Let’s Talk About It: The Disparities Between Race & Maternal Health

Maybe you’ve read about it, heard about it, or noticed it referenced in the headlines, but while racial discrepancies in maternal health and mortality rates are just recently garnering media attention, it’s been an issue for a long time.

The truth is, there’s a significant gap in just how safe it is to become a mother that rests on whether you are white or a woman of color, and there’s no easy way to explain why infant and maternal mortality rates are significantly higher for black women. But just because it’s not easy doesn’t mean we shouldn’t talk about it.

Our dedication to helping mothers live happier and healthier so they can have healthier, happier babies goes for everyone, everywhere. We’re on a mission to provide the best information and personalized coaching possible when it comes to living a healthier lifestyle and making it available to women around the world. But there are always some factors that women are fighting against that go beyond lifestyle changes alone, and this is one of them. But the more we talk about it, the more we can understand it and learn how to move the needle in the right direction towards better maternal wellbeing for all women.

The truth about racial disparities in maternal health

Earlier this year, Serena Williams broke the silence when she revealed that she’d dealt with severe, life-threatening complications during pregnancy. Williams developed a pulmonary embolism — a blood clot in her lung — that required an emergency C-section. Six-time Olympic gold medalist Allyson Felix was diagnosed with preeclampsia at a routine prenatal appointment and was required to deliver her daughter early via C-section.

These are two of the world’s fittest, strongest, healthiest women, and they’ve still fallen victim to some of the most common health risks facing pregnant women of color in the United States. The truth is: African American women are four times more likely to die during childbirth and twice as likely to have complications during pregnancy. Williams’ and Felix’s cases aren’t isolated incidents: they’re a mere glimpse into the maternal risks facing pregnant women of color every day.

In the U.S., the maternal mortality rate is worse than it was 25 years ago. And as the mortality rate increases, the percentage of black women who make up that statistic remains the majority. Black mothers are 3-4 times as likely to die from pregnancy-related causes as their white counterparts, and black infants are more than twice as likely as white infants. We’re not sharing these stats to generate fear, but to inform. It’s so important to understand what is happening so we can better understand why and do something about it.

Why is this happening?

One of the major culprits of infant death is low birth weight, which happens to be a particularly common condition for black babies. They’re 2-3 times more likely to be born preterm or at low birth weight, and for the first time in a decade, the number of low-birth-weight babies in the U.S. has increased. Since it’s a major factor in infant death, this is a statistic we need to better understand.

It’s hard to pin down any one reason as the sole cause of blame. But the racial disparity in maternal and infant mortality has been studied for years, and experts have some pretty solid ideas as to why it persists. Low birth weight babies and preventable health conditions are two significant factors, but what’s the root cause? Most studies point to implicit racial bias.

Linda Villarosa, professor and health journalist, says that this racial bias affects the kind of medical treatment that women receive, and also cumulatively affects them as they live their lives. This suggests that women of color are constantly operating in situations that are just more stressful than those of white women: the chronic stress, pressures, insults, oppression, and discrimination that have affected black women for decades have a physical effect on the body because of sustained, elevated cortisol levels. Villarosa calls this toxic stress, and it’s one of the best ways to explain why black women are more likely to suffer from preeclampsia and other pregnancy complications — and it’s affecting all women of color, regardless of background or socioeconomic status.

This unconscious racial bias impacts the care women of color receive as well. It’s hard to talk about implicit bias because it’s impossible to see, but it can be responsible for physicians dismissing patient concerns, spending less time with them, not communicating as effectively, and under-treating their pain. Of course, this lack of proper treatment doesn’t just impact the woman, but her growing child as well.

Where do we go from here?

This isn’t a quick fix — it’ll require systemic change and a continued push for further awareness and action. It’s so important that we change the high-risk reality of pregnancy and birth for women of color because, without change, they’ll continue to receive inadequate care and suffer from a mortality rate that’s far too high. Bringing stories, statistics, and studies to light are necessary to change things: the information is out there, but it’s still under-recognized, and there’s much more to be acted upon.

And of course, change needs to happen within the medical community. But that’s not a task left to physicians alone. With education and training on unconscious bias, the unequal nature of care that black women receive can be mitigated — and medical professionals can be trained on conditions black women are at a high-risk for, such as preeclampsia, so they can recognize them and check for warning signs before it’s too late. There are more factors at play as well; a study that came out less than 2 weeks ago found that physician burnout is a contributor to implicit racial bias, and burnout is reported by nearly half of currently practicing physicians. So, there’s a lot at play here, but that means there is a lot of room for improvement.

What’s the goal?

This isn’t just about preventing maternal deaths, it’s about reducing complications and lowering preventable near-deaths for mothers — and in the process, making the journey into motherhood a healthier, more positive, and safer experience for all women.

The number of near-deaths rose almost 200% from 1993 to 2014, and the C.D.C reported more than 50,000 that year. Dr. Anne Schuchat, the CDC’s principal deputy director, says that big-picture systemic change is the answer — and while it won’t be easy, it’s necessary. Large-scale changes have already been put in place by the CDC in 13 states, and Schuchat hopes other states will soon follow suit.

Women have taken their health into their own hands through advocacy. The Black Mamas Matter Alliance is spearheading the campaign to improve black maternal health by furthering research, improving education, pushing for change, and bettering resources for women. With these efforts, they hope to make pregnancy and motherhood healthier and safer for women of color.

Advocacy matters, accurate information matters, and listening matters — and when we all commit to that, that’s how change happens. One woman’s health is all women’s health. By lifting each other up and advocating for women’s health at scale, healthier pregnancies, healthier moms, and healthier babies will be our future reality.


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