Identifying Inequities in Black Maternal Health

Maternal health disparities in the United States are staggering. Pregnancy-related complications kill about three times more black women than white women. They are also more than twice as likely to have severe perinatal complications. Furthermore, black infants have the highest mortality rate of any race or ethnicity.

"We can see these maternal health disparities in our community, across the state, and nationally," says Tish Hill, nursing director of women and children's services at Henry Ford Jackson Hospital. "Right now, we're focusing on raising awareness and developing action plans to address this disparity." But, in my opinion, this is an urgent matter—we are in the midst of a national crisis."

According to Hill, there are several reasons for the large disparity in maternal health:

1.Having insufficient or no prenatal care. This could be due to socioeconomic factors such as a lack of transportation and other barriers to care. While Black mothers in lower socioeconomic brackets may face an increased maternal health risk, national data show that these inequities affect Black women regardless of socioeconomic status. According to the Association of American Medical Colleagues, "a college-educated Black woman faces a 60% higher risk of maternal death than a white woman with no high school diploma."

2.Being subjected to systemic racism and structural inequities. Black patients may experience implicit bias or a lack of respect from their healthcare providers. "This is why our providers receive implicit bias training," Hill explains. "It's critical that we understand our unconscious biases in order to better relate to and communicate with all of our patients." Furthermore, patients must trust their healthcare providers in order to report symptoms that may jeopardize their health."

3.Pregnancy-related education and post-birth warning signs are lacking. "Post-birth warning signs are symptoms that should be considered urgent," says Hill. "If someone experiences them, they should seek healthcare immediately." However, not all women are aware of the warning signs, which include a fever of more than 100.4 degrees Fahrenheit, pain or inflammation around a c-section incision, pain or burning when urinating, and intense lower-belly pain—among others.

While these maternal health statistics are concerning, efforts are being made both locally and nationally to change them. "At Henry Ford, we have a committee called the Diversity, Equity, Inclusion, and Justice (DEIJ), and their goal is to reduce infant and maternal morbidity and mortality," Hill explains. "We also require implicit bias and trauma-informed care training."

"We are also involved in state and national quality improvement collaborations, such as the Michigan Alliance for Innovation in Maternal Health" (MI AIM). In addition, we recently joined the Premier Inc., Perinatal Improvement Collaborative, a national collaborative. It connects us with a national company that examines our specific policies and outcomes and develops a customized plan for us to improve maternal and infant health. There are numerous plans in place, but we also need to raise awareness in order to focus on reducing it."