In the United States, maternal health inequities are staggering. Black women are about three times more likely than white women to die of pregnancy-related complications. They are also twice as likely to experience severe perinatal complications. And Black infants have the highest mortality rate of any other race or ethnicity.
“These maternal health inequities can be seen in our community, across the state and nationally,” says Tish Hill, nursing director of women and children’s services at Henry Ford Jackson Hospital. “Right now, we’re raising awareness and developing action plans to focus on reducing this disparity. But I would say this is urgent—we’re in a national crisis.”
Hill says there are a few factors as to why the disparity between maternal health is so great:
- Having limited or no prenatal care. This could be due to socioeconomic factors, including a lack of transportation and other access-to-care barriers. But while there may be an increased maternal health risk for Black mothers who are in a lower socioeconomic bracket, national data shows these inequities are affecting Black women regardless of socioeconomic status. As the Association of American Medical Colleagues reports, “a college-educated Black woman faces a 60% greater risk of maternal death than a white woman with no high school diploma.”
- Experiencing systemic racism and structural inequities. Black patients may feel an implicit bias or they may not feel respected by their healthcare providers. “This is why our providers undergo implicit bias training,” says Hill. “It’s important for us to understand our unconscious biases so we can better relate to and communicate with all of our patients. And it’s important for patients to feel they can trust their healthcare providers so they will report symptoms that could affect their health.”
- Lack of pregnancy-related education and post-birth warning signs. “Post-birth warning signs are symptoms that should be considered urgent and, if someone experiences them, they should seek healthcare immediately,” says Hill. But not all women know about these warning signs, such as having a fever higher than 100.4 F, experiencing pain or inflammation around a c-section incision, feeling pain or burning when you urinate, experiencing intense lower-belly pain—and more.
While these maternal health statistics are alarming, work is being done locally and nationwide to change them. “At Henry Ford, we have something called the Diversity, Equity, Inclusion and Justice (DEIJ) committee; their aim is to reduce infant and maternal morbidity and mortality,” says Hill. “We also have mandatory implicit bias training and trauma-informed care training.
"We’re also participating in state and national quality improvement collaboratives, such as the Michigan Alliance for Innovation on Maternal Health (MI AIM). And we recently joined a national collaborative called the Premier Inc., Perinatal Improvement Collaborative. It partners us with a national company that examines our specific policies and outcomes, and they create an individualized plan for us to improve maternal and infant health. There are a lot of plans in place, but we also really need to raise awareness so we can focus on reducing it.”
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Tish Hill is the nursing director of women and children’s services at Henry Ford Jackson Hospital.