Let's Talk About It: The Disparities Between Race & Maternal Health

Maybe you've read about it, heard about it, or noticed it referenced in the headlines, but while racial discrepancies in maternal health and mortality rates are just recently garnering media attention, it's been an issue for too long.

The truth is, there’s a significant -- no -- massive gap in how safe it is to become a mother that rests on whether you are white or a woman of color. There's not an easy way to explain why infant and maternal mortality rates are significantly higher for black women; because it's not a simple story to tell and it's not a pretty one either. But that's all the more reason why we need to talk about it.

Our dedication to helping mothers live happier and healthier so they can have healthier, happier babies goes for everyone, everywhere. We're on a mission to provide the best information on health and wellbeing during and after pregnancy and making that available to women around the world. And while educating women on healthy lifestyle behaviors can go a long way when it comes to carrying healthier pregnancies, there are factors that women are fighting against that go beyond lifestyle changes alone. For women of color, this is especially true.

But the more we talk about it, the more we can understand it and learn how to move the needle in the right direction towards better maternal wellbeing for all women. Because one mother's health is every mother's health.

The truth about racial disparities in maternal health

Earlier this year, Serena Williams broke the silence when she revealed that she’d dealt with severe, life-threatening complications during pregnancy. Williams developed a pulmonary embolism -- a blood clot in her lung -- that required an emergency C-section. Last year, six-time Olympic gold medalist Allyson Felix was diagnosed with preeclampsia at a routine prenatal appointment and was required to deliver her daughter early via C-section. Williams' and Felix’s cases aren’t isolated incidents: they’re a mere glimpse into the maternal health risks facing pregnant women of color every day.

Let's take a step back and let it all sink in. These two are some of the world’s fittest, strongest, healthiest women, and they’ve still fallen victim to some of the most common health risks facing pregnant women of color in the United States. The truth is: black women in America are four times more likely to die during childbirth and twice as likely to have complications during pregnancy.

In the U.S., the maternal mortality rate is worse than it was 25 years ago. And as the mortality rate increases, the percentage of black women who make up that statistic remains the majority.

Black mothers are 3-4 times as likely to die from pregnancy-related causes as their white counterparts, and black infants are more than twice as likely as white infants to not survive the neonatal period. We're not sharing these stats to generate fear, or make you feel sad, but to inform. It's so important to understand what is happening so we can better understand why and do something about it.

So, why is this happening?

Let's talk about what's going on from a health perspective: one of the major culprits of infant death is low birth weight, which happens to be a particularly common condition for black newborns. They’re 2-3 times more likely to be born preterm or at low birth weight, and for the first time in a decade, the number of low-birth-weight babies in the U.S. has increased. Since it’s a major factor in infant death, this is a statistic we need to better understand.

It’s hard to pin down any one reason as the sole cause of blame. But the racial disparity in maternal and infant mortality has been studied for years, and experts have some pretty solid ideas as to why it persists. Low birth weight babies and preventable health conditions are two significant factors, but what’s the root cause? Most studies point to implicit racial bias.

Linda Villarosa, professor and health journalist, says that this racial bias affects the kind of medical treatment that women receive, and also cumulatively affects them as they live their lives. This suggests that women of color are constantly operating in situations that are just more stressful than those of white women: the chronic stress, pressures, insults, oppression, and discrimination that have affected black women for decades have a physical effect on the body because of sustained, elevated cortisol levels. Villarosa calls this toxic stress, and it’s one of the best ways to explain why black women are more likely to suffer from preeclampsia and other pregnancy complications -- and it’s affecting all women of color, regardless of background or socioeconomic status.

This unconscious racial bias impacts the care women of color receive as well. Implicit bias can be responsible for physicians dismissing patient concerns, spending less time with them, not communicating as effectively, and under-treating their pain. Of course, this lack of proper treatment doesn't just impact the woman, but her growing child as well.

Where do we go from here?

This isn’t a quick fix -- it’ll require systemic change and a continued push for further awareness and action. It’s so important that we change the high-risk reality of pregnancy and birth for women of color because, without change, they’ll continue to receive inadequate care and suffer from a mortality rate that’s far too high. Bringing stories, statistics, and studies to light are necessary to change things: the information is out there, but it’s still under-recognized, and not properly acted upon. There's still so much more to be done.

And of course, change needs to happen within the medical community. With education and training on unconscious bias, the unequal nature of care that black women receive can be mitigated -- and medical professionals can be trained on conditions black women are at a high-risk for, such as preeclampsia, so they can recognize them and check for warning signs before it’s too late. There are multiple factors at play here as well; a study that came out less than 2 weeks ago found that physician burnout is a contributor to implicit racial bias, and burnout is reported by nearly half of currently practicing physicians. Does burnout then excuse racial bias? Not for one second. But at least we're learning how and where we can make a change, because we are in desperate need of one.

What's the goal?

This isn’t just about preventing maternal deaths, it’s about reducing complications and reducing the number of preventable near-deaths for mothers -- and in the process, making the journey into motherhood a healthier, more positive, and safer experience for all women.

Let's talk about these preventable near-deaths that women of color disproportionately face in their journey to becoming a mother. The number of maternal near-deaths rose almost 200% from 1993 to 2014, and the C.D.C reported more than 50,000 in 2014 alone. Dr. Anne Schuchat, the CDC’s principal deputy director, says that big-picture systemic change is the answer -- and while it won’t be easy, it’s necessary. Large-scale changes have already been put in place by the CDC in 13 states, and Schuchat hopes other states will soon follow suit.

Women have also taken their health into their own hands through advocacy. The Black Mamas Matter Alliance is spearheading the campaign to improve black maternal health by furthering research, improving education, pushing for change, and bettering resources for women. With these efforts, they hope to make pregnancy and motherhood healthier and safer for women of color.

Advocacy matters, accurate information matters, and listening matters -- and when we all commit to that, that's how change happens. One woman's health is all women's health. By lifting each other up and advocating for women’s health at scale, healthier pregnancies, healthier moms, and healthier babies will be our future reality.