Why are Latina maternal mortality rates so high in the United States?

Why are Latina maternal mortality rates so high in the United States?

It’s 2022, and no one should die while pregnant, during childbirth, or shortly afterwards.

And yet, this is happening at an alarming rate in the United States. According to statistics compiled by the Centers for Disease Control and Prevention (CDC) in 2018 (the most recent figures available), more than 17 out of every 100,000 U.S. women who delivered a live baby died during pregnancy or died up to a year after giving birth to a live baby due to a pregnancy-related or pregnancy-exacerbated condition. There were 41.4 deaths of Black women per 100,000 Black live births, compared to 13.7 deaths of non-Hispanic white women and 11.2 deaths of Hispanic women.

Women in other developed countries are less likely than women in the United States to die as a result of pregnancy or childbirth complications.

Why are Latina maternal mortality rates so high in the United States?

 

In comparison, women in similar developed countries are less likely to die of pregnancy or childbirth-related complications: according to a Commonwealth Fund report published in November 2020, the “maternal mortality ratio” of women in the Netherlands, Norway, and New Zealand who died during pregnancy or childbirth was less than 3 deaths per 100,000 live births. Maternal deaths per 100,000 live births were 5 or lower in Australia, Switzerland, Sweden, and Germany.

The COVID-19 pandemic harmed women in the United States. According to a research letter published in JAMA Network Open on June 28, 2022, the number of Hispanic women who died during or after March 2020 during pregnancy or within 42 days of pregnancy increased by more than 74%.

Maternal Health in the United States May Be Even Worse Post-Roe

The recent Supreme Court decision overturning Roe v. Wade, which makes abortion access a state-by-state decision rather than a federally protected medical procedure, isn’t helping. Maternal mortality rates in the United States are unlikely to improve, especially as more people attempt to end pregnancies on their own without the supervision of a healthcare provider or continue with pregnancies while also living with potentially life-threatening illnesses or conditions that develop or worsen as the pregnancy progresses.

Everyday Health spoke with Kristyn Brandi, MD, MPH, board chair of Physicians for Reproductive Health, about how to reduce the country’s rising maternal mortality rates.

The mortality rate in the United States is far too high, particularly for women of color.

“While we have low overall rates of pregnant women dying in childbirth, the United States has one of the highest mortality rates in the world, and this disproportionately affects Black and brown communities,” Dr. Brandi says.

Why Is Pregnancy or Childbirth-Related Death So Common in the United States?

“Pregnant Latine [Latinx] women are not a homogeneous group, but many face barriers to accessing reproductive healthcare for a variety of reasons,” Brandi explains. These can include money and communication issues such as:

  • It may be difficult to take time away from work to seek medical attention.
  • The costs of childcare and transportation to medical appointments may be prohibitively expensive.
  • Many patients who do not speak English struggle to navigate the healthcare system, including scheduling appointments, finding their way to providers’ offices, and comprehending instructions printed solely in English. “This may be more difficult for those who are undocumented, who may face additional barriers to receiving care,” Brandi says. “Things like navigating state checkpoints to get to care and concerns about being reported to ICE [U.S. Immigration and Customs Enforcement] when seeking care” are included.

How to Preserve the Lives of More Women

The issues are systemic, but “the first steps from a public health standpoint within the Latino community are to address some of the root causes,” including racism, according to Brandi. “We must address systemic racism in our healthcare systems, which disproportionately affects people of color.” People of color, in general, are not heard in medicine, and this includes concerns about pregnancy. We must trust people and foster trust within communities.”

Diagnosis and treatment of diabetes and hypertension

According to Brandi, focusing on underlying health issues before, during, and after pregnancy would significantly reduce maternal mortality rates. According to the American Heart Association, heart disease is the leading cause of death among new mothers. To combat this, their “Stay Fuerte for All” campaign emphasizes the importance of lowering blood pressure, which reduces the risk of stroke and heart problems. “Additional resources to identify and manage diseases like hypertension and diabetes during pregnancy would be beneficial, as these diagnoses are overrepresented in the Latino community,” Brandi says.

Increase Doula Care Access

More culturally appropriate support during and after pregnancy would also be beneficial. “Doulas and midwives, which have been shown to improve delivery outcomes,” she suggests. According to DONA International, the leading source of doula training and education, a doula is “a trained professional who provides continuous physical, emotional, and informational support to their client [a pregnant woman] before, during, and shortly after childbirth to help them achieve the healthiest, most satisfying experience possible.”

According to research published in the Journal of Perinatal Education, doula care is associated with improved health for both babies and parents. Doulas are typically hired by an expecting parent prior to delivery and can be included in the standard hospital birth experience. Midwives are trained and certified to deliver babies and care for women before, during, and after pregnancy; some are licensed nurses. They typically supervise simple pregnancies and are more likely to deliver babies outside of a traditional hospital setting, such as at home or at a birth center.

Increase the availability of Spanish-speaking providers and provide more information in Spanish.

“Having information and, even better, providers who speak Spanish would be especially beneficial in Spanish-speaking populations, both to improve communication and trust.” You can’t imagine how terrifying it would be to give birth in a room full of people shouting at you. We must make pregnancy care available to all.”

Without abortion, healthcare demand will rise, potentially harming everyone.

With abortion access being restricted across the country, healthcare for all women suffers.

Prenatal, postnatal, and complication care are in high demand.

“If people are unable to choose abortion, which is how roughly one in every four pregnancies in the United States ends,” says Brandi, “forced birth will dramatically increase the number of people seeking prenatal and postnatal care.” “This will further strain a healthcare system that has already struggled to retain staff, such as labor and delivery nurses, since the COVID pandemic.”

During pregnancy, a woman may experience a variety of maternal health issues. The United States Common pregnancy complications, according to the Department of Health and Human Services, include

  • Anemia
  • Postpartum depression and depression
  • Ectopic conception
  • Fetal issues
  • Diabetes during pregnancy
  • Blood pressure is high.
  • Pregnancy hyperemesis (extreme and persistent nausea and vomiting)
  • Infections that endanger fetal health, such as urinary tract infections (UTIs)
  • Miscarriage (pregnancy loss)
  • Placental issues, such as placenta previa or placental abruption
  • Preeclampsia
  • Early labor and delivery.

Women are “forced to continue pregnancies that put them at higher risk of complications,” she claims, because they do not have unrestricted access to abortions. “We must be clear that abortion access affects all of us, including people who are pregnant.”

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