Attallah Innis May 22, 2019

Prof. Groves

The Maternal Mortality Rate Gap between Black women and Other Races

The topic about MMR is heavily discussed but there never seems to be a lot of long term solution for this issue. The percentage of women that died because of pregnancy in the United States according to the CDC has increased by 26.6% from 2000 to 2014. Now the black women death rate compared to white women is three times higher according to The National Geographic. Even though over time US technology has improved drastically from the 1900s to now there is still a gap between the care of black women from other races. For almost 100 years this issue has been going on and the gap is still there. I want to bring this issue to light because too many women, specifically black women,  all over the country are dying at an alarming rate due to pregnancy. There are many factors that can contribute to the MMR gap between other races and black women and one of them include the lack of access and the lack of knowledge. This is a very important factor to consider because this can be fixed and it can change thousands of lives a year. This factor is one that can be changed through education more than people think. If education women more about their pregnancy, plenty of live will be significantly changed.

Most arguments are that women have to be engaged to want to be able to educate themselves about their pregnancy. Gadson states that some black women are not engaged in their pregnancy but she does not mention the factor that cause this. She does not mention the environment that these women are living in, affordable health care, or if these women know what can happen during childbirth. Gadson explains the issue “ Black women are also more likely to be late to prenatal care or be inadequate users of prenatal care.” (Gadson 2017). If they were more awareness about this issue in certain area where the rates are high it would be more beneficial in saving these women’s lives. To just state the issue is that black women just don’t get prenatal care or don’t get it in time, is unfair, because many women do not have the access or they simply do not know. A lot of women are not educated enough about their pregnancy and the risks, and this has a huge impact on the ratio. Educating women about the risks that they are more likely to contract is vital to closing the gap and eventually decreasing the amount to death during childbirth.

The factor about lack of knowledge and access is such and important factor to consider and it is one of may that can have many solutions. I think because this factor involves a lot of money and political strain people are afraid to do something about it. The MMR is hugely impacted by the social structures in most areas, and poverty is something that needs to be consider when the solutions are being researched. The issues is brought up in Bryant’s paper “ (in addition to broader social policy efforts in areas such as education, environmental justice, and poverty), we can strive toward a decrement in these obstetric disparities specifically and inequities in health and health care more generally”(Bryant 2010). With the inequalities present it makes it harder for these women to seek care, and that aids in the lack of access issue. If their health care does not provide certain benefits then they can’t know if they are at risk for certain thing while they are giving birth. Bad health care plans all come back to people being poor and not have the knowledge of the certain good health care plans that are out there. The rates are rising and not enough is being done to help the rates decline and end the gap between black women and other races.

The issue of there being lack of knowledge about the risks that black women are facing during childbirth is unfair to these women. They should be knowledgeable about the negative health outcomes that can befall them. There should be more being done such as walks for this cause and this in turn will bring more awareness to this issue. More women, especially black women will benefit greatly from knowing what their outcomes during childbirth will bring. But because a fast acting solution is seen to benefit the women sooner it is applied at many hospital, that includes policies. The hospital in acts these policies because they feel that it will help the situation at hand and eliminate the issue. The Epidemiology of Racial/Ethnic Disparities in Severe Maternal Morbidity and Mortality describe these solutions as such “ Disparities at the institutional level and beyond should be documented and policies developed and implemented that aim to provide equitable care… Such policies have been successful in the past to decrease disparities” (Somer 2017).  Creating policies that will hopefully elevate the issues that black women face is on of many ways to help the cause. The policy should include way to help women recieve care even if there health care doesn’t cover certain things. These women are suffering because of the lack of access, and they will continue to suffer if the effort is not there. Women should not bear the weight of their surrounding. Just because they are living in poverty does not mean they forgo their right to equal health care.

There are many ways to help this cause, the solutions just have to be researched and implemented. Knowing if you are susceptible to certain health outcomes, comes with the amount of awareness in your area. In area lack of awareness is a huge issue but it is an issue that can be solved. Naomi Spence suggest “ Media coverage coupled with the practical application to women’s lives in contemporary developed countries position this burgeoning field of demographic research uniquely in its ability to reach and inform the public about the ways in which their late life health and longevity are influenced by earlier conditions and what may be done to overcome disadvantages in health” (Spence 2009). The simply action of creating an ad, a section in a new paper, or even a segment in the daily news could change women’s lives drastically.  Putting a dent in the rising rates of black women maternal morbidity is very important because it affects a whole race, which is a whole section of the population. Making awareness of this issue is a huge step towards closing the gap between black women and other races. To educate these women about certain health outcomes due to pregnancy is something that can drastically save lives.

