{"id":5196,"date":"2023-06-30T08:45:47","date_gmt":"2023-06-30T01:45:47","guid":{"rendered":"https:\/\/loudhdtv.com\/?p=5196"},"modified":"2023-06-30T08:45:47","modified_gmt":"2023-06-30T01:45:47","slug":"we-have-a-black-maternal-mortality-crisis-what-can-be-done","status":"publish","type":"post","link":"https:\/\/loudhdtv.com\/?p=5196","title":{"rendered":"We Have a Black Maternal Mortality Crisis. What Can Be Done?"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script><br \/>\n<\/p>\n<div>\n<div class=\"drop-cap text-big text-gray\"> <span class=\"drop-cap__first text-dropcap \">T<\/span>he United States is a medical pioneer, offering some of the most advanced healthcare in the world and many of the top, leading-edge medical innovations. However, this country nonetheless has an alarming maternal mortality rate, with nearly <a href=\"https:\/\/www.cdc.gov\/nchs\/data\/hestat\/maternal-mortality\/2021\/maternal-mortality-rates-2021.htm\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.cdc.gov\/nchs\/data\/hestat\/maternal-mortality\/2021\/maternal-mortality-rates-2021.htm\">33 deaths per 100,000 births<\/a>\u2014a rate that has quadrupled in the last 30 years. Statistics from the Centers for Disease Control and Prevention indicate that <a href=\"https:\/\/www.npr.org\/sections\/health-shots\/2022\/10\/21\/1129115162\/maternal-mortality-childbirth-deaths-prevention\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.npr.org\/sections\/health-shots\/2022\/10\/21\/1129115162\/maternal-mortality-childbirth-deaths-prevention\">84 percent of these deaths are preventable<\/a>. And, although fatalities are obviously the most heartbreaking, past data shows that for every death, there were at least <a href=\"https:\/\/orwh.od.nih.gov\/sites\/orwh\/files\/docs\/ORWH_MMM_Booklet_508C.pdf\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/orwh.od.nih.gov\/sites\/orwh\/files\/docs\/ORWH_MMM_Booklet_508C.pdf\">70 near-death experiences<\/a>.<\/div>\n<p>Black and brown birthing people <a href=\"https:\/\/www.wellandgood.com\/black-maternal-mortality-rate\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.wellandgood.com\/black-maternal-mortality-rate\/\">face the brunt<\/a> of these risks. Statistics show that in 2021 (the latest year for which data is available), the Black maternal death rate was <a href=\"https:\/\/www.npr.org\/sections\/health-shots\/2023\/03\/16\/1163786037\/maternal-deaths-in-the-u-s-spiked-in-2021-cdc-reports\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.npr.org\/sections\/health-shots\/2023\/03\/16\/1163786037\/maternal-deaths-in-the-u-s-spiked-in-2021-cdc-reports\">2.6 times higher<\/a> than that of white people. This racial disparity has long been the case\u2014even among patients with similar education and socioeconomic factors\u2014and when the maternal mortality rate rose sharply in 2021 (partially due to COVID and its ripple effects on hospitals), the increases were especially prevalent among Black birthing people.<\/p>\n<p>This begs the question: How do we fix this tragic trajectory?<\/p>\n<p>There are several channels working in parallel path to strike positive, life-saving change. From maternal care in and out of the hospital, to research and better diversity education within medical schools, multiple channels are trying to improve the dire and completely lacking state of healthcare for Black birthing parents.<\/p>\n<h2>Midwives and doulas can bring a more holistic approach to maternal care<\/h2>\n<p>It is <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29944777\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29944777\/\">well-documented<\/a> that doulas and midwives can positively impact birth outcomes for many, especially people of color who need advocates in the delivery room. While doulas can provide emotional support and assistance before, during, and after labor, midwives combine medical expertise with a patient-centered approach.<\/p>\n<div class=\"related-content \" style=\"\" data-module-init=\"related-content\" data-module-immediate=\"\" v-cloak=\"\">\n<div class=\"related-content__wrapper \" v-cloak=\"\" :class=\"{'is-loaded':isLoaded}\">\n<p> <span class=\"inline pr-6 text-seafoam-dark\">Related Stories<\/span> <\/p>\n<p> <related-content class=\"related-content__links\" parent-article-permalink=\"https:\/\/www.wellandgood.com\/black-maternal-mortality\/\" current-title=\"The U.S. Has an Alarming Maternal Mortality Rate\u2014Particularly for Black People. How Can We Change This Tragic Trajectory?