A healthy pregnancy starts before conceiving a baby, and ideally, continues through every stage of maternity (pregnancy, childbirth, and the postpartum period). When the physical, emotional, and social needs of pregnant people are addressed in a timely, safe, and respectable manner before, during and after giving birth, the likelihood of both the mom and infant having healthy outcomes dramatically increases.

While advances in healthcare in the United States have led to an overall improvement in patient safety and quality of care, approximately 700 women die every year from causes related to pregnancy and childbirth. Of those pregnancy-related deaths (i.e., deaths that occur within one year of pregnancy), 80% or 4 in 5 are preventable. Even more concerning is the higher rate Black women are dying due to preventable causes.

Black Maternal Health Week is nationally recognized April 11-17 as an opportunity to bring awareness and take action to improve the health outcomes of Black women throughout their maternity journey. Memorial's new chief of Maternal-Fetal Medicine, Terri-Ann Bennett, MD, will spearhead the activities taking place throughout the week to educate our healthcare providers. 

Why Do Racial Disparities Exist?

According to the Centers for Disease Control, Black women in the U.S. are three times more likely to die from pregnancy-related complications than White women. The top three preventable causes of pregnancy-related deaths for Black women are:

• Cardiac and coronary conditions (16%)
• Cardiomyopathy (14%)
• Embolism-thrombotic (12%)

• Social determinants of health: Education, income, neighborhood characteristics, housing, access to healthcare, safety, and food stability all play critical roles in maternal health outcomes.
• Variations in quality healthcare: When controlling for insurance status, income, age, and severity of conditions, people of color are less likely to receive routine medical procedures and experience a lower quality of care.
• Underlying chronic conditions: Complications from pre-existing, chronic conditions represent half of all maternal deaths and are the fastest rising cause.
• Structural racism: Discriminatory systems, laws, and policies put pregnant people of color at increased risk for poor mental and physical health outcomes.
• Implicit bias: Healthcare providers' negative or stereotypical perceptions and attitudes can create inequalities in access, patient interactions, treatment decisions, and health outcomes.

Health disparities persists even when accounting for socioeconomic status, education, and other factors. The impact of these disparities has been and continues to devastate to Black families, and the trauma associated with these experiences can have lifelong effects on their mental and physical health.

"While the most recent statistics reveal the risk of dying in pregnancy increased in every racial-ethnic group and age category, the maternal mortality rates for Black women worsened significantly."

Community-Based Maternity Care Approach

Addressing Black maternal health disparities requires a comprehensive approach that includes community-based solutions, policy changes, and improved healthcare practices. There are several federal, state, county, and community initiatives underway that aim to address these disparities.

As a community hospital and academic medical center, Memorial Healthcare System is dedicated to supporting all pregnant peoples' health, emotional, and social service needs throughout their maternity journey by providing high-quality prenatal care, high-risk pregnancy care, labor and delivery services, and postpartum care at each Memorial Family Birthplace location.

In an effort to improve Black maternal health outcomes, our labor and delivery team's approach to patient- and family centered care continuously works to:

• Improve access to high-quality healthcare: Memorial Primary Care's obstetric hypertension navigator helps improve outcomes for expectant women who develop preeclampsia, a condition that Black women born in the U.S. are at higher risk of developing. Our perinatal nurse navigator helps coordinate prenatal appointments for high-risk pregnant women, and our certified midwives are available to support them throughout their maternity care. Through our partnership with Healthy Start, an assessment of expectant moms' household needs is made prior to delivery, and we have a social worker dedicated to Black moms.
• Improve access to prenatal care: Memorial Family Birthplace offers free support groups and hybrid and online maternity classes focused on prenatal care, labor and delivery, lactation/breastfeeding, postpartum care, new parents, and newborn care.
• Improve access to behavioral health services: Memorial Mothers in Recovery program provides alcohol/drug addiction treatment services for pregnant people. We also offer outpatient Behavioral Health treatment services for people experiencing mental health issues.
• Increase diversity in the healthcare workforce: Hired two Black women as Maternal-Fetal Medicine physicians to lead system-wide initiatives to improve Black maternal health outcomes.
• Address systemic racism and bias within healthcare systems: Hired a board-certified OB/GYN, African-American woman committed to eliminating health disparities to be chief of Maternal-Fetal Medicine.

Adopt a Healthy Lifestyle During Your Maternity Journey

Many factors influence pregnancy-related health outcomes. Building a positive and supportive relationship with healthcare providers early in your maternity journey is one of the most important things you can do to improve your chances of receiving appropriate and timely medical advice and care.

In order to increase the chances of you and your baby having a healthy maternity journey, it's also wise to practice healthy lifestyle habits before, during, and after pregnancy, such as:

• Don't take any illicit drugs and talk to your doctor about all prescription drugs
• Don't vape or smoke cigarettes and avoid second-hand smoke
• Don't drink alcohol
• Maintain a healthy diet and weight
• Get 400 mcg of folic acid daily through food or supplements to help prevent some birth defects
• Be physically active for 30 minutes a day in a safe environment
• Prevent injuries by wearing a safety belt in cars and a helmet while cycling or skating
• Address any health problems before getting pregnant
• Visit your healthcare provider(s) throughout your maternity journey for prenatal and postpartum care

Black maternal health is a critical issue that requires urgent attention and action. With increased awareness, advocacy, and action, we can work towards achieving health equity for all women and families.