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Closing the gap on racial disparities in maternal deaths

African-American maternal patientMaternal deaths are typical rare — with 700 occurring out of 3.8 million births each year. While the rest of the developed world has seen a significant decrease in maternal deaths from 2000-2015, the problem has grown in the United States.

According to the Centers for Disease Control and Prevention (CDC), African American, Native American and Alaska Native women are three times more likely than white women to experience pregnancy-related deaths. Yet despite repeated calls for improved medical care for women of color, the racial disparity continues to grow.

Maternal death facts and figures

Here are the fatality rates per 100,000 live births:

  • Hispanic women - 11.4
  • White women - 13
  • Native American/Alaska Native women - 32.5
  • African-American women - 42.8
  • All women over age 40 - 76.5

Researchers conclude that roughly 60 percent of all pregnancy-related deaths are preventable when patients have access to:

  • Quality health care
  • Communication and support
  • Stable housing and transportation

Health among black maternal patients has become an issue of discussion among many Democratic candidates in the 2020 presidential campaign — especially among Senator Kamala Harris of California and Senator Elizabeth Warren of Massachusetts.

“Everyone should be outraged this is happening in America,” Harris tweeted.

Along with Democratic lawmakers, the American College of Obstetricians and Gynecologists has acknowledged that racial bias exists within our health care system and is a contributing factor to pregnancy-related deaths among women of color.

“We are missing opportunities to identify risk factors prior to pregnancy, and there are often delays in recognizing symptoms during pregnancy and postpartum, particularly for black women,” said Dr. Lisa Hollier, former president of the American College of Obstetricians and Gynecologists.

The majority of these deaths, according to the CDC, were caused by severe bleeding and complications related to high blood pressure and cardiovascular disease. Deaths within the first 42 days after delivery were usually caused by cerebrovascular events, including strokes. Heart disease may appear during pregnancy and can become acute after delivery if not detected.

“When we look at the proportion of pregnancy-related deaths by cause, the proportion due to cardiomyopathy has been increasing,” Hollier said. “It can occur in all women, but it is more common among black women.”

Prevention

Even after successful deliveries, new mothers can be at risk of developing potentially fatal conditions for up to a year later. That's why new mothers should be aware of any symptoms that appear after delivery, including:

  • Chest pain
  • Shortness of breath
  • Severe bleeding
  • C-section incision that heals slowly
  • Redness or swelling in legs
  • Fever
  • Headaches

Currently, postpartum care is available for new mothers for up to six weeks after delivery. However, the American College of Obstetricians and Gynecologists says that the process should be ongoing — including a comprehensive follow-up no later than 12 weeks after delivery. The college also released a guide on treating heart disease during pregnancy.

Under the new federal law, the Preventing Maternal Deaths Act, states that investigate pregnancy-related deaths may receive federal grants.

Doctors and other healthcare workers have a duty to leave no stone unturned when it comes to caring for maternal patients. When a condition or illness is missed because they didn't take the critical steps they should have taken, they should be held accountable. To find out what your legal options are in the event of a maternal death or serious condition, contact the Tyrone Law Firm, PC and schedule your free consultation.

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