April 11 – April 17th is Black Maternal Health Awareness Week. Declared by President Biden in a White House Press Release: “I call upon all Americans to raise awareness of the state of Black maternal health in the United States by understanding the consequences of institutional racism; recognizing the scope of this problem and the need for urgent solutions; amplifying the voices and experiences of Black women, families, and communities; and committing to building a world in which Black women do not have to fear for their safety, their well-being, their dignity, or their lives before, during, and after pregnancy.”
How many women die every day because of preventable childbirth or other pregnancy-related events or conditions? The CDC estimates around 800. This startling statistic is just one of the many reasons maternal health, both in the Black community and overall, is taken so seriously, with various related objectives from top agencies like the World Health Organization (WHO), the US Department of Health and Human Services (HHS), and the United Nations Population Fund (UNFPA).
Let’s look at the most common issues that pregnant women face, the many risk factors for preventable complications, some sobering statistics, and what is being done on the national and global levels to improve maternal mortality rates.
Common Pregnancy Health Concerns
There are a few discomforts women can expect during their pregnancy. Women can avoid acidic foods to aid heartburn and eat more fiber to help treat constipation, especially early on, to easily treat some discomforts at home. Women often turn to family or friends for advice to help treat such things, finding unique ways to ease soreness or dry skin. Even expected symptoms of pregnancy can affect maternal health, however, and easing them can increase mood and help expectant mothers look forward to the birth of their child.
Other Symptoms You Might Experience:
Cramps
Feeling faint
Hot flashes
Incontinent
Dry skin
Back pain
Headache
Pelvic pain
Stretch marks
Tiredness
Morning sickness
Risk Factors for Pregnancy-Related Complications
The Office of the Surgeon General published a “Call to Action” acknowledging the higher-than-average maternal mortality rates in the United States. In it, they call attention to the disparities within the Black population, suggest what should be done to reduce mortality rates for all mothers, and lay out a long-term plan with strategies to affect this and future generations.
But when do symptoms become risk factors and dangerous for both mothers and the child? Therefore, it’s critical to work closely with an OB/GYN or other health services throughout your pregnancy, so risk they can identify risk factors, monitored, and treated as early as possible.
High Blood Pressure
More women are at risk of high blood pressure (hypertension) prior to pregnancy, mainly due to increased obesity rates. Many women are waiting until later in life to start a family, also contributing to the probability they will begin their pregnancy with high blood pressure, develop it during, or experience a spike during delivery that may all lead to complications. High blood pressure during pregnancy is called preeclampsia.
Diabetes
If a woman did not previously have signs of diabetes but develops it during her pregnancy, they will diagnose her with gestational diabetes. Diabetes significantly increases the chance for complications and it closely related to preeclampsia. Managing maternal health in this condition is vital, as it can lead to miscarriage, stillbirth, preterm birth, birth defects, and more.
Obesity
With higher rates of obesity, it is becoming a more common risk factor for maternal health in the United States especially. An unhealthy weight can contribute to other conditions like high blood pressure, diabetes, and mental health that can contribute to other maternal health concerns, compounding the risk of pregnancy complications.
Illness and Infection
From Covid-19 to a common cold to more serious infections like chlamydia or HIV, illnesses and infections can affect maternal health and the health of the infant. A mother should work closely with a physician if they are diagnosed with an illness or infection prior to or while pregnant. Most times, there are ways to mitigate the risk to the baby before and after birth. However, many of these risks are preventable causes and can be reduced through education and other community resources, such as sexual and reproductive health.
Substance Use Disorders
A substance use disorder can describe everything from nicotine and alcohol to methamphetamine and cocaine. According to the Surgeon General’s report, 12% of the pregnant women polled reported using some type of nicotine product within the last month and 10% reported drinking alcohol. Another 5% reported drug use. Not only does substance use affect maternal health, but it increases health risk to the baby because of pregnancy complications.
Mental Health
Maternal health and mental health are closely linked. This can include pre-existing mood diseases, such as depression or anxiety, or postpartum depression which affects up to 20% of new mothers. In fact, over a ten-year period, they found that nearly 10% of all pregnancy-related deaths were because of a mental health condition. Only by addressing mental health stigma and offering more patient-centered care in the United States can we support maternal health as well.
Domestic Violence
In some states, especially in the south, domestic violence is the single most common cause of maternal deaths for the Black population. This violence often begins during pregnancy or soon after it. Intimate partner violence among Black Americans is one of several preventable causes of maternal and child deaths in the US, especially when addressed at a socioeconomic level.
More Maternal Health Statistics
The United Nations Population Fund offers insight into the global importance of maternal health and that women everywhere are susceptible to preventable causes of maternal mortality. Around the world, nearly 300,000 women died in 2017 alone, mostly due to:
Severe bleeding
Obstructed labor
Sepsis
Unsafe abortion
Eclampsia
These deaths are significantly lower than those recorded in 2000, but are still unacceptable. Many of these deaths occur in sub-Saharan Africa or Southern Asia, and global efforts are making an impact.
The Commonwealth Fund analyzed data from the WHO, National Center for Health Statistics, and other studies to get a better picture of who is at the highest risk. In the United States, mortality rates are getting worse year after year, starting in 2000, and worsening significantly since the start of the Covid-19 pandemic. The current maternal mortality rates are three times that of the country with the next highest death rate, New Zealand. The hardest hit are African Americans, who account for more than half of all maternal deaths.
A National and Global Response
Maternal health is a concern not only in the United States, where it affects the Black population and multiracial people disproportionately but the world over. What is being done to improve health outcomes?
US Department of Health and Human Services (HHS)
Health and Human Services has formed a workgroup comprised of four US federal agencies working together to address maternal health as a national crisis and the disparity affecting the non-Hispanic Black population. The workgroup has focused not only on supporting women and infants directly but also by addressing other emerging health concerns that affect maternal death, such as drug use and sexually transmitted diseases.
American Public Health Association (APHA)
The American Public Health Association is focused on addressing preventable causes of maternal death. They do this by investing in sexual and reproductive health education, preventative health care for women, and more. Like other agencies, they have focused their efforts on the disproportionate affects of poor maternal health on Black Americans, partnering with the Center for Reproductive Rights for “Black Mamas Matter” and the World Federation of Public Health Associations for “Reducing Maternal Mortality as a Human Right.”
The United Nations Population Fund (UNFPA)
The focus of the United National Population Fund is sexual and reproductive health care, promoting basic health standards around the world, especially where maternal deaths are most common. Working in sub-Saharan Africa, Southern Asia, and other regions, the UNFPA supports programs that train providers in preventative care during pregnancy, emergency birth response, and critical care for newborns. These initiatives have improved health outcomes over the last two decades and more improvement is expected.
The World Health Organization (WHO)
The World Health Organization helps to support all members with their individual efforts to address maternal health, especially maternal deaths. They closely monitor the progress being made and how effective initiatives are at supporting those that are most vulnerable. This includes the United States, where the majority of those affected are Black people and deaths continue to increase.
Maternal Health: Disparity in Preventable Deaths
Yes, women experience common symptoms during pregnancy. Most will agree that these symptoms are well worth the discomfort once their child is born healthy. However, many women don’t have the same access to care or are at risk for miscarriage, preterm labor, cesarian birth, birth defects, other birth complications or even maternal death because of an increase in risk factors that could be preventable.
Maternal mortality rates have only worsened over the last two decades in the US and this trend will only change with more education about maternal health and better access to care for those disproportionately affected. Black Health Matters is helping to do just that by raising awareness, challenging the system, and bringing more resources to the Black population most vulnerable.
