Attallah Innis 04/08/19
Prof. Groves
The Trend of How Black Women Are a Target During Pregnancy

There is a disparity in the Maternal Mortality Rate between black women and any other race in North America. The authors of the research articles have a clear pattern of showing the difference in these women's pre and post care. These patterns include black women being re-admitted into hospital after giving birth, the way the authors compare black females treatment to other race, and the poor treatment of black women in hospitals. Even though over time United States technology has improved drastically from the 1900s to now there is still a gap between the care of black women from other races. Black women are at more of a risk than any other race when they decide to have a child. This is an issue in America because the rate  for black women are 73% higher than white women when it comes to post readmission care (Aziz 2019). People need to start coming up with ways to help these women survive throughout their whole pregnancy and their post pregnancy care. This is an alarming issue because these rates do not apply to any other race. Whether it is the obstetrician who neglects the African American patients, or the policies that does not benefit the patients, the articles do not all concur with a cause of the maternal mortality gap. Each article has their on belief as to what the MMR is caused by, and despite the fact that they overlap they each have their own overall consensus. 
One articles state that the issue is not really soling based on race but that age has a big impact on the maternal morbidity rates. Even though black women have higher MMR rates, the article state that white women have higher rates in certain cases (Spence 2009). As stated in the article “We find early childbearing to be associated with higher mortality among whites, while later childbearing is associated with higher mortality among blacks” (Spence 2009). I wonder if the fact that the paper was written ten years ago has anything to do with the findings that they came across back then. This article breaks the pattern of showing the factors to be obstetrics negligence, racial/ethnic disparities, and certain health complication for women of color.  Other articles seem to make this factor a very important one by framing everything plainly. The article points out that  race is something that needs to come into play when thinking about MMR, the article states “We have summarized data demonstrating that Black women disproportionately receive inadequate prenatal care compared to non-Black counterparts”( Gadson 2017 ). The articles differ in what they perceive to be the underlying cause of MMR and Spence seems to be the only author that makes age element to consider. 
Another huge trend in the articles state that there is a difference between the way health care is provided for black women versus other races. The pattern that is continued amongst the articles is that these women face health complications, but the statement that the articles fail to bring to light is what people are doing about the complications. The pattern shows that it is mention but no solution follows the observation. The injustice is mention as stated “Racial/ethnic health disparities are complex and reflect multiple levels of inequities—from patient characteristics to health care policies” (Leonard 2019). The articles mention policies a lot in the their conclusions and how they tend to in act a change, but if that the case why are black women rates still so high. I was searching in the articles for a section that would highlight solutions that showed very sound results over a long period of time. Some of articles have very poor way of showing the change and that it is long lasting change rather than a quick fix. The articles have a tendency to mention quick fixes that may or may not have an impact on these women’s lives. The article that shows a continuation of this pattern states “At-risk women including black women with cardiovascular risk factors may benefit from short-term postpartum follow up” ( Aziz 2019). The words that they use most often is may and should, these are words that are use to show people hope without a promise for success. The authors do not show a steady trend of finding a result for these epidemic besides the single sentence in the conclusion. 
The racial disparity that has to do with the in hospital care is displayed in a pattern that is well demonstrated. Black women do not receive the same care as white women, and that is highlighted in multiple articles. The author succeed by giving real factors that pertain to the MMR as stated “black individuals in primarily non-black-serving hospitals had significantly poorer outcomes than other races/ethnicities, while at primarily black-serving hospitals all races/ethnicities had similarly poor outcomes, which the authors suggested indicated that the primarily black-serving hospitals were of poorer quality in general. ” ( Somer 2017). The hospitals that tend to services more black patients have the worst results, and that effects the MMR. Nothing is being done to fix this problem, and it is something as simple as maybe more fund, better qualified doctors, and/or easier access. All of these options and more and very heavily talked about but the rates are still failing to decline and that is not as highlighted as it should have been. The articles have a very clearly way of stating the issues and all of the causes, that each author felt to be different, but it feels like they are missing information. It’s like the reader is left to finish the conclusion on their own by creating their own inference, and that happens to be a consist trend of the way the author finish of their paper. All the articles have a different way of stating a cause of the MMR, as stated in the article “ We present a theoretical framework connecting the complex factors that may link race, social context, prenatal care utilization, and maternal morbidity/mortality” ( Gadson 2017). The articles all on the same overall topic have different ways of showing the MMR in black women. This evidence shows that there is an area in this study thats missing, because there isn’t much connection between the articles. 
Finding solution for this epidemic has been and ongoing process of doctors, one of the first reports about racial disparities in obstetrics began in 1946 in Alabama and they talked about the attempt to resolving the issue (Somer 2017).  Now almost 73 years later we are still facing these issues and black females  rates of maternal mortality are the highest of every ethnicity. This show that scientist knew about the issue and even wrote about it, but yet did not come up with viable results to fixing the problem. Most of the articles that I uncovered discuss the problem as an epidemic but they do not have any concrete results as to how to solve this matter. The topic is very well talked about but the action is not present and is not sufficient enough because the rates are still the highest for black women. The idea that they are still trying to devise more resolutions is promising, because the fact that black women are dying more every day due to pregnancy is a disturbing fact. The article states “There is also an increase in visibility of disparities at all levels of health policy, as evidenced, for example, by their priority among Healthy People 2020 goals” ( Somer 2017). The problem that black women are facing everyday is being push to a 2020 goal instead of being a goal for now. The tendency the articles have of seeing the issues and not calling obstetrician out is extremely disappointing. 
The articles display similar patterns in the way they get their message across to their readers. Wether the patterns they show are negative or positive it was effect to have an understanding as to what the articles believe to an important factor to MMR of black women. There are articles that did not agree with the others in certain areas, especially with what the underlying cause of the maternal mortally rates  being so high in women of color is and why it is not declining with time. The articles did have similarity with the way the mentioned certain criteria that has to do heavily with the MMR and what they are doing to manage and eventually stop the rate from being solely high with black women. The article are failing to place the blame on something or someone, it feels as if they are tip toeing around the issue. The articles have a great tendency of showing the issue to be awfully prevalent in our society. This topic is truly talked about a lot all around the world and this causes the factor of MMR in black women to be different everywhere. With that being the case it should cause the solutions to be in abundance all around the world and the pattern of the conclusion lacking a true finish should end. 

