Pregnancy related mortality can be defined as death of the mother during pregnancy, delivery, or within one year postpartum. Every pregnancy-related death is tragic, especially because two in three of them are preventable. Recognizing the warning signs and providing timely treatment and quality care can prevent many pregnancy-related deaths.
Black women are three times more likely to die from a pregnancy-related cause than White women. According to the CDC, black mothers in the U.S. die at three to four times the rate of white mothers, one of the widest of all racial disparities in women’s health. Put another way, a black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, but 243 percent more likely to die from pregnancy- or childbirth-related causes.
In a national study of five medical complications that are common causes of maternal death and injury, black women were two to three times more likely to die than white women who had the same condition. Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias. Social determinants of health have historically prevented many people from racial and ethnic minority groups from having fair opportunities for economic, physical, and emotional health.
Overall pregnancy related mortality in the United States occurs at an average rate of 17.2 deaths per 100,000 live births. However, that number jumps to 43.5/100,000 for Black women.
For mothers of all backgrounds, leading causes of death include cardiovascular conditions, hemorrhage, and infection. However, for Black women, leading causes of death include cardiovascular conditions in addition to cardiomyopathy, pre-eclampsia, and eclampsia (hypertensive disorders).
For much of American history, these types of disparities were largely blamed on black women’s supposed innate susceptibility to illness — their “mass of imperfections” — and their own behavior. But now, many social scientists and medical researchers agree, the problem isn’t race but racism.
Over and over, black women told of medical providers who equated being African American with being poor, uneducated, noncompliant, and unworthy. “Sometimes you just know in your bones when someone feels contempt for you based on your race,” said one Brooklyn woman who took to bringing her white husband or in-laws to every prenatal visit. Much too often, Black women are subject to discrimination in the health care field — 22 percent report discrimination when going to the doctor or clinic.
Public policies and medical practice should incentivize providing patient-centered care that focuses on Black women’s individualized needs, including non-clinical, social needs. Moreover, policies should endeavor to eradicate cultural biases and discrimination in medical practice and medical education, increase provider diversity in maternity care and hold individual providers and hospital systems accountable if they fail to provide unbiased, high-quality, evidence-based care.
For black women, the risks for pregnancy likely start at an earlier age than many clinicians — and women— realize, and the effects on their bodies may be much greater than for white women. This doesn’t mean that pregnancy should be thought of as inherently scary or dangerous for black women (or anyone). Health care should be respectful, culturally competent, safe and of the highest quality.