Promoting Health Equity for Women's Healthcare Month

5 Ways to Improve Maternal Mortality Rates in the US

Thousands of women in the United States give birth yearly, but not all survive. In the US, Black women are disproportionately affected by maternal mortality. Research has shown that the maternal mortality rate for Black women is 2-3 times that of White women (Hoyert, 2022). While there are various contributing factors, multiple solutions must be implemented. 

This Women's Healthcare Month, it is essential that we raise awareness about this critical issue. That is why we will explore the factors contributing to maternal mortality and five ways to improve maternal health outcomes. 

What is Maternal Mortality?

Maternal mortality refers to the death of a woman during pregnancy, childbirth, or within 42 days of delivery or termination of pregnancy (Hoyert, 2022). Therefore, maternal mortality rates (MMR) are calculated as the number of maternal deaths per 100,000 live births. 

In the US, the MMR has been steadily increasing, with a rate of 32.9 deaths per 100,000 live births in 2021 (Hoyert, 2022). Unfortunately, the harsh reality is that these numbers will continue to increase unless something is done to address disparities that adversely impact Black women. 

Disparities in Maternal Mortality Rates

Despite advances in modern medicine, maternal mortality rates in the US continue to be high. Moreover, there are significant disparities in maternal mortality rates by race and ethnicity. As mentioned, Black women are at an exceptionally high risk of dying from pregnancy-related complications than White women. Even though many in the healthcare field recognize maternal mortality amongst Black women as a severe issue, not everyone sees it that way.

For instance, Louisiana Senator Bill Cassidy said in response to a question about African Americans having a higher incidence of maternal mortality, "If you correct our population for race, we are not as much of an outlier as it would otherwise appear" (Levin, 2022). Not only are statements like this problematic, but they also illustrate a lack of acknowledgment that maternal mortality amongst Black women is a pressing issue.  

Factors Contributing to Maternal Mortality

Factor 1: Limited access to quality healthcare. 

Women without access to healthcare or limited access to prenatal care are at a higher risk of complications during pregnancy and childbirth. Whether that means that the healthcare facilities are difficult to access or the person is uninsured, we must acknowledge that access is a serious issue that can impact maternal health outcomes. 

Factor 2: Chronic health conditions.

Women with chronic health conditions such as diabetes or hypertension are more likely to experience difficulties during pregnancy. For instance, chronic health conditions can lead to preterm delivery and other complications that pose a significant risk to mother and child.

Factor 3: Racial and ethnic disparities.

As has been alluded to, structural racism and social determinants of health contribute to disparities in maternal health outcomes. Severe differences can impact maternal health, from unequal resource access to housing insecurity.  

Factor 4: Implicit bias in healthcare. 

Implicit biases, stereotypes, and prejudices among healthcare providers can impact the quality of patient care. When these unconscious processes are utilized to make medical decisions, inequalities increase in maternal health outcomes.

5 Ways to Improve Maternal Health Outcomes

Despite the many factors contributing to maternal mortality, there are ways to improve maternal health outcomes. However, doing so requires a comprehensive approach that addresses the root causes of maternal mortality. Here are some strategies healthcare providers can use to promote health equity and address disparities in maternal health outcomes.

Solution 1: Provide culturally competent care. 

Healthcare providers should receive training on cultural humility and competence to provide care responsive to the needs and values of diverse patient populations. From online courses to in-person workshops, this training can help transform healthcare. 

Solution 2: Address implicit bias. 

It should go without saying that healthcare providers should acknowledge and address their own implicit biases. Addressing implicit bias means recognizing when we are making assumptions and taking the time to challenge our preconceived notions to ensure that all patients receive equitable care.

Solution 3: Increase access to quality healthcare. 

Healthcare providers can work to increase access to prenatal care and other healthcare services for underserved communities. Access is essential for low-income women and women of color who experience significant burdens in access to care.

Solution 4: Improve care coordination. 

Healthcare providers can collaborate across healthcare systems to ensure that women receive comprehensive, coordinated care before, during, and after pregnancy. For example, research has shown that better coordination across healthcare systems can help reduce adverse health consequences for mothers and children (Hillemeier et al., 2015). 

Solution 5: Support policy change. 

Healthcare providers can advocate for policies that promote maternal health and reduce disparities. For instance, increasing Medicaid coverage for pregnant women or expanding access to paid family leave are policies that, when implemented, can significantly improve maternal health outcomes. 

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Therefore, the maternal mortality rate in the US is a critical issue requiring action from healthcare providers. In addition, disparities in maternal mortality rates by race and ethnicity highlight the need for an approach that addresses the root causes of maternal mortality, including implicit bias in healthcare, limited access to quality healthcare, and social determinants of health. 

Healthcare providers can take concrete steps to promote health equity and address disparities in maternal health outcomes, including providing culturally competent care, addressing implicit bias, increasing access to quality healthcare, improving care coordination, and supporting policy change. By working together, healthcare providers can help create a more equitable healthcare system and improve maternal health outcomes for all women.

Reference

Hillemeier, M. M., Domino, M. E., Wells, R., Goyal, R. K., Kum, H. C., Cilenti, D., Timothy Whitmire, J., & Basu, A. (2015). Effects of maternity care coordination on pregnancy outcomes: propensity-weighted analyses. Maternal and Child Health Journal, 19(1), 121–127. https://doi.org/10.1007/s10995-014-1502-3

Hoyert DL. Maternal mortality rates in the United States, 2020. NCHS Health E-Stats. 2022. https://doi.org/10.15620/cdc:113967

Levin, B. (2022, May 20). Louisiana Senator Bill Cassidy: Our maternal death rates are only bad if you count Black women. Vanity Fair. https://www.vanityfair.com/news/2022/05/bill-cassidy-maternal-mortality-rates