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NNLM Reading Club: Racism and Health

Black Maternal Health

Black Maternal Health Week is recognized in April each year. But one week isn't enough. Throughout the year, libraries can raise awareness.

I Know My Body

There's an NIH for that ... and more

Office of Research on Women's Health (ORWH) is the leading National Institutes of Health for women's health research. To learn about steps toward a healthy pregnancy, use its Maternal Morbidity, and Mortality web portal as well as the National Institute of Child Health and Human Development (NICHHD) and the U.S. Department of Health and Human Services (HHS) Office on Women’s Health (OWH) websites.

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The National Institute of Minority Health and Health Disparities (NIMHD) has recently launched a new section on its website that highlights recent research findings on minority health and health disparities by its grantees. Visit the Research Spotlights section for a quick glance at research that spans diverse topics affecting health disparity populations, such as maternal health and sexual and gender minority (SGM) mental health.

Race, Racism, and Health is a collection of research and perspectives on the effects of race and racism on health in the United States compiled by the Robert Wood Johnson Foundation, the nation’s largest philanthropy dedicated solely to health. Since 1972, they have supported research and programs targeting some of America’s most pressing health issues.

Fact Sheet: Health Disparities by Race and Ethnicity by Sofia Carratala and Connor Maxwell, Center for American Progress, May 7, 2020

Start the conversation!

First-time mother Dani McClain sets out to understand how to raise her daughter in what she knows to be an unjust and even hostile society in We Live for the We: The Political Power of Black Motherhood. Nefertiti Austin recounts adoption for a single African-American woman in Motherhood So White: A Memoir of Race, Gender, and Parenting in America. Finally, researchers and doulas from an organization known as Black Women Birthing Justice bring together the birth experiences of more than 100 California women to make recommendations for improving care in Battling Over Birth: Black Women and the Maternal Health Care Crisis.

Book cover images for Battling Over Birth, Motherhood So White, and We Live for the We

Dr clayton

By Janine A. Clayton, MD, Associate Director for Research on Women’s Health and Director of the Office of Research on Women’s Health at the National Institutes of Health (NIH)

Reprinted from its original source

Black women die from pregnancy complications two to three times more than their White and Hispanic counterparts, according to a January 30, 2020, Centers for Disease Control and Prevention (CDC) report containing the first national data on maternal deaths in the United States since 2007. Black Maternal Health Week (April 11–17) helps keep this heartbreaking health disparity front and center, where it belongs. When our sisters, mothers, daughters, friends, and co-workers are in danger, we need to do more. We all need to elevate and amplify the national conversation to raise awareness, spur action, and take steps to address Black maternal health. We know that about 60% of pregnancy-related deaths are preventable, and these new data are an important tool to guide our efforts.

According to that January CDC report, 658 women died from pregnancy complications in 20181. There were an additional 277 deaths occurring more than 42 days but less than 1 year after delivery; these “late maternal deaths” represented 11.7% of maternal mortalities between 2011 and 2015, according to a previous CDC analysis. The new data reveal stark disparities related to race and ethnicity—with a 2018 maternal mortality rate for Black women of 37.1 per 100,000 live births, compared with 14.7 for White women and 11.8 for Hispanic women. Importantly, higher levels of education and income do not mitigate the risk for maternal deaths among Black women, according to prior analyses.

For every woman who dies of pregnancy complications, at least 70 experience a near miss—that is, severe maternal morbidity (SMM) (50,000 annually), which includes an unintended outcome (or outcomes) of the process of labor and delivery that results in significant consequences for a woman’s health. Potential short-term consequences include bleeding requiring a transfusion, infection, cardiovascular disease, high blood pressure, and gestational diabetes. In essence, pregnancy is a stress test, meaning it reveals risk factors. Specifically, women who experience complications are at risk for developing chronic diseases later in life, such as hypertension—some as early as 3 years after delivery. Addressing SMM will go a long way toward reducing maternal deaths and improving the health of women during pregnancy and throughout their lives. 

SMM also shows disparities related to race and ethnicity—as the incidence is 166% higher among Black women than White women. This disproportionate burden affects health beyond pregnancy and for years to come. For some women, pregnancy complications influence the risk of disease in later life. For example, women who experience gestational diabetes show a threefold greater risk for disorders of glucose metabolism 10 to 14 years postpartum.

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Reproductive health studies have shown that African American women experience a high burden of maternal mortality, infant mortality, and sexually transmitted infections (STI), including HIV. Furthermore, racism is a fundamental determinant of health status because it contributes to social inequalities (e.g., poverty) that shape health behaviors, access to healthcare, and interactions with medical professionals. -- Cynthia Prather, Taleria R. Fuller, William L. Jeffries IV, Khiya J. Marshall, A. Vyann Howell, Angela Belyue-Umole, and Winifred King. Health Equity. Dec 2018. 249-259 http://doi.org/10.1089/heq.2017.0045

Jamila Taylor, Cristina Novoa, Katie Hamm, and Shilpa Phadke. "Eliminating Racial Disparities in Maternal and Infant Mortality: A Comprehensive Policy Blueprint" Center for American Progress