\" current-image=\"WG_Editorial_-FightforBlackMaternalHealth_feature-425x285.jpg\" v-on:parsely-posts-loaded=\"onPostsLoaded\" start-date=\"2022-12-29\" tag=\"div\" inline-template=\"\" url=\"https:\/\/www.wellandgood.com\/black-maternal-mortality\/\" secret=\"w5ztterVB03LGZJLfXS0hf3EvQBuFFIWew9hmVQxthU\" apikey=\"wellandgood.com\" limit=\"3\"> <\/p>\n<div>\n<div class=\"related-content__card mb-[10px] sm:mb-[20px]\" :class=\"{'related-content__card--full':posts.length === 1}\" v-for=\"(post, key) in posts\"> <a v-on:click.prevent=\"trackLinkGA($event, key)\" :href=\"https:\/\/www.wellandgood.com\/black-maternal-mortality\/post.url\" data-url-source=\"related-content\" class=\"related-content__link\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"\"> <\/p>\n<div class=\"related-content__card--image bg-tan\" :style=\"{ backgroundImage: 'url(' + post.image_url + ')' }\"> <img :src=\"https:\/\/www.wellandgood.com\/black-maternal-mortality\/post.image_url\" :alt=\"post.title\"\/> <\/div>\n<p> <\/a>  <\/div>\n<\/p><\/div>\n<p> <\/related-content> <\/div>\n<\/p><\/div>\n<p>According to <a href=\"https:\/\/oulahealth.com\/team\/saonjie-hamilton-lm-cnm\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/oulahealth.com\/team\/saonjie-hamilton-lm-cnm\/\">Saonjie Hamilton, CNM<\/a>, the lead midwife for Oula Health, a New York City-based midwifery clinic, \u201cMidwives are licensed medical professionals who take a more holistic approach to pregnancy, childbirth, and postpartum care.\u201d Midwives don\u2019t just focus on the labor, but the birthing person as a whole. Their work goes beyond test results: Midwifery often takes into account social determinants of health\u2014like family support, access to nutrition, the stability of a patient&#8217;s housing situation, implicit bias, and partner violence (homicide is the <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34619735\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34619735\/\">leading cause of death<\/a> for pregnant people)\u2014and they build relationships that aren\u2019t often forged in a typical seven-minute obstetrics visit.<\/p>\n<p>Midwifery can be a standalone practice, or part of interprofessional collaboration with physicians, nurses, dietitians, and even social workers. Though they can\u2019t perform C-sections, midwives can collaborate with other physicians in hospital settings if complications arise.<\/p>\n<p>Particularly in parts of the country that are considered \u201cmaternal-care deserts,\u201d <a href=\"https:\/\/www.newyorker.com\/culture\/the-new-yorker-documentary\/black-mothers-face-dangerous-health-care-disparities-can-midwives-bridge-the-gap\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.newyorker.com\/culture\/the-new-yorker-documentary\/black-mothers-face-dangerous-health-care-disparities-can-midwives-bridge-the-gap\">midwifery has been called the answer<\/a> to offering more care for low-risk pregnancies. Counties classified as deserts are those that have zero birthing centers, obstetricians, or nurse midwife access. And they are unfortunately quite common. A 2022 <a href=\"https:\/\/www.marchofdimes.org\/maternity-care-deserts-report\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.marchofdimes.org\/maternity-care-deserts-report\">March of Dimes report<\/a> shows that 1,119 counties in the US are considered deserts, affecting 6.9 million women. These areas overlap with ones that are known for <a href=\"https:\/\/data.hrsa.gov\/maps\/mchb\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/data.hrsa.gov\/maps\/mchb\/\">poor outcomes for birthing people and their babies<\/a>.<\/p>\n<p>For a little history: Prior to the 1920s, <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2804652\/?loclr=blogadm\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2804652\/?loclr=blogadm\">Black midwives<\/a> were the standard for prenatal care throughout the South for Black pregnant people. When laws were enacted that prevented them from practicing without a license or medical education, obstetrics\u2014mostly led by white men\u2014became the norm. Today, only eight percent of births are overseen by midwives.<\/p>\n<h2>Medical schools are training providers more intentionally<\/h2>\n<p>According to 2018 data, <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2589933320301221\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S2589933320301221\">68 percent<\/a> of OB\/GYNs are white, and 43 percent are men. Even leadership roles in universities are more likely to be held by white physicians. This is why some universities are actively encouraging and fostering the careers of future doctors from diverse backgrounds.