BLACK MATERNAL HEALTH

Black Maternal Health Week April 11 - April 17, 2019

FACTS:

• Approximately 830 women die every day from preventable causes related to pregnancy and childbirth.
• 99% of maternal deaths occur in developing countries.
• The maternal death rate is higher in women living in rural areas.
• Between 1990 and 2015, maternal death decreased worldwide by 44%.
• Women in developing countries have, on average, more pregnancies than women in developed countries and a higher risk of maternal death in their lifetime.
• USA is one of only 13 countries in the world where rate of maternal mortality is now worse than it was 25 years ago.
• In one study done by Propublica: Black women who hemorrhaged, or had a lot of blood loss, during childbirth had higher rates of complications compared to white woman who hemorrhaged, regardless of what hospital they visited.

WHAT IS MATERNAL DEATH?

Death of a woman while pregnant or within 42 days after giving birth, from any cause related to pregnancy or worsened by the pregnancy. Maternal death does not include accidental or incidental causes.

MOST COMMON CAUSES OF MATERNAL DEATH:

• Severe bleeding
• Infections
• High blood pressure
• Delivery complications
• Unsafe abortions
• Diseases such as AIDS or malaria

MATERNAL DEATH IS EVERYONE’S ISSUE. HERE’S WHY:

In a study done at Harvard University, over 60% of pregnancy related deaths were preventable.
Patient/family and provider factors were the largest contributors to maternal death

Two main reason for the above medical issues result in maternal death:

1. Lack of knowledge about warning signs and when to seek care by patients

2. Wrong diagnosis, ineffective treatment and poorly coordinated care by medical providers.

Both direct and underlying causes were found to lead to maternal death and were found to be varied by race.

TIMELINE:

• In 1850, black infant-mortality rate was 340 per 1,000 births. White infant mortality rate was 217 per 1,000 births.
• From 1915-1990s, infant mortality rate dropped by >90%. This decrease was due to improvements in hygiene, nutrition, living conditions, and healthcare.
• As of 2018, black infants in America are more than twice as likely to die as white infants (11.3 per 1,000 black infants vs. 4.9 per 1,000 white infants) which is a wider disparity than in 1850.
• This infant mortality rate includes deaths and near deaths in black mothers themselves.

RACIAL COMPONENT:

• High blood pressure and cardiovascular disease are the two leading causes of maternal death according to the CDC.
• Preeclampsia and eclampsia, both high blood pressure disorders during pregnancy, were leading causes of death among non-Hispanic black women.
• Department of Health and Human Services found in 2017 that pre-eclampsia and eclampsia were 60% more common in African-American women compared to other races, and also more severe in African American women.
• Non-Hispanic black women in US die from pregnancy related causes at a rate 3-4 times that of Non-Hispanic white women, according to the CDC.

WHAT’S BEING DONE?

• In June 2018, U.S. Committee proposed $50 million funding towards preventing mothers dying in childbirth.
  • More than ¾ funding would go to federal Maternal and Child Health Bureau to expand life-saving, evidence-based programs at hospitals and increase access to Healthy Start program for new moms and babies.
  • The remaining $12 million would go to CDC for data collection and research as well as support state boards that count and review maternal deaths.
• Another bill, the Maternal Health Accountability Act, was passed as well.
• Monica Simpson, executive director of SisterSong (the country’s largest organization dedicated to reproductive justice for women of color) testified in 2014 before the United Nations Committee on Elimination of Racial Discrimination in maternal health.
  
  • After her testimony, the committee called on the USA to “eliminate racial disparities in the field of sexual and reproductive health and standardize the data-collection system on maternal and infant deaths in all states to effectively identify and address the causes of disparities in maternal and infant-mortality rates.”

There is still so much that can be done in the aspect of black maternal health and black infant health. Improving policies and funding towards these issues could provide crucial data needed to progress treatment and close the disparity seen between black and white maternal health.