Pregnancy Loss in the Black Community

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Our maternal death rates in the United States are disproportionate in the black community. These increasing rates are staggering for a developed country with access to research and medical advances. According to the Centers for Disease Control and Prevention, black women in the United States are over three times more likely to die from pregnancy or childbirth-related causes. These statistics are unrelated to socioeconomic status. For example, Serena Williams had a life threatening birth experience after she alerted her medical team to symptoms indicating a pulmonary embolism (a condition in which one or more arteries in the lungs becomes blocked by a blood clot). Her medical history and initial concerns were ignored by her medical team which unfortunately happens more frequently with people of color.

Growing up black in America increases the risk for pre-term birth, low birth weight and stillbirth among black mothers. Studies have shown that racial discrimination is a major factor. Research has shown that the grandchildren of African immigrant women as well as those from black women who had emigrated to the United States from the Caribbean were more likely to be born premature.

I feel inspired by some of the work being done to increase racial equality and cultural awareness in our medical system. Recently, I had the opportunity to attend a presentation offered by the EMBRACE clinical team at the UCSF Maternal Mental Health conference. EMBRACE offers multi-disciplinary group prenatal care for Black families. I was inspired by the work Andrea Jackson, MD, Markita Mays, LCSW and Melinda Fowler, CNM are doing to address the inequities in our medical system and our community.

For mothers who are giving birth especially during this time of COVID-19 please check out the Birthing People’s Bill of Rights offered through the SF Department of Public Health’s Family Planning and Perinatal Services.

I am also grateful for the work RTZ HOPE is doing to increase awareness around pregnancy loss in the Black community. RTZ HOPE is offering webinars to educate and provide accessible support and resources for bereaved parents and the providers who serve them.

More Statistics

The Causes

  1. Women of color have more limited opportunity. Black women are more likely to live in communities that have fewer educational resources and employment opportunities. This is said to be due to historical segregation through housing and education policies.

  2. Women of color face accumulated stress. Black women are more likely to be affected by the accumulated stress of discrimination regardless of socioeconomic status. For women of color who attain a higher socioeconomic status, pregnancy-related outcomes are worse than those of white women at lower socioeconomic levels.

  3. Implicit bias in health care. Disparate treatment of mothers of color may also play a role in worse birth outcomes. Implicit bias in health care delivery may prevent women of color from receiving sufficient patient education in the prenatal period about risks to maternal and fetal health.

  4. Access to health care. Women in poverty experience more challenging life circumstances. They are more likely to have limited access to health care services, adequate food, transportation, and housing.

  5. System racism. The social and economic forces of institutional racism set Black women on distinct life tracks, with long-term consequences for their health and the health of their future children. The experience of systematic racial bias—not race itself—compromises health.

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