Why Are Black Women More Likely to Die from Childbirth?
February 16, 2021
There is a crisis in U.S. maternal healthcare. Not only are the mortality rates for mothers-to-be and babies the highest among our developed country peers, but African American mothers and their infants experience mortality rates far higher than for any other part of the population. The Center for American Progress shares just how bad those numbers are, offering, “African American women across the income spectrum and from all walks of life are dying from preventable pregnancy-related complications at three to four times the rate of non-Hispanic white women, while the death rate for black infants is twice that of infants born to non-Hispanic white mothers.” In addition, women who survive their pregnancies are also more likely in the U.S. to experience life-threatening pregnancy-related complications, also known as severe maternal morbidity (SMM). The same source tells us that “African American women [are] twice as likely to experience SMM compared with non-Hispanic white women. What’s more, African American mothers are twice as likely to have an infant who dies by their first birthday.”
The Unfortunate Truth of Racism in Healthcare
Harvard Medical School writes unsparingly that “It is well-established that blacks and other minority groups in the U.S. experience more illness, worse outcomes, and premature death compared with whites. These health disparities were first ‘officially’ noted back in the 1980s, and though a concerted effort by government agencies resulted in some improvement, the most recent report shows ongoing differences by race and ethnicity for all measures.” According to Scientific American, an implicit bias test of healthcare professionals claiming to be free of racial bias showed that those workers “demonstrated a significant preference favoring white Americans, while their perception of Black Americans was negative relative to cooperation with medical procedures. The study also found that the more physicians were implicitly biased towards white people, the more likely they were to perform certain treatments on white patients in comparison to Black patients.”
A Celebrity Example of Bias in Healthcare – Serena Williams
Harvard Public Health offers the example of tennis superstar as a case of bias in healthcare. Her experience began “the day after delivering her baby, Olympia, by emergency C-section, [when] Williams lost her breath and recognized the warning signs of a serious condition.” Fearing a blood clot she asked for a CT scan and a dose of heparin, but a nurse initially downplayed her request. Blood clots were eventually identified after her insistence. During this process, however, “Severe coughing had opened her C-section incision, and a subsequent surgery revealed a hemorrhage at that site. When Williams was finally released from the hospital, she was confined to her bed for six weeks.” Imagine what happens to women with similar complaints without the healthcare access and experience with making themselves heard.
Cultural Humility Training
A very important strategy for fighting racism in healthcare is to institute training on a cultural humility model. The Center for American Progress advises that healthcare providers must learn to be “affirming of and sensitive to cultural differences.” It also suggests that “A service-learning component should be part of all cultural humility trainings, which would require physicians and nurses to work in underserved communities to get a better sense of their patients’ lived experiences. Perceptions about biological differences between racial groups, particularly those pertaining to African Americans—for example, that they have ‘tougher skin’—must be dismantled.”
Foster a More Diverse Maternity Caregiver Workforce
Attention also needs to be paid to the diversity of the maternity care workforce. The Center for American Progress cites a “report from the ACOG found that in 2016, only 11 percent of OB-GYNs were African American. For women who choose to give birth in a hospital or clinic setting, a diverse medical team is important for building trust and understanding between a pregnant woman and her care team. This relationship is particularly important for black women, who have suffered a long history of obstetric violence and abuse in the medical system. Black women will feel more comfortable receiving the support of a care team that looks like them—they will feel listened to, looked after, and respected for their life experiences.
Promoting Diversity and Inclusion in Healthcare
In order to provide quality care and positive outcomes for all patients, it is imperative to address and manage diversity and inclusion. There are many implications to this topic and its impact on morale, quality of care, cost of patient attrition, and healthcare disparity. Create a culture with no tolerance for bias by pausing, planning, and practicing positive interactions. A workforce that understands the importance of recognizing unconscious bias, diversity in the workplace, cultural competence, and health literacy not only improves peer-to-peer and caregiver-to-patient relationships, but also has the power to influence your organization’s bottom line. Explore HealthStream diversity and inclusion training solutions for healthcare.