Black women struggle with maternal health disparities

Over the last few years, maternal mortality has worsened significantly in the United States. In 2021, the United States had a maternal mortality rate of 32.9 deaths per 100,000 live births, one of the worst rates in the country's history.

There are also significant disparities when it comes to maternal mortality in the United States. In 2021, Black women had a maternal mortality rate of 69.9 deaths per 100,000 live births — 2.6 times the death rate for white women, with 26.6 deaths per 100,000 live births.

These disparities have also persisted across education levels. According to a 2019 CDC report, Black women with a college degree were five times more likely to experience pregnancy-related mortality than college-educated white women. The maternal mortality rate for college-educated Black women was also significantly higher than it was for white women without a high school diploma.

According to the New York Times, pervasive bias in the healthcare system likely contributes to these disparities. Many Black women report medical staff not listening to them when they report symptoms or dismissing and downplaying their concerns. A recent CDC report also found that Black women were more likely to report some form of mistreatment or discrimination during pregnancy.

"There are many people in the health-care industry who do not understand what baggage Black women are bringing into the doctor's office," said Meika Neblett, a physician and chief medical and academic officer at Community Medical Center. "We are coming into the environment with these fears of not being heard, with these fears of needing to be understood."

Stress and poor mental health can also negatively impact women's health during pregnancy, especially for Black women. According to Catherine Limperopoulos, director of the Center for Prenatal, Neonatal & Maternal Health Research at Children's National Hospital, maternal stress and depression is the top complication of pregnancy, affecting up to 25% of pregnant women and almost 40% of low-income Black women.

"This is not a one-off," Limperopoulos said. "This doesn't happen once in a while. This is incredibly prevalent."

How to address maternal health disparities

According to Advisory Board's Gabriela Marmolejos, there is an urgent need for providers to apply a trauma-informed approach to maternity care. In particular, providers should strive to reduce the stress and anxiety experienced by Black people during pregnancy through trauma-informed care.

Notably, Chandra Higginbotham, an obstetrician who has been practicing for over 30 years, said that "[n]othing is routine in the world of OB/GYN." This means that it's highly important for maternity care providers to dedicate time to understand the individual needs of their Black patients.

To offer their patients this kind of care, many organizations are integrating support from midwives and doulas in patient's pregnancy care journeys. Midwives and doulas typically spend more time with patients than obstetricians, which allows them to build trust and closer relationships. The support of midwives and doulas has also successfully improved pregnancy outcomes and reduced maternal health disparities.

Organizations interested in launching their own midwifery programs can utilize this Advisory Board white paper, which outlines key tactics and explains how to overcome common implementation challenges. Other beneficial resources include this report on how to address the root causes of maternal health inequity and the five steps health systems can take to improve women's health and well-being.

For a broader look at maternal health in America, this Radio Advisory episode discusses key drivers of poor maternal health outcomes and explains why there needs to be a massive shift in how the healthcare industry thinks about maternal health going forward. (Rabin, New York Times, 12/12; Johnson, Washington Post, 12/14)

Misconceptions about women's health have led to a healthcare system that fails to provide comprehensive, high-quality care for women. Learn five steps you can take now to improve outcomes and promote better health and well-being for women.