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Pregnancy-Related Deaths Are a Serious Women’s Health Disparity. How Can We Improve?

For many expectant mothers, worries can build from the moment the test turns positive. One thing they shouldn’t have to fear is dying during pregnancy or childbirth, but that’s a real possibility for too many women, particularly those who are African-American.

 

The pregnancy-related mortality rate has doubled in the past 25 years, according to the Centers for Disease Control and Prevention, and black mothers are much more likely to die in childbirth than white mothers. According to America’s Health Rankings’ 2018 Health of Women and Children Report, expectant African-American mothers die at a rate of 47.2 deaths per 100,000 live births compared with 18.1 for white mothers -- one of the widest disparities in women’s health. The gap is particularly acute in Louisiana, Texas, New Jersey, Missouri and New York, where the maternal death rate among expectant black mothers exceeds 50 deaths per 100,000 live births.

Some factors behind these statistics include rising rates of chronic diseases such as obesity, hypertension and cardiovascular disease among minority groups. However, systemic issues abound. According to healthypeople.gov, social determinants such as access to health care and early intervention programs, as well as educational, employment and economic opportunities influence outcomes. Additionally, inequities in the level of medical care for expectant black mothers play a major part.

Given these disparities, it’s important to support expectant black mothers in taking control of their health before, during and after their pregnancy. Expectant mothers can help reduce the risks that come with pregnancy and childbirth by taking the following actions.

  • Preconception health: Healthy pregnancies begin before conception. Treatment of chronic illnesses – particularly cardiovascular diseases – before getting pregnant will help reduce complications.
  • Prenatal care: Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care, according to womenshealth.gov. Expectant mothers should schedule a visit as soon as they know they are pregnant and talk to their doctor about their family, medical and pregnancy history, current physical and mental health concerns, as well as their diet and exercise routine.
  • Proper nutrition: A balanced diet and a healthy weight during pregnancy can improve outcomes for mother and baby. Expectant mothers should ask their doctor if prenatal vitamins may be right for them.
  • Be vocal about your medical care: Patients have a right to know everything that relates to their medical treatment. Expectant mothers should be encouraged to ask questions or raise concerns about their level of care or treatment, including routine procedures and tests.

There are also numerous community resources available for expectant moms, including two from UnitedHealthcare. Baby Blocks is an online program that rewards pregnant women and new parents for staying on top of their prenatal and well-baby care. Healthy First Steps helps improve pregnancy outcomes through case management and robust support services.

Early engagement with pregnant mothers, enhanced support for care providers, an enriched health care experience and access to community partners are keys to healthy pregnancies for all women.