A Mother's Cry: A Race to Eliminate the Influence of Racial Disparities on Maternal Morbidity and Mortality Rates Among Black Women in America.

Geraldine I Oribhabor,Ivan Cancarevic,Maxine L Nelson,Keri-Ann R Buchanan-Peart

doi:10.7759/cureus.9207

Abstract

Racial/ethnic disparities in maternal care exist, even as medicine continues to progress on several aspects, medical care continues to fail countless women each year, particularly minority women and women of color. Black and American Indian/Alaska Native women experienced exponentially more pregnancy-related deaths. Recognizing factors that underlie disparities in pregnancy-related deaths and implementing preventive approaches to resolve them may mitigate racial/ethnic disparities in pregnancy-related mortality. Future research on these disparities should focus on strategies for reducing racial/ethnic inequalities in pregnancy-related deaths, including improving access to high-quality preconception, maternity, and postpartum care for minority women, multi-ethnic education for physicians and healthcare providers in a bid to eliminate implicit biases, adequate funding, and improvement of healthcare facilities in minority areas, education of healthcare providers on variation in the incidence of some certain conditions in different ethnic groups so that care is patient-centered and culturally appropriate. All of these can be enforced through the community, healthcare facility, patient, family, physician, and system-level collaboration.

Highlights

BackgroundMaternal death, described as the death of a woman during pregnancy or within 42 days of the end of a pregnancy - regardless of the result, period or place of pregnancy - from any cause linked to or caused by the pregnancy or its management, but not from unintended or incidental causes [1]
As reported by the Centers for Disease Control and Prevention (CDC), the United States maternal mortality rate (MMR) has more than doubled, from 7.2 deaths per 100,000 live births in 1897 to 16.7 deaths per 100,000 live births in 2016, while the number of reported pregnancy-related deaths has seen a steady decline in most parts of the world [2]
With black non-Hispanic women 3.3 times more likely to die from pregnancy-related causes, it is safe to say that the sizeable racial/ethnic disparities in pregnancy-related mortality are hard to overlook

Summary

Introduction

Maternal death, described as the death of a woman during pregnancy or within 42 days of the end of a pregnancy - regardless of the result, period or place of pregnancy - from any cause linked to or caused by the pregnancy or its management, but not from unintended or incidental causes [1]. Recent evidence indicated that a significant proportion of racial and ethnic disparities in severe maternal mortality and morbidity could be explained by differences in hospital quality, comparable to a series of studies in other fields of medicine that have shown that minorities receive care in hospitals of dissimilar and lower quality than whites [18,19,20]. The "Reduction of Peripartum Racial/Ethnic Inequalities Patient Safety Kit" has recently been released by the Council on Patient Safety in Women's Health Care and Alliance for innovation in maternal health (AIM Program), that includes action measures that hospitals and clinicians could adopt to reduce maternal morbidity and mortality inequalities [23] As suggested by both the AIM kit and others, teaching clinicians and staff about racial and ethnic differences in maternal outcomes, the significance of mutual decision-making, cultural competence, and unconscious bias are essential measures in mitigating healthcare inequalities [23]. Preconception care is a significant avenue for addressing inequalities in maternal morbidity and mortality

Conclusions

Disclosures

Burns J

Findings

Sohn H: Racial and Ethnic Disparities in Health Insurance Coverage