Racial Disparities Among Maternal Mortality Rates

by Anastasia Klipa and Ellen Durkin

October 21, 2020

According to the CDC, Black mothers die at three to four times the rate of white mothers in the United States of America. This means that Black women are 243 percent more likely to die from pregnancy or childbirth-related issues than white women. This alarming statistic depicts one of the widest racial disparities in women's health, which has tragically been around for centuries.

The racial disparities present among maternal mortality rates is a phenomenon that has been, and continues to be, studied. Evidence suggests that the disparities are a product of the harmful racial discrimination faced by Black women within the healthcare institution. A 2017 survey published by NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health, found that 33 percent of Black women reported personally having been discriminated against because of their race when going to a doctor or health clinic, and 21 percent reported that they have avoided going to a doctor or seeking treatment out of concern they would be racially discriminated against. Hundreds of heartbreaking stories collected by NPR and ProPublica document the tragic realities behind these statistics - from a mother in Florida who was told her breathing problems were the result of obesity, when in reality her lungs were filling with fluid, to an Arizona mother whose anesthesiologist assumed she smoked marijuana because of the way she styled her hair.

Data analysis has concluded that higher mortality rates among Black women are not necessarily connected to other disparities, such as socio-economic inequalities, as Black college-educated mothers who gave birth in local hospitals were still more likely to suffer severe complications of pregnancy and/or childbirth than white women who never graduated from high school. Therefore, even Black women who have greater social and economic advantages than some white women, are still more likely to die from complications arising from pregnancy or child-birth due to systemic issues within the healthcare system.

The racial disparities evident among maternal mortality rates shed light upon the broader issue of institutionalized racism and prevailing prejudices present in our healthcare system. According to a 2016 study published in the Proceedings of the National Academies of Science, half of trainees surveyed held one or more false beliefs, such as “Black people’s nerve endings are less sensitive than white people’s,” “Black people’s skin is thicker than white people’s,” and “Black people’s blood coagulates more quickly than white people’s.” It was reported that 40% of first- and second-year medical students endorsed the belief that “Black people’s skin is thicker than white people’s.” These perpetuated false notions and misconceptions continue to drive the mistreatment of Black patients and foster dangerous biases and patient care practices leading to tragic, but avoidable, outcomes.

The Black Mamas Matter Alliance is a Black women-led cross-sectoral alliance dedicated to advocating, driving research, building power, and shifting culture for Black maternal health, rights, and justice. They fight to eliminate the disparities and biases that put Black women in danger. We encourage readers to visit their website and engage with their impactful work.

It is vital that the American healthcare system actively works to identify and eliminate institutionalized racism, prejudices and biases present within itself. To ensure proper care is administered to all patients, healthcare students, personnel, and professionals need to be made aware of racial disparities, prevailing biases, and become educated on how to combat the prejudices in our system so that patients are not mistreated.

Following the protests regarding the death of George Floyd, multiple nursing groups have spoken out on racism in the field. National Nurses United, the American Association of Colleges of Nursing, the American Association of Nurse Practitioners, and the American Nurses Association all issued statements, highlighting how relevant the issue is in the nursing field. Ernest J. Grant, PhD, RN, FAAN and President of the ANA was recently interviewed regarding the issues related to racism. “The Code of Ethics for Nurses obligates nurses to be allies and to advocate and speak up against racism, discrimination and injustice. This is non-negotiable," says Grant.

As a Black man and a nurse, he talked about how he has experienced racism in medical settings. “I've taken care of patients who were white supremacists and they made it very blatant that they did not want any black person taking care of them. It's something that we experience in healthcare all the time,” says Grant. As for his thoughts on change in this industry, Grant believes that, “the only way we're going to see change is if people don't become complacent and they speak up and be the voice of change. Racism is a public health crisis, and I think as nurses, the most important thing that we can do is to educate ourselves and use the fact that we do have the trust of the [public] to influence and educate others and to realize the systemic injustice that is going on.”

It is important to remember a lot of the fatalities and mistreatments in the healthcare field can be avoided with appropriate training. Ethics education provides training medical personnel with the opportunity to address ethical questions that may arise in their workplace. In addition to ethics training, doctors and nurses need sufficient training with simulations prior to and while working with real patients.

“We're building new Learning Modules within our InSight Platform that focus on maternal care and diversity. We appreciate the guidance and contributions from our clinical and community collaborators as we develop this content.” - Doug Nelson, Lumis CEO

Please feel free to browse our other articles that explore the topic of diversity in simulation to learn more about relevant racial issues and challenges currently present in the world of simulation.

To learn more about Lumis Corp, visit our website at Lumiscorp.com

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