Pregnancy should not be a life-or-death gamble, yet it is for black women in America. Why does race still dictate survival in childbirth? Let's get to the root of the problem, and the solutions can rewrite the future.

Data Trends on Black Maternal Health

According to the Centers for Disease Control and Prevention (CDC), about 50,000 females experience serious problems during pregnancy.^[1] However, African Americans are three times more likely to die from pregnancy than Caucasians.^[1] In 2019, about 20 per 100,000 mothers died from pregnancy-related causes; this compared to 24 per 100,000 in 2020.^[1] For African Americans, the rate was about 55.3 per 100,000 births, leading to 1,800 deaths.^[1]

Every pregnancy-related death or serious health problem has its causes, but the most common ones in the U.S. include high blood pressure during pregnancy, blood clots in the lungs, severe bleeding, infections, heart problems, weak heart muscle (cardiomyopathy), and other issues unrelated to the heart.^[1]

Health problems like high blood pressure, heart disease, diabetes, and obesity can make pregnancy more dangerous.^[1] However, African Americans face higher risks of pregnancy complications and death even without these illnesses. This shows that racial inequalities exist in healthcare and play a huge role. 

Social Determinants of Health (SDOH) that Contribute to Maternal Mortality

Social Determinants of Health (SDOH) are the root causes of health and conditions where we learn, play, live, age, and worship.^[2] Examples include economic stability, neighborhood and built environment, social and community context, and access to quality healthcare ^[3]. 

Economic Stability

Unfair policies and systems make it harder for African Americans to obtain a quality job with a decent income and have access to good education.^[3] For example, the median income for Caucasian families is almost ten times higher than the median income of African American families.^[4]

Because of this, many people struggle financially, leading to health problems that could have been prevented. While there is a relationship between poverty and maternal death, racial inequalities persist among black women, no matter how much money they make and what their education level is.

Neighborhood and Built Environment

Where Americans live and what their surroundings look like are still affected by unfair rules about who can buy homes or get loans. Because of these unfair practices, many black communities remain segregated and face bigger challenges, including poor housing, exposure to pollution, and other dangerous conditions that put people's health at risk.^[3]

When mothers don't have stable, safe housing, it can damage their mental health.^[3] This makes pregnancy more dangerous and increases the risk of serious health problems or death for moms and babies. 

Social and Community Context

Due to unfair housing policies from the past and segregation, pregnant women of color are more likely to live in neighborhoods with more crime, violence, unstable living conditions, and heavy police presence compared to white women.^[3] When mothers live in violent neighborhoods, their environment can raise their risk of pregnancy complications and premature birth.^[3]

Access to Quality Healthcare

Studies show that hospitals where most black mothers deliver babies often provide lower quality care compared to hospitals where white mothers give birth.^[3] These hospitals tend to be unsafe, have fewer resources, and have poorer outcomes.^[3] 

Solutions to Addressing this Issue

• Increase equal access to doulas.

• Offer preconception counseling(education on how to improve health outcomes before pregnancy) to underserved mothers.^[5]  

• Establish a positive rapport with the community and partner with healthcare providers, faith-based organizations, local citizens, etc. ^[5]  

• Perform community outreach to inform people of the resources available and foster engagement.^[5]

Policy Recommendations

• Expand Medicaid coverage to address healthcare costs among mothers with low income and increase access to doulas/midwives.^[3]

• Fund programs for mental health, treatment for substance use disorders, and smoking cessation classes.^[3]

• Invest in telehealth services and other digital tools to increase equal access to quality care.^[3]

These numbers aren't just facts; they're flashing warning signs. Someone's skin color, paycheck, or zip code should never decide if motherhood becomes a tragedy.