Death Rate of African American during Childbirth
Comprehensive Essay on the Death Rate of African American during Childbirth
Significance of the Problem
Over the past several decades, maternal mortality in the U.S. has significantly decreased. From 1915 to 2014, the rate dropped from 607.9 maternal deaths per 100,000 new births to 21.5. The change seems insignificant when current statistics are compared to those that prevailed in the late 1960s (Singh, 2021). Recent data demonstrate an increasing trend and a noticeable rise in maternal mortality over the previous 20 years (Singh, 2021). Given that rates for some racial/ethnic minorities and socioeconomic groups continue to be relatively high, reversing present trends and lowering the maternal death rate are crucial public health objectives for the country.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Black and American Indian/Alaska Native (AIAN) women have maternal death rates roughly two to three times greater than Caucasian women. Maternal mortality rates for U.S. women are more than twice as in high-poverty regions than in wealthier ones. The U.S. rate of 22 pregnancy-related deaths per 100,000 live births is higher than the rates for at least 52 other nations, including Canada, Japan, Australia, and all the Western and Northern European nations, according to a cross-national comparison of 2013 statistics by the World Health Organization (WHO) (Singh, 2021). In 2018, the Organization for Economic Co-operation and Development (OECD) released data showing that among the selected developed nations, the U.S. had the second-highest maternal death rate, behind Mexico.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Although maternal mortality rates in the USA drastically decreased over the 20th century, non-Hispanic white women dropped more than African American women, creating a racial disparity that still exists today. Maternal mortality in the U.S. is again rising for women of all races after decades of significant progress, rising by about 27% between 2000 and 2014 (Novoa & Taylor, 2018). The United States is the only developed nation where this is true, which is alarming. Infant mortality in the United States decreased significantly over the 20th century. However, the racial disparity in infant death rates has existed since the government and hospitals first began gathering this information more than a century ago, and it has not materially improved in more than fifty years. African American mothers have higher rates of preterm deliveries and low birth weights, contributing to this disparity. African American newborns had a 3.2-fold higher risk of dying from problems associated with a low birth weight than non-Hispanic white children (Novoa & Taylor, 2018). More children die during the neonatal period, from birth to one month than during the post-neonatal period, from one month to one year, across all ethnic groupings.(Comprehensive Essay on the Death Rate of African American during Childbirth)
About 700 women in the U.S. perish either during their pregnancy or the following year (CDC, 2022). Each year, 50,000 additional women report unexpected pregnancy and delivery events that substantially impact their short- or long-term well-being (CDC, 2022). Every pregnancy-related fatality is regrettable, especially considering that two out of every three may be avoided. Numerous pregnancy-related deaths can be avoided by identifying early warning signals and promptly treating patients with high-quality care. Compared to White women, Black women have a three times higher risk of dying from pregnancy-related causes. These inequities are caused by several variables, including variations in healthcare quality, underlying chronic illnesses, institutional racism, and unconscious bias (CDC, 2022). Many members of racial and ethnic minority groups cannot access equal economic, physical, and emotional health opportunities because of social determinants of health.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Risk Factors
Most studies on maternal and infant mortality health inequalities concentrate on the higher African American women’s exposure to risk factors during pregnancy, such as poverty and low socioeconomic status, restricted access to maternity care, and poor physical and mental health (Novoa & Taylor, 2018). While research has shown that African American women are at an increased risk than Caucasian women to encounter these intertwined risk factors, it fails to adequately explain the racial gap in maternal mortality outcomes (Novoa & Taylor, 2018). The disparities result from racial and gender discrimination throughout these women’s lifetimes.(Comprehensive Essay on the Death Rate of African American during Childbirth)
