Abstract
Ways Forward in Preventing Severe Maternal Morbidity and Maternal Health Inequities: Conceptual Frameworks, Definitions, and Data, from a Population Health Perspective.
Highlights
Severe Maternal Morbidity (SMM) and its inequities should be conceptualized within a multidimensional causal chain of events framework that intentionally incorporates multiple relevant theoretical frameworks not every study or prevention strategy will address all of the complexities we have described, grounding in their essence will produce better research that is more likely to lead to sustainable, equitable improvement of maternal health
Reducing SMM is critical to improving maternal health
SMM is a national outcome measure for Title V, it is part of new Healthy People 2030 Goals, and it is one of the few quality indicators that focuses on maternal healthdall of which attest to the importance of understanding its causes
Summary
We conceptualize SMM and its inequities within a multidimensional causal chain of events framework that spans the “macrosocial” (i.e., structural and societal factors) to the “microclinical” (i.e., pathways from specific clinical precursors to specific SMM indicators) (Figure 2). Health and racial equity Given stark disparities by race and social disadvantage, SMM research should be centered on achieving equity, within a framework that is informed by multiple relevant movements and theories, including, for example, Critical Race Theory, EcoSocial Theory, Intersectionality, and Reproductive Justice (Black Women Scholars and the Research Working Group of the Black Mamas Matter Alliance, 2020; Roberts, 1998; Ford & Airhihenbuwa, 2010; Krieger, 2020; Ross, 2017) [see references for further explication]. SMM and its inequities should be conceptualized within a multidimensional causal chain of events framework that intentionally incorporates multiple relevant theoretical frameworks (see Table 1.) not every study or prevention strategy will address all of the complexities we have described, grounding in their essence will produce better research that is more likely to lead to sustainable, equitable improvement of maternal health
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