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Recent Data on Maternal Health Inequalities Indicative of Ongoing Structural Racism in Healthcare

Written by Elizabeth Gilbert

pregnant woman touching belly belly while resting on couch

Black women in the United States are nearly 4 times more likely than white women to die from pregnancy complications, a statistic that has proven consistent for the past 65 years. Recently, the National Bureau of Economic Research released a study that found Black mothers and their newborns experience significantly worse health outcomes than their white counterparts regardless of income level. Study co-author and assistant professor of economics at Stanford University Petra Persson, Ph.D., explained, “The standard story in the United States over the last 40 years has been that infant and maternal health is worse when the mom is poorer. Our research shows that the U.S. fails to deliver for mothers and their newborns across the entire income distribution, including at the very top.”

Despite its wealth, the United States has notoriously exhibited the highest maternal mortality rate among comparable countries in the developed world. This is largely due to a greater amount of infant health inequality in the US than in other countries. Although extensive research has been performed on infant health disparities across racial and educational groups, less is known about the relationship between parental income and infant health. Dr. Persson et al.’s study sought to fill that research void, and in doing so, revealed glaring realities of how structural racism effects health outcomes regardless of income. For instance, the study found that low birth weight and pre term birth rates for infants of Black parents in the top of the income distribution are approximately 1.5 times higher than those for instances of white parents in the bottom of the income distribution.

Study co-author and associate professor of health policy at Stanford Maya Rossin-Slater, Ph.D., clarified, “In a society that still suffers from structural racism, our research indicates that policies only addressing economic drivers of disparities are likely not enough to close racial health gaps.” This finding is supported by others in the field, including Nicole Redmond, M.D., Ph.D., a medical officer with the National Heart, Lung, and Blood Institute. Dr. Redmond explained, “We tend to conflate race with class and assume all the problems are due to poor women of color lacking access to care, but Black women at all income and educational levels experience bad maternal outcomes. And research is showing detrimental effects of some interactions between women and their health care providers – the way women feel treated due to the assumptions being made about them can hurt.”

What Can Be Done to Combat Systemic Racism in Maternal Healthcare?

An important way to combat systemic racism in maternal healthcare is to address health care providers’ implicit bias. Researchers Zenobia Bryant, Ph.D., and Bani Saluja, MPH, propose methods of intervention such as improving the training of health care providers from medical and nursing school onwards to ensure clinicians are aware and acknowledge the impact of biases and address their own such biases. Dr. Bryant and Saluja also recommend providing opportunities for patient empowerment, such as facilitating patient access to clinical notes to help patients feel heard, validated, and understood, and giving patients information to make informed decisions about continuing or ending a relationship with a provider. As the researchers explain, expectant mothers are not obligated to remain with a particular health care provider for their entire pregnancy and they should be encouraged to find the right fit, especially early in the pregnancy.

The CDC advises pregnant people and their families to take the following steps to reduce Black maternal mortality:

  • Talk to a healthcare provider if something is concerning or does not feel right.
  • Seek immediate medical care if experiencing any urgent maternal warning signs such as severe headache, extreme swelling of hands or face, trouble breathing, heavy vaginal bleeding or discharge, overwhelming tiredness, and more.
  • For up to one year after delivery, document and share pregnancy history during each medical care visit.
  • Before, during, and after pregnancy, maintain ongoing healthcare and social support systems.

The CDC advises healthcare providers to take the following steps to reduce Black maternal mortality:

  • Ask questions to gain a better understanding of the patient and things that may be affecting their lives.
  • Help patients and those with them to understand urgent maternal warning signs that require immediate medical care.
  • Assist patients with managing chronic conditions or conditions that may arise during pregnancy like hypertension, diabetes or depression.
  • Identify unconscious bias in themselves and in their office.
  • Address any patient concerns.
  • Provide all patients with care that is respectful.

What Can You Do if You or Your Loved One Experience a Maternal Health Injury?

If you or a loved one experience a maternal health injury due to preventable causes, you should reach out to an attorney right away. Contact the experienced attorneys at Berkowitz and Hanna, LLC if you have any questions about your legal rights regarding this concern. To schedule a free, no-obligation consultation, call or contact us online today.