Facing—and solving—high maternal-fetal mortality rates in Black communities

We know the maternal-fetal mortality rates in Black communities in the United States have been too high for too long – in large part because of a longstanding lack of access and support from existing medical resources. Using patient navigators and harnessing medical data, we’re working hard to reverse that trend.

Growing up in Ireland, it was common for families to experience loss in childbirth. My own mother experienced it and how it was dealt with troubled her for the remainder of her life.?

But that was in the late 1940’s and early 1950’s. The thatch-roofed village of Knockaderry, Ireland didn’t have access to cutting-edge healthcare.

So, what excuse do we have for the abysmal maternal-fetal mortality rates in Black communities throughout the United States today? The short answer: none. It’s well past time to create access to top-quality obstetric and gynecological care in communities of color.

Tennis star Serena Williams experienced a medical complication after the birth of her daughter in 2017 that highlights this problem. She let medical staff know that she wasn’t feeling well after her delivery and was dismissed. So she insisted. If she hadn’t, Ms. Williams might’ve died from blood clots following the birth of her daughter.

She did a service to Black women by using her platform to tell her story. But it should not take a high-profile close call to draw attention to how the voices of Black women are diminished, making an already high-risk experience even more fraught.?

Black women in America face about the same odds of surviving childbirth as women in some of the world’s poorest countries. While some industrialized countries have maternal death rates that are less than two per every 100,000 births, the U.S. Centers for Disease Control & Prevention (CDC) reported that, in 2020, the maternal mortality rate for women in the U.S. was 10 times that. Shockingly, Black non-Hispanic women in this country are nearly three times more likely than whites to die from pregnancy-related causes. Advances in medical care and technology mean little against statistics like those.

It’s our job to face these losses head on, and urgently. Here’s what we’ve started doing:

• Because Black women are three times more likely to develop preeclampsia than their white peers, we’re trying to help prevent pregnancy complications by encouraging those at high risk to take a low dose of aspirin daily — a known preventive measure. Our health system is working with a national drug store chain that has donated baby aspirin for us to provide to women at risk.
• We’re expanding a program that identifies women at high risk for hospitalization and connects them with a health navigator to watch for concerning symptoms and connect them to services, educate about best self-care practices during pregnancy and advocate for their medical needs. Patients in this program also have access to chatbot interactions that will flag potential problems, so medical staff can intervene sooner.
• Building on that program, our doctors are working with data science teams to create algorithms that will help identify women who might be at risk for conditions like preeclampsia. They’re examining past cases to more effectively forecast future patients and the algorithm will take into account clinical and socioeconomic factors.

This is not a short-term effort. We need make a long-term commitment to build a foundation that supports women and ensures they receive the care they need during pregnancy — and keeps them well long afterwards.?