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Maternal Mortality & the Hidden Inequality for Black Mothers

Maternal Mortality & the Hidden Inequality for Black Mothers

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The hard reality is that African American women in the US are dying from preventable pregnancy-related complications.  In fact, Black maternal mortality rates are roughly four times higher than the rate of non-Black women in the US, according to the Centers for Disease Control.  

This staggering statistic begs the question, “Why are Black women more likely to die in childbirth?”  This article seeks to answer that question as well as investigate the causes of maternal mortality in Black mothers.

What is the definition of maternal mortality?

Maternal mortality is the result of a woman dying during or after childbirth.  The term also applies to a woman’s death occurring during pregnancy.  According to the World Health Organization, 75% of maternal mortality cases are caused by complications such as severe bleeding after childbirth, infections during or after giving birth, and high blood pressure (known as pre-eclampsia and eclampsia) during pregnancy.  

Other causes may include unsafe abortions and unforeseen complications during childbirth.  Pre-existing medical conditions in mothers such as diabetes or cardiac disease can also lead to premature deaths during pregnancy or childbirth. 

To be clear, women of all races, income, and all walks of life are vulnerable to complications pre, during, and post-pregnancy. However, African American women are one of the largest segments of the population who impact the maternal mortality rate definition. Therefore, they are in the strongest position to reform the medical community in order to render better outcomes and survival rates for Black mothers.  

What are the causes of maternal mortality in Black women?

In an effort to answer the question, “Why are Black women more likely to die in childbirth?” The Population Reference Bureau composed an exhaustive study, curating data from medical organizations across multiple sources.  

Their research concluded that the leading cause of a higher maternal mortality rate in Black mothers is due to preeclampsia and eclampsia, which is pregnancy-related high blood pressure.  The second and third leading causes of Black maternal mortality are cardiomyopathy (heart disease) and excessive hemorrhaging (bleeding). 

How do maternal mortality rates in the US compare and differ across races?

A journal published by the US Department of Health and Human Services uncovered disturbing statistics regarding maternal mortality rate by race.  The publication revealed that the Black maternal mortality rate was 3.5 times higher than among non-Black women.   A more current study conducted in 2020 by the Centers for Disease Control studied 100,000 live births in the US, which confirmed the alarmingly high rate of deaths in Black mothers.  Of these births, 55.3 Black mothers lost their lives during pregnancy.  Alternatively, there were only 19 deaths among white mothers and 18 deaths among Hispanic mothers during pregnancy.

What do maternal mortality rates look like across the US states?

According to the World Population Review, maternal mortality rate by state revealed that Louisiana and Georgia have the highest death rates, with 58 and 48 lives lost out of 100,000 births, respectively.  New Jersey and Alabama are in second and third place, with 38 and 36 lives lost out of 100,000 births, respectively.  The lowest maternal mortality rate in the US is found in California, with only 4 lives lost among 100,000 births per year.  

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The Black Women’s Health Study (BWHS)

The Black Women’s Health Study (BWHS) is an ongoing body of research conducted by Boston University that has been deeply investigating health issues among Black women in the US since 1995.  The study has revealed that women of color in the US are highly underrepresented, and therefore a direct correlation between Black maternal mortality and ethnicity is clearly evidenced in BWHS reports. 

How do Black maternal mortality rates in the US compare to other countries?

According to the American Journal of Medicine’s research on maternal mortality rate by country, the United States has the highest Black maternal mortality rate when compared to 11 other developed countries. Alternatively, Norway has the lowest mortality rate among mothers in the 11 developed countries studied.   Across all ethnicities, 17.4 maternal mortalities occurred in 2020 in the US. The 2nd highest maternal mortality rate is in France, which experiences only 8.7 deaths on average per year. The journal goes on to reveal that two-thirds of Black maternal deaths in the US are considered preventable.

Final thoughts

While knowing the statistics and leading causes of maternal mortality in Black mothers is informative, it still doesn’t conclusively answer the question, “Why are Black women more likely to die in childbirth?”  For this, medical administrators and advocates are investigating the imbalances within social infrastructure in the medical industry. 

Specifically, social research is beginning to reveal that Black women are more subject to racial discrimination as opposed to non-Black mothers.  As a result, many African American mothers are not receiving adequate medical care and attention, which could potentially prevent maternal mortality.  Ongoing efforts must be made to ensure mothers are fully treated and have access to proper natal care regardless of race. 

The Affordable Care Act (ACA) of 2010, was a boon for Black mothers, as it improved coverage for pregnant women by expanding Medicaid eligibility. With the passing of the Act, Black mothers now have better access to preventative and prenatal treatment such as regular screenings, testing, supplements, and other medical resources.  Moreover, the ACA provided women of color with more access to educational resources for better health practices before, during, and after pregnancy.  

This means that Black women are more adequately equipped to make better choices for their health and well-being.  For instance, women armed with better knowledge about their reproductive health are now utilizing ovarian reserve testing to assess viability for fertilization, as well as practicing better health habits during pregnancy to achieve optimal health results for themselves and their unborn children.

While this is encouraging, attention must still be paid to the reality of discrimination against Black mothers as a direct connection to an increased Black maternal mortality rate.  To explain, mothers who experience discrimination are understandably less likely to receive preventative wellness checks during pregnancy.  

These checks are essential to identify the aforementioned leading causes of maternal mortality rates in Black women.  Therefore, the medical industry must make more concerted efforts to eradicate discrimination in order for mothers of color to feel the freedom and respect required to get regular preventative care before, during, and after pregnancy.


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