Black women in the United States face unacceptably poor maternal health outcomes, including high death rates during pregnancy or childbirth. While pregnancy-related deaths have declined dramatically over the last century, further reductions are a vital public health priority. This is especially true for ethnic minority and socioeconomic groups whose mortality remains disproportionally high.
The World Health Organization (WHO) defines maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”
Overall, Black women are three to four times more likely to experience a maternity-related death than white women. In addition, their chances of experiencing preventable maternal death are more significant, and the heightened risk spans income and education levels, reports the National Partnership for Women & Families.
The Centers for Prevention and Disease Control (CDC) reported that 754 women died of maternal causes in the U.S. in 2019 compared to 658 in 2018. The 2019 rate of 20.1 deaths per 100,000 live births is a significant increase over 2018 at 17.4. Two hundred and six non-Hispanic Black women died in 2019, or the rate of 44 deaths per 100,000 — 2.5 times higher than non-Hispanic white women.
Many factors focus when evaluating the differences between Black maternal health and white. These include racism, sexism, and other systemic barriers such as income inequality.
Non-Hispanic Black women are typically paid 63 cents for every dollar a non-Hispanic white man earns. According to the National Partnership for Women & Families, the wage disparity means Black women and their families have less money to support themselves, which means they may have to choose between housing, child care, food, and health care, according to the National Partnership for Women & Families.
These trade-offs are apparent in the health outcomes and use of medical care for Black women. A significant problem is access to affordable medical insurance. Black women face more significant financial barriers when needing medical care and are less likely to access prenatal care. Compared to white women, they experience higher rates of preventable diseases and chronic health conditions such as cardiovascular disease, diabetes, and hypertension. When pregnant, those with medical problems have a higher poor maternal and infant health rate.
Black women also experience more health complications throughout their pregnancies than white women. They have a greater possibility of developing benign tumors and fibroids that grow in the uterus that can cause postpartum hemorrhaging. According to U.S Health and Human Services, fibroids are more common, more severe, and occur at a younger age than in white women.
Another condition that Black women show signs of earlier than white women is preeclampsia, which involves high blood pressure during pregnancy. Preeclampsia can lead to dangerous complications and death if treated improperly.
Exposure to chronic stress linked to socioeconomic disadvantage, systemic racism, and structural violence ages a person faster, causes physical “weathering,” and negatively affects pregnancies. This makes pregnancy riskier at an earlier age for Black women.
Maternal mortality review committees seek to increase the understanding of the underlying and contributing causes of pregnancy-related deaths at such a high rate for Black women. Experts encourage medical professionals, community leaders, health advocates, patients, and family members to work together to identify the factors that lead to complications and develop practical strategies to avoid preventable situations. They should also be tasked with providing recommendations that could reduce pregnancy-related deaths, suggests the National Partnership for Women & Families.
Written by Cathy Milne-Ware
National Partnership for Women & Families: Black Women’s Maternal Health: A Multifaceted Approach to Addressing Persistent and Dire Health Disparities
SELF: 8 Health Conditions That Disproportionately Affect Black Women; by Zahra Barnes
Harvard Chan School News: How discrimination can harm black women’s health
USDA Health Resources and Services Administration: Maternal Mortality in the United States, 1935-2007:
Substantial Racial/Ethnic, Socioeconomic, and Geographic Disparities Persist; Gopal K. Singh, PhD
CDC: Maternal Mortality Rates in the United States, 2019
Interview: Dr. David Ansell; December 21, 2021
The University of Chicago Press: The Death Gap: How Inequality Kills; David D. Ansell, MD; 2017
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