeman earned a Doctorate of Strategic Leadership with a concentration in leadership coaching from Regent University. She is the founder, owner and CEO of Leadernificent LLC, an organizational development company.
