Missing Maternal Health

In the United States, women of color are more likely to die due to pregnancy-related complications than white women. Women of color are less likely to access affordable and quality health care, as well as timely maternal care, impacting their ability to achieve quality maternal health outcomes. Over 30% of Black women and over 40% of American Indian and Alaskan Native women do not receive proper prenatal care. Black women are less likely than other women to receive preventative care for chronic health problems, such as hypertension, that contribute to maternal death.

California is the only state to show consistent reductions in maternal mortality, having reduced maternal mortality deaths from 16.9 per 100,000 live births in 2006 to 7.3 in 2013. However, racial disparities among California women remain. In 2019, non-Hispanic Black women experienced 63.9 deaths per 100,000 live births, non-Hispanic white women 17 deaths, Hispanic women 14.6 deaths, and Asian/Pacific Islander women 4.1 deaths.

On September 10, 2019, the California Dignity in Pregnancy and Childbirth Act was passed to reduce racial disparities in maternal mortality. The Act requires hospitals, alternative birth centers, and primary clinics providing perinatal care to establish evidence-based implicit bias training for perinatal healthcare providers.

Enacting a policy similar to the California Dignity in Pregnancy and Childbirth Act in Mississippi has the potential to create conditions for improving maternal health outcomes and narrowing racial disparities.

People of color have experienced systemic inequity for years. Implicit bias training is one method of making individuals aware of their unintentional involvement in perpetual discrimination and inequity. Individuals confront their biases and privileges to help them reduce their discriminatory thoughts and practices. By completing bias training, perinatal health care providers can prevent prejudice and stereotyping from negatively affecting birth and maternal health outcomes.

The California Dignity in Pregnancy and Childbirth Act has the potential to reduce racial disparities in maternal mortality. States with racial disparities in maternal deaths should adopt a policy like the California Dignity in Pregnancy and Childbirth Act.

Mississippi is one such state. A 2017 review by the Mississippi Maternal Mortality Review Committee found that the overall pregnancy-related mortality ratio for Mississippi women from 2013 to 2016 was 22.1 deaths per 100,000 live births. During the same period, non-Hispanic Black women were almost three times more likely than  non-Hispanic white women to die from pregnancy-related causes. The for non-Hispanic Black women ranged from 51.9 to 64.1 deaths per 100,000 live births to 18.9 to 36.7 deaths for non-Hispanic white women. These disparities are linked to the challenges uninsured Mississippi women face in accessing quality maternal health.

At the moment, Mississippi is not working towards implementing perinatal implicit bias training to improve maternal and child health. Doing so would be an important and low-cost method of improving the lives of many women of color predisposed to health conditions that make them vulnerable for mortality during pregnancy and/or childbirth. Enacting a policy similar to the California Dignity in Pregnancy and Childbirth Act in Mississippi has the potential to create conditions for improving maternal health outcomes and narrowing racial disparities.

Photo via Getty Images