African American women continue to have an increased maternal and newborn mortality risk even after factoring in socioeconomic status and education. Even considering factors including income, gestational age, maternal age, and overall health, African American women are nearly three times more likely than non-Hispanic White women to die from pregnancy or delivery problems (Novoa & Taylor, 2018). According to Novoa and Taylor (2018), controlling for the same variables, college-educated African American women have a nearly three-fold higher risk of miscarrying than their non-Hispanic White counterparts.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Early and sufficient prenatal care is fundamental in fostering healthy pregnancies and preventing mother and child mortality. It promotes healthy behavior through maternal health screening, education, and counseling (U.S. Department of Health and Human Services, Office on Women’s Health, 2018). Although evidence indicates that fewer African American women than non-Hispanic white women have access to prenatal care, inequalities in prenatal care availability do not account for any racial disparities in mother and infant mortality. In actuality, infant death rates were more significant for African American mothers who started prenatal care in the first trimester than for non-Hispanic white women who started care later or not at all. It can be a result of disparities in the caliber of prenatal care. When African American women seek prenatal care, the service is frequently of lower quality, and the women frequently experience difficulties (Novoa & Taylor, 2018). When combined with poorer-quality prenatal care, current health status, health history, distress, and racism may increase mother and newborn mortality.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Although many physical health issues and behaviors affect maternal and fetal outcomes, behavioral therapies frequently concentrate on smoking, drug misuse, and obesity. Both fail to explain the disparity in mother and newborn mortality by race. Drug use and smoking are risk behaviors that significantly increase the likelihood of premature birth, low birth weight, and sudden infant death syndrome (Novoa & Taylor, 2018). However, more non-Hispanic white women admit tobacco use than African American women, and neither group is more likely to use alcohol or drugs while pregnant.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Obesity, more common in African American women and is linked to pregnancy problems like preeclampsia, impacts maternal and newborn mortality. However, recent research from the New York City Department of Health and Mental Hygiene found that African American women with a healthy weight still had a higher chance of dying during pregnancy than non-African-American obese women (Villanueva, 2018). Non-Hispanic white women were consistently at a decreased risk for infant mortality compared to obese African American moms (Novoa & Taylor, 2018). Therefore, the racial discrepancy in newborn or maternal mortality cannot be explained by the greater incidence of obesity among African American women.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Maternal mental health difficulties can develop when women suffer sudden and ongoing stressors while pregnant. However, given that African American women have not regularly reported greater levels of stress throughout pregnancy, disparities in a mother’s mental health are also insufficient to account for the discrepancy in delivery outcomes. However, it is uncommon for women of color to be aware of the mental health problems that might arise during pregnancy and after giving birth because they do not understand the warning signs and symptoms of mental health issues (Taylor & Gamble, 2017). Black women’s maternal mental health difficulties are significantly underreported, and symptoms are frequently ignored. Although maternal mental health disparities might not have entirely explained the disparity in birth outcomes between non-Hispanic white and African American women, they should not be disregarded (Novoa & Taylor, 2018). Policymakers should consider African American women’s limited access to proper mental health care evaluations and services and the correlation between extreme stress and maternal mental health to address trends in unfavorable outcomes throughout pregnancy and after childbirth.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Role of Race
The health of pregnant women is frequently the focus of research that considers maternal risk factors as reasons for racial differences in maternal and child mortality. However, this strategy ignores a crucial fact: women in good physical and mental health before getting pregnant are more likely to experience optimal, full-term pregnancies and safe childbirth. An alternate theory claims that racial differences result from entirely different developmental paths (Novoa & Taylor, 2018). In other words, institutional racism’s social and economic effects put Caucasian and Black women on different life paths, with long-term effects on their health and the well-being of their future babies. Health is compromised by widespread racial bias, not by the race itself. Despite being equally eligible in terms of income and credit score, African American families, for instance, are given fewer suitable housing options than non-Hispanic white families and thus face more housing instability and eviction (Lund, 2016)(Comprehensive Essay on the Death Rate of African American during Childbirth). It is more likely for African American girls to live in inadequate housing throughout their early years, where environmental pollutants like lead can impair healthy development, than non-Hispanic white girls. African American girls tend to experience higher suspension rates in school than their non-Hispanic white female counterparts for similar conduct throughout their time there. Furthermore, stress is more likely because 72% of African American mothers are the only breadwinners (Novoa & Taylor, 2018). Together, these instances demonstrate how social and economic factors can significantly impact the development of African American women throughout their lives.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Long-term risk exposure in early childhood and critical developmental stages affects women’s health. An increased incidence of childhood obesity and diabetes is associated with maternal depression and anxiety during pregnancy (Novoa & Taylor, 2018). Diabetes and obesity are recognized maternal risk factors that endanger the lives of expectant mothers and their unborn children.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Standard of Care
