High Rates of Maternal Mortality for Women of Color
Birth is supposed to be a beautiful moment for families as they celebrate new life entering the world. However, women of color are three to four times more likely to die of birth or pregnancy complications than their white counterparts (CDC 2017). Instead of celebrating new life, families are mourning loss of life. The cause of this disparity, as well as how these deaths can be prevented and the effect of a mother’s death on her family, are explored in this paper.
While doctors are sworn to practice certain ethical standards, various factors may influence doctors in breaking this oath, racism included. When it comes to POC patients, doctors seem to be failing to uphold their vow. The fact that 43.5 (per 100,000 births) black women die of birth-related complications compared to the much smaller 12.7 deaths of white women certainly indicates discrepancies in the treatment of women of color (CDC, 2017). One woman’s birth-related death exemplifies the discrimination against mothers of color. Shalon Irving, aged 36, died shortly after giving birth to her daughter despite being a member of the medical community and having more advantages than her uninsured, less wealthy counterparts (Martin, 2017). Women of color report that they are treated as “poor, uneducated, noncompliant and unworthy” by medical personnel. Thirty-three percent of black women reported discrimination due to their race by doctors and health clinic employees, and not surprisingly 21% reported avoiding seeking health care to avoid further acts of discrimination (NPR, Robert Wood Johnson Foundation, & Harvard T. H. Chan School of Public Health, 2017). Other women have reported a non-believability component — despite telling doctors of a health complication, doctors do nothing to investigate or alleviate the problem, as exemplified by one Nebraskan woman who had two heart attacks before doctors took action (Martin, 2017). Women of color are being treated poorly by medical staff, resulting in the avoidance of seeking medical help and, more tragically, a disproportionate percentage of deaths due to birth complications for black women.
A variety of birth complications may arise during or after birth. The most common cause of maternal death is hemorrhaging, followed by hypertensive disorders, and unsafe abortions (UNICEF, 2018). Additionally, some disease outbreaks may be associated with complications, such as influenza A (H1N1) during the spring of 2009 and summer of 2010 (WHO, 2017). Increasing numbers of pregnant women appear to suffer from chronic illnesses, such as diabetes and heart disease (CDC, 2017). However, doctors should know about these conditions during and after pregnancy and childbirth and should be prepared for complications resulting from these diseases. Yet it would seem that important actions are not being taken. Women of color are dying because of the inaction of some medical professionals.
In the late 1990s through the early 2000s, a movement began to reduce maternal mortality across the world (Bustreo et al., 2013). Though the suggestions created to help end maternal mortality were created specifically for developing countries, some suggestions seem applicable to the United States. For instance, McCarthy and Main (1992) suggest that prevention must achieve one of three goals in order to be effective at reduction: reduce pregnancy rates, reduce potential for serious complications during pregnancy or childbirth, and/or improve the outcomes for women experiencing complications. While reduction of falling pregnant largely falls on the women to take birth control or practice abstinence (and allows blame to be laid on women for getting pregnant in the first place), the latter two implicate that doctors and medical personnel need to take action. Doctors and other medical personnel must work to overcome any racial discrimination against their patients if they are to prevent complications from occurring or act with efficiency if a complication does occur.
Despite reported decreases in maternal mortality globally, more work must be done in order to further understand causes of birth-related deaths and create better ways of preventing such deaths (Bustreo et al., 2013). According to UNICEF, the United States had a maternal mortality rate of 25 deaths per 100,000 births by 2015. Yet, black females are dying of birth complications at much higher rates in the year 2017, about 44 deaths per 100,000 births (CDC, 2017). According to UNICEF (2018), a large majority of maternal mortality can be prevented. And it should be prevented.
Maternal death has severe effects on the family, causing emotional turmoil and financial difficulties. While many studies focus on the topic of maternal loss in developing countries, the conclusions still seem applicable to the United States. Of course, families grieve the loss of life and the mourning cycle can take years. Additionally, financial instability, loss of role model, and difficulty managing the household can also result (Tulloch, 2015). Moreover, maternal death may be followed by infant death soon thereafter (Moucheraud et al., 2015). If the baby does survive, older siblings and grandparents may have to fill the role of mother and housekeeper (Pande et al., 2015) which undoubtedly adds more stress to these already vulnerable members of the family. If the funeral of Shalon Irving is any example, family and friends mourn horrifically for the loss of a mother’s life and must come together to help raise an infant who is without her mother (Martin, 2017) After all, it takes a village to raise a child who has a mother. Imagine the difficulty a mourning village endures raising a motherless baby.
The rate of maternal mortality for black women in the United States is not only preventable, it is inexcusable. Actions need to be taken by medical professionals (perhaps even as part of medical schooling) to reduce racial discrimination by doctors toward patients of color in order to halt the tragedy of so many unnecessary, preventable deaths.
References
Bustreo, F., Say, L., Koblinksy, M., Pullum, T. W., Temmerman, M., & Pablos-Méndez, A. (2013). Ending preventable maternal deaths: The time is now. The Lancet, 4(1), e176–e177, DOI: https://doi.org/10.1016/S2214-109X(13)70059-7
CDC. (2017 November 9). Pregnancy mortality surveillance system. Retrieved from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html
Martin, N. (2017 December 7). Black mothers keep dying after giving birth. Shalon Irving’s story explains why. National Public Radio. Retrieved from https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dying-after-giving-birth-shalon-irvings-story-explains-why
Moucheraud, C., Worku, A., Molla, M. , Finlay, J. E., Leaning, J., & Yamin, A. E. (2015). Consequences of maternal mortality on infant and child survival: A 25-year longitudinal analysis in Butajira Ethiopia (1987–2011). Reproductive Health, 12(Suppl 1):S4. https://doi.org/10.1186/1742-4755-12-S1-S4
McCarthy, J. & Maine, D. (2013). A framework for analyzing the determinents of maternal mortality. Studies in Family Planning, 1(23), 23–33. Retrieved from http://www.jstor.org/stable/1966825
NPR, Robert Wood Johnson Foundation, & Harvard T. H. Chan School of Public Health. (2017). Discrimination in America: Experiences and views of African Americans. National Public Radio. Retrieved from https://www.npr.org/assets/img/2017/10/23/discriminationpoll-african-americans.pdf
Pande, R. P., Ogwang, S., Karuga, R., Rajan, R., Kes, A., Odhiambo, F. O., Laserson, K., & Schaffer, K. (2015). Continuing with “…a heavy heart” — consequences of maternal death in rural Kenya. Reproductive Health, 12(Suppl 1):S2. https://doi.org/10.1186/1742-4755-12-S1-S2
Tulloch, T. (2015 May 6). The economic and social impacts of maternal death. BMC. Retrieved from http://blogs.biomedcentral.com/on-health/2015/05/06/economic-social-impacts-maternal-death/
UNICEF. (2018). Maternal mortality fell by almost half between 1990 and 2015. Retrieved from http://data.unicef.org/topic/maternal-health/maternal-mortality/#