<\/p>\n<p>Patients of color often feel better having practitioners who look like them, but studies also show that there are merits to <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5591056\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5591056\/\">racial concordance<\/a> that extend to <a href=\"https:\/\/www.thephdmamma.com\/about-me\/\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.thephdmamma.com\/about-me\/\">infant survival<\/a>. Racism has been built into medical care, and many doctors still believe in biological differences between Black and white bodies. For instance, one 2016 study even showed that some doctors believe that Black people have <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4843483\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4843483\/\">thicker skin and feel less pain<\/a>.<\/p>\n<p>Of course, doctors don&#8217;t necessarily need to be the same race as their patient to provide them with quality treatment. But more equitable care does require providers of all backgrounds to be aware of how implicit bias can show up in a doctor\u2019s notes, tests ordered, and patient communication. This is why public health expert <a href=\"https:\/\/pophealth.wisc.edu\/staff\/green-tiffany\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/pophealth.wisc.edu\/staff\/green-tiffany\/\">Tiffany Green, PhD,<\/a> is launching a class at the University of Wisconsin-Madison that teaches medical school students about racial disparities in healthcare. \u201cI can&#8217;t tell you how many doctors, including obstetricians, are just now learning about reproductive health disparities,\u201d she says. \u201cSo I&#8217;ll be teaching what is probably one of the first, if not the first, medical school classes on race and obstetrics in American obstetrics and gynecology.\u201d<\/p>\n<p>Dr. Green emphasizes that surviving pregnancy and childbirth shouldn\u2019t just be the responsibility of the pregnant person, and that often the disparities begin before conception. She explains that history is rife with examples of Black and brown, and even Irish, bodies being used solely for the advancement of gynecology: They were treated as test subjects instead of people, and often without anesthesia. \u201cWhen we&#8217;re talking about the solutions to this problem, and asking universities to be a part of promoting evidence-based solutions to this problem, start with a true acknowledgment of why this problem exists,\u201d she says. Med students in her class will gain an understanding of this long history of doctors ignoring Black women&#8217;s pain.<\/p>\n<h2>University-led research can highlight where interventions are needed<\/h2>\n<p>Last year, Tufts University launched <a href=\"https:\/\/blackmaternalhealth.tufts.edu\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/blackmaternalhealth.tufts.edu\/\">The Center for Black Maternal Health and Reproductive Justice<\/a>. This center is a part of its medical school, and as one of a handful of universities looking to close the maternal health gap, is focused on researching the racial disparities that continue to feed it. Similarly, health equity researcher <a href=\"https:\/\/directory.sph.umn.edu\/bio\/sph-a-z\/rachel-hardeman\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/directory.sph.umn.edu\/bio\/sph-a-z\/rachel-hardeman\">Rachel Hardeman, PhD, <\/a>founded the <a href=\"https:\/\/carhe.umn.edu\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/carhe.umn.edu\/\">Center for Antiracism Research for Health Equity<\/a> at the University of Minnesota. She has conducted extensive research on birth outcomes in heavily policed areas, and on<a href=\"https:\/\/1410c6d1-d135-4b4a-a0cf-5e7e63a95a5c.filesusr.com\/ugd\/c11158_150b03cf5fbb484bbdf1a7e0aabc54fb.pdf\" target=\"_blank\" rel=\"noopener nofollow\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/1410c6d1-d135-4b4a-a0cf-5e7e63a95a5c.filesusr.com\/ugd\/c11158_150b03cf5fbb484bbdf1a7e0aabc54fb.pdf\"> racial concordance of doctors and birth outcomes for Black babies<\/a>.<\/p>\n<p>\u201cBy establishing and prioritizing centers for maternal and infant health research, policy, and birth equity, dedicated funding can help close the maternal and infant health mortality gap through targeted, evidence-based interventions,\u201d says <a href=\"https:\/\/www.thephdmamma.com\/about-me\/\" referrerpolicy=\"no-referrer-when-downgrade\" rel=\"nofollow\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.thephdmamma.com\/about-me\/\"><span style=\"font-weight: 400;\">Quantrilla Ard, PhD, PMH,<\/span><\/a>\u00a0a maternal and infant health advocate, who adds that from education comes quality, empathetic care.<\/p>\n<h2>Government is aware, but legislation takes time<\/h2>\n<p>With a problem of this magnitude, you&#8217;d expect the government to get involved as well. And there are some strides being made. The <a href=\"https:\/\/blackmaternalhealthcaucus-underwood.house.gov\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/blackmaternalhealthcaucus-underwood.house.gov\">Black Maternal Health Caucus<\/a> in Congress is bringing the concerns of Black parents to the forefront and inspiring legislative action, like the recently reintroduced <a href=\"https:\/\/www.wellandgood.com\/momnibus-bill\/\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.wellandgood.com\/momnibus-bill\/\">Momnibus Act<\/a>, made up of 12 individual bills that target Black maternal health equity through efforts around affordable housing and transportation, mental health care, nutrition, and support for women in prison.<\/p>\n<p>\u201cOther proposed legislation such as the <a href=\"https:\/\/www.whitehouse.gov\/build-back-better\/\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.whitehouse.gov\/build-back-better\/\">Build Back Better<\/a> bill and <a href=\"https:\/\/www.congress.gov\/bill\/117th-congress\/senate-bill\/1234\/text?q=%7B%22search%22%3A%5B%22Maternal+CARE+Act%22%5D%7D&amp;r=1&amp;s=3.\" target=\"_blank\" rel=\"noopener\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.congress.gov\/bill\/117th-congress\/senate-bill\/1234\/text?q=%7B%22search%22%3A%5B%22Maternal+CARE+Act%22%5D%7D&amp;r=1&amp;s=3.\">Maternal Care Act<\/a> all work together to build the infrastructure necessary to reduce and eliminate maternal and infant morbidity and mortality,\u201d Dr. Ard says. She believes these strides will start to change the systems that put Black birthing people and their babies at risk.<\/p>\n<p>Yet it&#8217;s anyone&#8217;s guess when this legislation might kick in, if it ever does. So in the meantime, nonprofit organizations like the <a href=\"https:\/\/www.wellandgood.com\/bmma-maternal-mortality\/\" referrerpolicy=\"no-referrer-when-downgrade\" data-vars-event=\"body text\" data-vars-click-url=\"https:\/\/www.wellandgood.com\/bmma-maternal-mortality\/\">Black Mamas Matter Alliance<\/a> are shifting cultural understanding of the issue so that more Americans are aware of the problem and can start making noise about its dire consequences.<\/p>\n<p>Altering the trajectory of the birthing experience will require changes in all areas of healthcare. Working together is imperative. Fixing health and, specifically, birth disparities, must touch every level of our society, from the government to the very classrooms where future frontline medical staff are trained.<\/p>\n<\/p><\/div>\n<div data-type=\"_mgwidget\" data-widget-id=\"1675549\">\r\n<\/div>\r\n<script>(function(w,q){w[q]=w[q]||[];w[q].push([\"_mgc.load\"])})(window,\"_mgq\");\r\n<\/script>\r\n\n","protected":false},"excerpt":{"rendered":"<p>The United States is a medical pioneer, offering some of the most advanced healthcare in the world and many of the top, leading-edge medical innovations. However, this country nonetheless has an alarming maternal mortality rate, with nearly 33 deaths per 100,000 births\u2014a rate that has quadrupled in the last 30 years. Statistics from the Centers &hellip;<\/p>\n","protected":false},"author":3,"featured_media":5197,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-5196","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts\/5196","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5196"}],"version-history":[{"count":0,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/posts\/5196\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=\/wp\/v2\/media\/5197"}],"wp:attachment":[{"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5196"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5196"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/loudhdtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5196"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}