July: Maternal health disparities in the U.S.

Written by Alka Dev

POint of View:
How we can improve maternal health before, during, and after pregnancy

Dr. Elizabeth Howell identifies several systemic issues that contribute to maternal health disparities. These include a lack of access to healthcare services, inadequate prenatal and postpartum care, insufficient support for mothers during the perinatal period, and implicit biases among healthcare providers. These issues are often compounded for women of color, who face additional challenges such as racism, discrimination, and socioeconomic disadvantages. Dr. Howell offers solutions such as increasing access to healthcare services, improving communication between healthcare providers and patients, and addressing implicit biases and emphasizes the need for a comprehensive and equitable approach to maternal healthcare.

Resource:
Birth Stories in Color

BSiC is a website that aims to amplify and celebrate the voices and experiences of Black and Brown birthing people. The website features a podcast that shares personal birth stories, as well as blog posts, resources, and a directory of birth workers of color. The podcast highlights the diverse experiences and perspectives of Black and Brown birthing people, including those who have faced systemic barriers and discrimination within the healthcare system. The website also provides information and resources to help birthing people make informed decisions about their care, and to support them in finding culturally responsive and compassionate care providers.

News Story:
In Louisiana, pregnant women struggle to get maternal health care, and the situation is getting worse

This 13-minute segment highlights the struggles women face in accessing quality maternal healthcare in Louisiana, a state with one of the highest maternal mortality rates in the country. Black women in Louisiana are three times more likely to die from pregnancy-related causes than White women. The segment follows the stories of several women who have experienced complications during pregnancy and childbirth and struggled to receive adequate care. The segment also explores the systemic issues that contribute to these disparities, including a lack of investment in healthcare infrastructure, a shortage of healthcare providers, and systemic racism and bias. The segment calls for systemic change, including increased funding for healthcare infrastructure, policies to address systemic racism and bias in healthcare, and efforts to center the voices and experiences of women and mothers in these efforts.

Scientific Publication:
Maternal and Infant Health Inequality: New Evidence From Linked Administrative Data

This study provides evidence of maternal and infant health inequities due to income and racial bias. By linking several administrative datasets from California, the researchers found that low birth weight (LBW) and preterm birth, were not consistently better for babies born to richer parents. Children of parents in the top 20% of income had lower average birth weight and higher LBW than children born to people in the bottom 20%, which is different from other outcomes like life expectancy that consistently increase with income. A major reason for this discrepancy was that worse birth weight outcomes at higher income levels were due to higher average parental age and a greater share of non-singleton births among those families. Advance maternal age is a known risk factor as well as lower birth weight and shorted gestation among multiple births (twins triplets etc.). However, infant mortality did not show this pattern. Children of richer parents were more likely to survive than children of poorer patients - meaning that even though their pregnancies were riskier, richer parents’ babies were least likely to die. These pregnancies were the most protected by resources such as high quality childcare and paid family leave despite their risk. The same relationships were observed for maternal mortality as well. Finally - and incredibly important - across all income levels, Black infants and mothers have much worse health than their non-Hispanic White counterparts. LBW and preterm birth rates for infants of Black parents in the top of the income distribution was around 1.5 times higher than those for infants of White parents in the bottom of the income distribution while the maternal mortality rate among the richest black mothers was similar to that among the poorest White mothers. The rates for these two groups never converged.