Written by Dr. Gina Charles
The numbers are staggering. Each year, the U.S. continues to drop the ball when it comes to maternal mortality. Amongst industrial nations, the U.S. ranks number 1 with maternal related deaths and complications. The stats are even more egregious when we talk about expectant black mothers.
Since 1987, the maternal mortality rate has doubled in the U.S. Now, approximately 800 maternal deaths occur every year. This is in addition to the increase in peri and postpartum related complications that black mothers experience. According to the Center for Disease Control, African American, Native American, and Alaskan Native women are three times more likely to die from pregnancy-related complications or during childbirth than their Caucasian counterparts. This is largely due to racial bias within the healthcare system, more specifically within maternal health.
It is reported that 60% of all pregnancy-related deaths can be prevented with more adequate healthcare, communication, and support, as well as access to stable housing and transportation.
Black women are three to four times more likely to die from pregnancy-related complications, which include cardiac issues and hemorrhage. What is striking is this risk is equally shared by all black women regardless of income, education, or geographical location. Several years ago, it was deemed that the disparities within black maternal health were attributed to low socioeconomic status and lack of education. That myth has been debunked by several studies showing that black women who are highly educated and financially stable are also experiencing similar complications. For example, Beyoncé Carter, Serena Williams, and Kira Johnson, the daughter-in-law of TV Personality Judge Glena, have all experienced various complications with their pregnancies. The latter succumbed to her death, making national news and calling for an end to racial disparities within maternal health. I too, a board-certified family physician, has experienced complications during pregnancy.
Causes of pregnancy-related complications and death include internal bleeding, cardiovascular disease, hypertension, and stroke. What exactly is the driving force behind these diseases? There is still much research to be done in this regard. One suggestion is the notion that there is a different level of awareness and attention to the concerns and complaints made by black women during pregnancy and the postpartum period. This is why advocating on your behalf and behalf of your love ones is paramount.
What can we do to help reduce the rates of maternal mortality and complications? Various studies have shown that interventions such as wider access to midwifery, group prenatal care, and social and doula support are effective in improving maternal health outcomes. Additionally, diversification of the healthcare workforce and better communication with the patient and her healthcare team would aid in reducing racial bias and ultimately improve patient satisfaction and maternal health outcomes.
Several groups and organizations have called for more advocacy when it comes to maternal health outcomes. They have presented research to highlight the fact that black maternal health is indeed in crisis, there needs to be more advocacy initiatives around rectifying this issue. Funding to increase the number of midwives and doulas would be a great support for mothers and to help reduce their stress levels pre and postpartum.
There have been countless reports of black expectant mothers complaining about certain signs and symptoms being ignored by their health care providers. Women in their postpartum phase should seek medical care if they develop any of these symptoms: chest pain, shortness of breath, heavy bleeding, a slow-healing C-section incision, redness and/or swelling of the leg (could indicate a blood clot), fever (can be a sign of infection), and headaches. These are all symptoms that require immediate attention and should not be ignored. Educating women about critical signs and symptoms and teaching them to speak up for themselves is most important. The goal is to keep black women alive by advocating on their behalf and by also listening to them as they advocate for themselves. Sadly, there is still a lot of work to do and legislation to be enacted in the fight for equality within the black maternal health space.
