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EQUITY IN MOTHERHOOD: CONFRONTING DISPARITIES IN BLACK MATERNAL WELLNESS

As advocates for motherhood, we recognize the significance of addressing gaps in maternal wellness to ensure that every mom receives the care and support she deserves. It is crucial that we acknowledge the shocking statistics surrounding pregnancy-related complications and deaths in our country.

Pregnant women in the United States are more than twice as likely to die from complications related to pregnancy or childbirth than those in most other high-income countries in the world. Thousands more have unexpected outcomes and situations resulting in serious health consequences for the woman and the child. Every pregnancy-related death is tragic, especially because more than 80% of pregnancy-related deaths in the U.S. are preventable. Recognizing urgent maternal warning signs, advocating for timely treatment, and supporting pregnant mothers can help prevent many pregnancy-related deaths.

As we celebrate Black History Month, it is paramount that we shine a spotlight on the critical issue of maternal wellness discrepancies affecting black women. While we commemorate the achievements and resilience of the Black community, it is equally essential to address the stark realities that persist within maternal healthcare. Black women face alarming disparities in maternal health outcomes, with higher rates of severe maternal morbidity and mortality. Understanding and acknowledging these discrepancies is not only a matter of health equity but also an act of empowerment.

This Black History Month, let us embark on a journey of awareness, advocacy, and support, ensuring that every woman, regardless of race, receives the care and attention she deserves during the transformative journey of motherhood.

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RACIAL DISPARITIES

According to findings released in April 2023, Black women are 3 times more likely to die from a pregnancy-related cause than White women. That results in 69.9 deaths per 100,000 live births for Black women.

It's essential to investigate the root causes to address these discrepancies effectively. Variations in healthcare quality, underlying chronic conditions such as bleeding disorders, diabetes, and heart disease, along with structural racism and implicit bias, collectively contribute to the higher maternal mortality rates among Black women. Awareness of these factors is a crucial step toward dismantling the systemic barriers that disproportionately affect maternal outcomes for Black women.

While severe maternal morbidity (SMM) rates have been increasing among all women, the statistics are disproportioned for women of color. SMM measures unexpected outcomes from labor and delivery with significant short- or long-term consequences to a woman’s health. The Centers for Disease Control and Prevention categorizes SMM by 21 “indicators.”

Black communities have a 63% higher rate of SMM than white women. Some examples of conditions classified under severe maternal morbidity include:

  • Hemorrhage: Excessive bleeding during pregnancy, childbirth, or the postpartum period can lead to severe maternal morbidity.

  • Hypertensive disorders: Conditions such as preeclampsia and eclampsia, characterized by high blood pressure during pregnancy, can pose significant risks to maternal health.

  • Severe infection: Infections that become severe and require extensive medical intervention can contribute to SMM.

  • Cardiomyopathy: A condition where the heart becomes weakened, impacting its ability to pump blood effectively, can occur during or after pregnancy.

  • Amniotic fluid embolism: A rare but severe condition where amniotic fluid or other debris enters the maternal bloodstream, leading to serious complications.

  • Organ failure: Severe complications that result in the failure of one or more organ systems, such as liver, kidney, or respiratory failure.

Monitoring and addressing severe maternal morbidity are crucial aspects of maternal healthcare - especially for Black and Brown women. Postpartum Peace of Mind, a 501(c)(3) non-profit organization that centers the experiences, health, education and safety of postpartum Black, Brown, and Indigenous women, shared with us, “Research is showing that Black and Brown women are dying of perinatal complications at a higher rate versus their counterparts. Women need to know what hypertensive disorders and perinatal complications look like postpartum.”

MATERNAL WARNING SIGNS

"Maternal warning signs" refer to specific indicators or symptoms that may suggest potential complications during pregnancy or childbirth and are directly linked to preventing maternal mortality. By addressing these signs early on, we can contribute to reducing the alarming rates of maternal mortality experienced by Black women.

Awareness of maternal warning signs empowers Black communities to engage actively in education and advocacy. Equipping individuals with knowledge allows them to play a role in demanding better healthcare, addressing disparities, and fostering a supportive environment for pregnant Black women.

Examples of maternal warning signs may include, but are not limited to:

  • Severe abdominal pain: Persistent or intense abdominal pain can be a sign of various complications such as placental abruption or preterm labor.

  • Vaginal bleeding: Any unexpected bleeding during pregnancy may indicate a potential issue that requires medical attention.

  • Severe headaches or visual disturbances: These symptoms could be signs of conditions like preeclampsia, a severe complication of pregnancy.

  • Severe nausea or vomiting: While morning sickness is common, persistent and severe nausea or vomiting may signal hyperemesis gravidarum, which requires medical attention.

  • Reduced fetal movement: A decrease in fetal movement may suggest potential problems, and it's essential to seek medical advice if a pregnant woman notices a significant change in fetal activity.

  • High fever: Fever during pregnancy can be a sign of infection, and prompt intervention is necessary to protect the mother and the baby.

  • Swelling of the hands, face, or legs: Excessive swelling, especially when accompanied by other symptoms, could indicate conditions like preeclampsia.

Recognizing warning signs can empower women to advocate for themselves, ensuring they receive medical attention – despite potential systemic barriers.

LACK OF CARE

According to Every Mother Counts, more than a third of all counties in the United States do not have an obstetric care provider. "Shortages of obstetricians, midwives, hospitals, and birth centers mean that some people, especially in rural areas, have to travel an hour or more to get basic prenatal and delivery care. For women with complications who need to see a specialist, the trip can be prohibitive, leading some women to go without the level of care they need for the best chance at a healthy birth," shares Every Mother Counts.

Most people assume a woman will see the same physician throughout pregnancy. However, many pregnant women, especially those enrolled in Medicaid, see different care providers at each prenatal visit or meet the physician or midwife attending their birth for the first time when they arrive at the hospital in labor. This means that warning signs, symptoms, and progressive health concerns often fall through the cracks, and women are not receiving the necessary care at the correct time.

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NEXT STEPS

These statistics highlight the urgent need to address maternal health, especially for Black women. Recognizing and tackling maternal warning signs is of utmost importance, as prompt intervention is crucial in preventing the rapid escalation of pregnancy-related complications. Educational and awareness initiatives can empower Black pregnant women, their families, and healthcare providers, ensuring they can effectively identify and respond to these warning signs.

Moreover, the vital role of support systems cannot be overstated. Black pregnant women benefit significantly from access to comprehensive prenatal care, emotional support, and a robust network that encourages them to seek timely medical attention when needed. Closing health disparities and enhancing access to quality healthcare services is imperative for marginalized communities, particularly Black women, to diminish maternal mortality rates.

To address this pressing issue, a multifaceted approach is essential, specifically focusing on the unique challenges Black women face. Improving maternal health outcomes requires increased access to quality healthcare, targeted efforts to overcome social determinants of health, specific measures to address racial disparities, and advocacy for policy changes prioritizing the maternal well-being of Black women. By proactively addressing preventable factors, providing tailor-made comprehensive care, and fostering a supportive environment, we can make substantial strides in reducing maternal mortality rates and ensuring safe pregnancies and childbirth for Black women.

WHAT YOU SHOULD DO

Recognizing urgent maternal warning signs, advocating for timely treatment, and being a support system for pregnant mothers can help prevent many pregnancy-related deaths.

It is no longer enough just to read the statistics—research local maternal support groups in your area. Become an advocate, volunteer your time, shop businesses that give back, and donate financially to organizations determined to change the narrative.

Follow and donate to companies doing good, hard work such as: