Racial justice in maternal health: How to reduce Black maternal mortality

In the United States, maternal health is an important indicator of the overall health of our nation, states, cities and communities. Even though a maternal death is a rare event, this country’s maternal death rate continues to increase and is three to four times higher than other developed nations.

All women are not at equal risk of dying in childbirth. In this country, Black women are three to four times more likely to die from pregnancy-related causes than white women. Black patients are also 2.1 times more likely to experience severe maternal morbidity and 1.5 times more likely to have a preterm delivery when compared to white women.

How to Advocate for Yourself as a Pregnant Black Person

Why is Black maternal health important?

Even though Black women and babies have been the most affected by adverse health outcomes in this country, this is a public health crisis for all people living in the United States. Discrimination and ill treatment have the potential to harm everyone. Mothers and birth parents are a community and what happens to one person’s health affects the health of the entire community.

We need solutions that will helpoptimize and elevate the health of all people. We must improve trust and eliminate the power of systemic racism in healthcare. Distrust and mistrust in our healthcare system are among the biggest problems we face. We must reconnect with our community of birthing parents and develop an organized community-based infrastructure to support every individual in choosing a healthy lifestyle that will benefit all people.

As a Black mother, physician, obstetrician and gynecologist, I work to ensure all my patients receive the best possible care that will improve their overall health before, during and after pregnancy.

Why are Black women at higher risk for pregnancy complications?

The most straightforward answer is racism. The root causes of disproportionate pregnancy complications in Black women are driven by inequality, discrimination and long-standing racism deeply rooted in the U.S. healthcare system.

Systemic racism impacts every aspect of healthcare. It begins before birth and continues until death. Black babies are more than twice as likely as white babies to die at birth or in the first year of life. And life expectancy is shorter for Black women compared to white women.

Race is a social construct with significant impact on the health and well-being of Black people. At every stage of life, generations of structural racism impact Black people disproportionately in the form of social and health disparities, such as segregated housing, the digital divide, educational barriers, economic suppression and access to quality healthcare.

How do racism, inequality and discrimination lead to disparities in Black maternal health?

The leading causes of maternal death and complications in the U.S. are all treatable conditions, including:

• Heart disease
• High blood pressure
• Infection
• Embolism
• Hemorrhage

There is nothing in a Black person’s genes or anything inherently wrong with their body that raises the risk for complications. But treatable conditions can become life or death illnesses when implicit bias and systemic racism lead to:

• Delayed or missed diagnosis
• Delayed or withheld treatment
• Disparities in access to health education

What can medical care providers do to reduce Black maternal mortality rates?

The short answer:

Control the things we can control by treating every patient we encounter with dignity and respect.

We must:

Listen to Black patients and change the culture of medicine.

Find out what our patients need and meet them where they are. We need to always provide quality care to Black mothers and birthing parents, and not just focus on maternal death and complications during pregnancy.

Improve the overall health of all women of reproductive age.

We need to provide a full spectrum of care during the entire reproductive life cycle — through family planning, preconception, conception and postpartum, as well as managing chronic conditions like heart disease, high blood pressure, diabetes, obesity and mental health disorders.

At the University of Chicago Medicine, our multidisciplinary team cares for both birthing parents and babies through every phase of the pregnancy journey. We offer the full range of prenatal and postpartum care, from low-risk prenatal care with our midwives, obstetricians and gynecologists, to high-risk care with our highly skilled maternal-fetal medicine physicians and neonatologists. We also have a wonderful team of lactation consultants, community health workers and social workers. Our prenatal classes assist parents as they prepare for delivery and parenthood.

How can everyone help to reduce Black maternal mortality rates?

Work together to end disparities in Black maternal health.

On a national level, congressional leaders have established the Black Maternal Health Momnibus to address every dimension of the Black maternal health crisis. On a state level, Illinois was the first state in the nation to extend full Medicaid benefits from sixty days to one full year postpartum. This is a major win in terms of improving the continuity of care for women after pregnancy. On a community level, we need community leaders and everyday people to raise their voices and demand better access to care and engage in collaborative efforts that focus on the needs of Black reproductive-aged women.

Be advocates for racial justice.

Lastly, we all must have the courage to speak up against racism and be willing to uncover and learn about the pervasive effects of racism in this country. We must realize how we are all harmed by systemic racism. We cannot think of our nation as having the most advanced medical technology in the world if we have the highest infant and maternal mortality rate in comparison with other well-developed countries.