Maternal Mortality Disparities

The United States has one of the highest maternal mortality rates (MMR) in the developed world? The MMR measures the number of mothers that have died due to complications of pregnancy, childbirth, and postpartum effects within 42 days of their pregnancy ending. This rate has increased significantly over the past few decades with over half of these deaths being preventable. However, examining MMRs between different racial groups offers a unique perspective for this statistic; African American and Native American/Alaskan Native women are three to four times more likely to die from pregnancy-related issues compared to Hispanic, non-Hispanic White, and Asian women. Let’s work to better understand why this may be:

1. Are there biological differences that promote a different course of care based on one’s race? Not a large scale level, and this a very common misconception in the medical field. Implicit bias based off of stereotypes regarding African Americans heavily contribute to the lower standard of care many patients receive. For example, Black patients are often prescribed less pain medications when compared to white patients who have the same complaints because it is incorrectly believed that they have thicker skin. It is true that Black women are more likely to have chronic health conditions, such as obesity and hypertension, which increase the risk of having pregnancy-related complications, however, it is important to examine the root cause. The higher prevalence of these health conditions is the outcome of structural racism - food deserts, higher exposure to environmental toxins, lack of adequate housing options, etc. - rather than biological factors.
2. Is it possible that the disparity is due to other factors such as socioeconomic status (SES) or education? Many reports have shown that the disparity for African American mothers persists, with the same strength, even after controlling for SES and education level. College-educated Black women are still three times more likely to die due to pregnancy, childbirth, and postpartum complications compared to similarly educated non-Hispanic white women.
3. How can Caralyst help? The high MMR in the United States is largely due to the implicit bias and structural racism that is rampant within our healthcare system. The remedy to this issue is more implicit bias training during medical education and rethinking standards and reference models, since BIPOC and women are often underrepresented in these. While this institutional change will take decades, Caralyst aims to provide a more immediate solution by matching African American and Indigenous women with physicians who have experience working with patients of their race and are committed to offering underserved populations the standard of care they deserve.