Some black people are not given proper health care due to the fact that they’re living in poverty this all stems back to race. If black people are forced to live in areas where they don’t receive good healthcare or they are not given the opportunity to go to hospital where their lives and their child’s life is being care for, then this gap will never close. When scientist are doing their research they need to consider more things that impact a person life. Leonard explains this idea as such “In particular, our study supports public health endeavors to consider factors beyond those captured in administrative data sets, including patient-reported measures of stress, structural racism, and cultural congruency between health care providers and patients” (Leonard 2019). The kind of healthcare that a person is offered is a very major factor to think of because it enables you to have to benefit of certain test and programs. Black people have to be awarded the same type of healthcare as others to be able to receive benefits. The lack of access to healthcare is one of the leading factor as to why black women are dying three times faster than other races.

Other countries are trying to stop this gap as well but they have different methods to stopping their crisis. In the healthcare community I’m sure that there is a lot of talk and idea sharing and it this all continues the gap is sure to disappear. When other countries conduct their research they consider many factors to the one cause because that is the best way to help their patients. Neggers mentions “In many European countries there are systematic Confidential Enquiries into maternal deaths, through which a critical analysis of the care provided in each death is reported and action steps recommended to addressing gaps” (Neggers 2016). They are taking the necessary steps to addressing the issue whereas in America we are not address this issues as an emergency. The fact the black women are dying three times faster than other race does not seem to be a priority. In America we need to bring more attention to this issue and educate women about the steps they should take to save their lives.

It’s time to start saving these women’s lives and to ensure that we need to make sure that they have the knowledge that they need to have. Just knowing the outcomes that they are supsitiable to will probably save most of these women from going into the hospitals blind. All these women need is the access and the knowledge and they will be able to control their pregnancy. Coeytaux stated “ the global and national communities seem to be coming together to ensure that all women access the life-saving knowledge and technologies that can prevent and treat most pregnancy and delivery complications”(Coeytaux 2011). Knowledge and access to certain technology can save so many women, but they have to be given the chance. Women have to know that these options are available for them. A whole section of a population should not have to suffer from something that can be changed. Black women need to know that they are not alone in the fight to end the gap of black women death during childbirth compared to other races. Black women need to know that they are three times more likely to die than their peers. With this knowledge black women will know what to ask, and make sure that their doctors know what to look for.

The more sciences do their research and keep pushing to see these women’s lives then the better our nation will be as a whole. The more we strive to making sure that women are educated about their pregnancy and understand everything that is going on the better everything will be. We can surely prevent the amount of black women dying by education and making sure that they have the knowledge that they need before they get into the hospital. Giving women access to these types of technology and information will only benefit the whole nation. It’s understandable that education will not automatically fix the whole issue, but to atleast make a dent in the rates would be an amazing thing.

Work cited

1. Bryant, Allison S., et al. “Racial/Ethnic Disparities in Obstetric Outcomes and Care: Prevalence and Determinants.” American Journal of Obstetrics and Gynecology, vol. 202, no. 4, 2010, pp. 335–343., doi:10.1016/j.ajog.2009.10.864.
2. Coeytaux, Francine, et al. “Reducing Maternal Mortality: a Global Imperative.” Contraception, vol. 83, no. 2, 2011, pp. 95–98., doi:10.1016/j.contraception.2010.10.009.
3. 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.
4. Leonard, Stephanie A., et al. “Racial and Ethnic Disparities in Severe Maternal Morbidity Prevalence and Trends.” Annals of Epidemiology, 2019, doi:10.1016/j.annepidem.2019.02.007.
5. Neggers, Yasmin H. “Trends in Maternal Mortality in the United States.” Reproductive Toxicology, vol. 64, 2016, pp. 30–31., doi:10.1016/j.reprotox.2016.06.065.
6. 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.