Women in the United States face a far higher risk of dying from pregnancy and childbirth complications than in many other comparable countries. The Centers for Disease Control and Prevention (CDC) reported that Black women face higher risks of pregnancy and childbirth complications and are dying during childbirth three times the rate of their White counterparts. This growing racial disparity has attracted national attention. Serena Williams even shared the issues she faced during and after the birth of her daughter.
The CDC also found that about 3 out of 5 pregnancy and childbirth-related deaths are, in fact, preventable. Researchers list better health care, increased communication and access to transportation and housing as ways to prevent maternal deaths. Regardless of the research, health care providers are still failing Black women. Despite significant advances in modern medicine, the United States is missing opportunities to identify pregnancy-related risk factors and close gaps in care.
The federal government’s Health Resources and Services Administration (HRSA) recently linked institutionalized racism and unconscious bias as reasons why Black women and people giving birth are dying during childbirth. When they try to discuss health concerns, Black women’s voices and opinions are not being heard or believed. Interactions with medical professionals have left Black women feeling frustrated and less inclined to come in to be served. Dara Mendez, PhD, MPH, assistant professor of epidemiology at the University Of Pittsburgh Graduate School Of Public Health, focuses her research on addressing additional contributing factors to the racial inequalities in pregnancy, birth and women’s health. Her work examines how the environment, policies and systems affect pregnancy outcomes. Historically and currently, neighborhoods of color have been systematically cut off from resources.
“Residential segregation and redlining has been one of the main ways in which I’ve measured forms of institutional racism in my research in relation to health,” says Dr. Mendez. The term “redlining” was coined by sociologist James McKnight in the 1960s and derives from how lenders would literally draw a red line on a map around the neighborhoods they would not invest in based on demographics like race.
Are professionals doing more to identify and close gaps in maternal ill health and death?
The good news is that they are. A recent federal law, the Preventing Maternal Death Act, supports the creation of Maternal Mortality Review Committees. Dr. Mendez was recently appointed to Pennsylvania’s newly established committee. In a recent Health Affairs article, Dr. Mendez agrees that the work of this committee is crucial. But she stresses the importance of including and partnering with women who are most at risk.
“If we’re trying to center the experiences of the most marginalized, then they also need to be at the forefront of research,” Dr. Mendez says, “We need to be working in tandem with them.”
People are working to find answers. Collaborative efforts in Pittsburgh have emerged. Achieving health equity needs to be a systematic approach.
“There’s a local Infant mortality collaborative that has included Healthy Start and New Voices Pittsburgh, University of Pittsburgh scholars and folks within the maternal-and child-health space,” Dr. Mendez says. “We’ve been looking at things throughout the continuum, beyond just pregnancy and birth. Much of our work has focused on naming racism as the main element contributing to racial disparities in maternal health.”
We need to focus on the ways structural racism operates in the lives of birthing parents before, during and after childbirth. The American College of Obstetricians and Gynecologists has also linked racial bias within the health care system to growing Black mortality rates. Racial bias plays a significant role in the high maternal death rates for Black women. Over the last few years, the Black maternal mortality crisis has received more media coverage, attention, and support. Organizations like the Black Mamas Matter Alliance are raising awareness, organizing and engaging cross-sector, grassroots action nationwide.
Practitioners, researchers, community members and organizers need to review the data and understand why Black women are dying. From there, we must create solutions to address this public health concern. The inclusion of community voices is one way to make pregnancy and delivery experiences much safer for Black women. Dr. Mendez hopes to continue to center the voices of community members and organizers by intentionally collaborating with organizations who are doing this work.
“Our partnerships are co-led by community members and are grounded in principles of equity as it relates to power and decision-making,” says Dr. Mendez.
Carissa Ashby of Swissvale, holds the memory box for her deceased son, Dayon. Ashby’s son was stillborn when she was 30 weeks pregnant in 2005. She now speaks openly about the importance of all women being advocates for their own health when talking to healthcare professionals. (Photo by Kat Procyk/PublicSource/File)(Feature Photo)
by Courier Newsroom