BY SIMONE J. SMITH
You are six months pregnant, and you are on your way home from work. As you walk, you are thinking about your life, and the world that you are bringing your child into. You don’t live in the best area of the city, and this is evident as you step over a sleeping man in the middle of the sidewalk. You have experienced some discomfort during your pregnancy, but you have limited access to prenatal care and educational resources even though it is vital for ensuring a healthy pregnancy and birth outcomes.
You are surprised that you still have a job, and now with only three months to go, you have to worry about whether you are going to have enough money to take care of your child. You are not getting maternity leave, and you are barely making ends meet now. As you climb the stairs of your apartment, tears run down your face; you feel lost, confused, and alone. You have no idea how life is going to look in a few months…
A new study has found that maternal mortality rates in the U.S. dramatically worsened from 1999 to 2019. The overall rates of maternal mortality are far higher in the U.S. than in other industrialized countries. According to the study’s findings, there were an estimated 12.7 maternal deaths per 100,000 live births in the U.S. in 1999. In 2019, this rate more than doubled to 32.2 deaths per 100,000 births. By comparison, Canada currently reports 10 deaths per 100,000 live births, the U.K. reports 9.6 deaths per 100,000 births, and Norway and Denmark report 2.7 and 2.4 deaths per 100,000 births, respectively.
The research, published in July in the journal JAMA, reveals maternal mortality rates more than doubled in the U.S. in the past 20 years and bolsters existing evidence that certain racial and ethnic groups are at a greater risk of maternal mortality than others. The study used data on deaths and live births from the National Vital Statistics System and generated estimates of maternal deaths by state, race and ethnicity from 1999 to 2019.
Women of African descent consistently had the highest maternal mortality rate across each year studied, and the largest increase in rate over the study period was seen in American Indian and Alaskan Native populations.
African American women face barriers in accessing high-quality healthcare services, including prenatal care. These barriers are due to financial constraints, lack of health insurance, limited availability of healthcare facilities in certain neighborhoods, and implicit biases within the healthcare system. They are also more likely to experience poverty and have limited access to resources, which can impact their overall health and the care they receive during pregnancy.
“When you think about what do Black people and Indigenous people have in common, one of the greatest factors is systemic racism,” said Dr. Amanda P. Williams, clinical innovation adviser at the California Maternal Quality Care Collaborative and an adjunct professor at the Stanford University School of Medicine.
Systemic racism in the U.S. affects where people live and work, which also impacts their access to quality healthcare and likelihood of developing various diseases. The Centers for Disease Control and Prevention (CDC) states that, in part due to these factors, Black women are three times more likely to die from pregnancy-related causes than White women.
Studies have also shown that racial bias and discrimination in healthcare settings can negatively affect the quality of care provided to minority patients, including African American women. This bias can lead to delays in treatment, and suboptimal care during pregnancy and childbirth. Pre-existing chronic health conditions, such as hypertension, diabetes, and obesity, are more prevalent among African American women. These conditions can increase the risk of complications during pregnancy and delivery.
Like anything else, unless we discuss these issues, nothing will be addressed. Africans living in the diaspora go through a lot living here in North America, and dealing with these disparities requires a comprehensive approach that focuses on improving access to quality healthcare, addressing implicit biases in the healthcare system, reducing socioeconomic disparities, and providing adequate support during and after pregnancy.
Additionally, community engagement and awareness campaigns can help raise awareness about maternal health disparities and advocate for changes in policies and practices to improve outcomes for African women and other vulnerable populations.