Work Cited
Aziz, Aleha, et al. “5: Maternal Outcomes by Race during Postpartum Readmissions.” American Journal of Obstetrics and Gynecology, vol. 220, no. 1, 2019, doi:10.1016/j.ajog.2018.11.006.

Gadson, Alexis, et al. “Exploring the Social Determinants of Racial/Ethnic Disparities in Prenatal Care Utilization and Maternal Outcome.” Seminars in Perinatology, vol. 41, no. 5, 2017, pp. 308–317., doi:10.1053/j.semperi.2017.04.008.

Leonard, Stephanie A., et al. “Racial and Ethnic Disparities in Severe Maternal Morbidity Prevalence and Trends.” Annals of Epidemiology, vol. 30, 2019, doi:10.1016/j.annepidem.2019.02.007.

Somer, Sarah J. Holdt, et al. “Epidemiology of Racial/Ethnic Disparities in Severe Maternal Morbidity and Mortality.” Seminars in Perinatology, vol. 41, no. 5, 2017, pp. 258–265., doi:10.1053/j.semperi.2017.04.001.

Spence, Naomi J., and Isaac W. Eberstein. “Age at First Birth, Parity, and Post-Reproductive Mortality among White and Black Women in the US, 1982–2002.” Social Science & Medicine, vol. 68, no. 9, 2009, pp. 1625–1632., doi:10.1016/j.socscimed.2009.02.018.