“It’s a little out of body to be an expert in maternal health and then to experience microaggressions while in labor.” Ndidiamaka Amutah-Onukagha, a professor of Black maternal health at Tufts University School of Medicine, told me. “I experienced it firsthand in labor,” Dr. Amanda Williams, the collaborative’s clinical innovation adviser, said racial bias can sometimes be indicated in cases where nursing notes describe patients who later died as “disruptive,” or in which medical professionals were slow to respond to lab results. Along with the federal government, states can also push every hospital to look at California’s model, or other proven ways to make childbirth safer.Ĭalifornia’s maternal mortality review committee also investigates each pregnancy-related death and whether racial bias may have played a role.
Legislators in other states can expand this coverage, so all women can seek the health care they need for up to a year after giving birth.
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Virgin Islands, has also expanded Medicaid coverage to include postpartum care for women for a full year after birth. California, like 35 other states, the District of Columbia and the U.S. That allowed the state to identify trends and share what worked, leading to changes such as adding “hemorrhage carts” to delivery suites, reducing the incidence of a leading cause of maternal death. Membership includes benefits, such as financial bonuses for reducing C-section rates, and responsibilities, like sharing data with other members. Nearly every hospital in the state belongs to the group. The same year, it began a public-private partnership with Stanford University, known as the California Maternal Quality Care Collaborative, aimed at reducing the deaths. In 2006, its Department of Health began investigating maternal deaths, which were on the rise in the state. The state has been working on this issue for more than a decade. Though the racial disparities persist in California, as in the rest of the country, it had, before COVID, narrowed that gap. That is still higher than in many developed countries, but significantly under the national rate of 20.1 deaths for every 100,000 births in 2019. But in the years before COVID hit, the state had significant success in reducing its maternal mortality, lowering it to 12.8 deaths per 100,000 births. One way forward is to take a close look at how California made progress.Ĭalifornia’s maternal mortality rate surged during the pandemic, a trend seen across the country. Researchers, medical professionals and advocates say the United States should adopt best practices similar to those deployed in states like California, which according to federal data has the lowest rate of maternal deaths in the country focus on improving the health care received by American women - but especially Black and Native women - during pregnancy and delivery, and up to a year after and enhancing the social services offered to pregnant women, from transportation to housing. Yet the United States seems to have accepted these deaths, failing to widely carry out measures that have been shown to stop them.
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But plenty is already known about how to reduce deaths from childbirth and pregnancy in general. Research is underway to better understand why the deadly racial disparity persists, and how to close it. The concern is particularly acute in states like Mississippi, which have among the highest rates of maternal deaths in the country and have enacted near total bans on abortion. The Supreme Court decision overturning abortion rights may lead to still more maternal deaths, by further limiting access to reproductive care in the United States.
Even when Black women have higher incomes, they are more likely to die from pregnancy and childbirth than white women are. Even as maternal mortality declined globally by one-third from 2000 to 2015, deaths rose in the United States. Grace Meigs, Americans are still dying of pregnancy and childbirth-related causes at rates far above many parts of the world. Yet more than 100 years after that landmark report, written by Dr. Over the next century, deaths in childbirth declined in the United States, largely thanks to advances in care in the 1940s, especially the use of sulfa drugs and antibiotics, as well as blood transfusions and high blood pressure screenings.
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