Healthcare facilities frequently widen racial inequities, despite evidence that mothers’ upbringing significantly influences maternal and infant mortality. For instance, compared to Caucasian women, women of color have limited access to crucial reproductive health services like family planning, abortion, and testing for STDs and cervical cancer (Novoa & Taylor, 2018). A lesser standard of care is often provided to African American women, increasing their risk of mortality over their lifetimes. Racial differences in illnesses, including heart disease, cancer, HIV, AIDS, and diabetes mellitus, and risk factors for pregnancy, like hypertension, anemia, and gestational diabetes, result from lesser standards of care. In addition, within the same facilities, African American infants receive less quality care than non-Hispanic white kids. Inadequate bias training among healthcare workers is another issue. Medical professionals frequently make African American mothers feel undervalued and disrespected, impacting their healthcare experiences and outcomes (Novoa & Taylor, 2018). Mothers also commonly complain that medical professionals do not address their pain adequately, particularly when it comes to patients of African American descent.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Addressing the Problem
Advocates, healthcare professionals, and policymakers play a critical role in handling the alarming maternal and newborn mortality situation in the United States. For instance, campaigns for racial and reproductive justice by advocacy groups like the National Birth Equity Collaborative and the Black Mamas Matter Alliance raise public awareness (Novoa & Taylor, 2018). A few states, like North Carolina and California, have established health care and research collaboration groups to enhance the health of pregnant women and newborns. Through the Alliance for Innovation in Maternal Health and the Collaborative Improvement and Innovation Networks tackling maternal and infant wellness, national, state, and local officials from other states can also communicate lessons gained (DeSisto et al., 2019).(Comprehensive Essay on the Death Rate of African American during Childbirth)
To design prevention strategies and quality improvement initiatives, however, researchers and practitioners still require improved data on health disparities and a more rigorous, ongoing evaluation of maternal and infant fatalities. State and local entities’ attempts to gather some of this data can be supported by federal laws like the Maternal Health Accountability Act of 2017, although data collection is inadequate (Weigel, 2019). Future policy initiatives will benefit from funding research that tries to comprehend maternal risk factors, similar to the Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act.(Comprehensive Essay on the Death Rate of African American during Childbirth)
References
CDC. (2022, April 6). Working Together to Reduce Black Maternal Mortality. https://www.cdc.gov/healthequity/features/maternal-mortality/index.html(Comprehensive Essay on the Death Rate of African American during Childbirth)
DeSisto, C. L., Kroelinger, C. D., Estrich, C., Velonis, A., Uesugi, K., Goodman, D. A., Pliska, E., Akbarali, S., & Rankin, K. M. (2019). Application of an Implementation Science Framework to Policies on Immediate Postpartum Long-Acting Reversible Contraception. Public health reports (Washington, D.C. : 1974), 134(2), 189–196. https://doi.org/10.1177/0033354918824329(Comprehensive Essay on the Death Rate of African American during Childbirth)
Lund, A. (2016). Evicted: Poverty and Profit in the American City, Matthew Desmond (New York: Crown Publishing Group, 2016). Alberta Law Review.(Comprehensive Essay on the Death Rate of African American during Childbirth)
Novoa, C., & Taylor, J. (2018). Exploring African Americans’ high maternal and infant death rates. Center for American Progress, 1.
Singh G. K. (2021). Trends and Social Inequalities in Maternal Mortality in the United States, 1969-2018. International Journal of MCH and AIDS, 10(1), 29–42. https://doi.org/10.21106/ijma.444(Comprehensive Essay on the Death Rate of African American during Childbirth)
Taylor, J., & Gamble, C. M. (2017). Suffering in silence: Mood disorders among pregnant and postpartum women of color. Center for American Progress, November 17.(Comprehensive Essay on the Death Rate of African American during Childbirth)
U.S. Department of Health and Human Services, Office on Women’s Health. (2018). Prenatal care and tests. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests (Comprehensive Essay on the Death Rate of African American during Childbirth)
Villanueva, C. (2018). Effects of Racial and Ethnic Background on Maternal Health in the U.S. THE SLU MCNAIR RESEARCH, 81.
Weigel, R. (2019). Maternal Mortality in the United States:: A Brief History, Overview, and Update. Public Health Review, 2(1).(Comprehensive Essay on the Death Rate of African American during Childbirth)
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