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The United States has some of the worst maternal health outcomes in the world. And for Black women, the statistics are even more alarming. 

In recent months a good deal of attention has been paid by the media to the issue of birth outcome disparities among Black women. Recent stories in Essence Magazine, NPR, ProPublica, and others have highlighted the fact that in the United States, Black women are three to four times more likely to die after childbirth than white women.  And "Black babies in the United States die at just over two times the rate of white babies in the first year of their life," says Arthur James, an OB-GYN at Wexner Medical Center at Ohio State University in Columbus. According to the most recent data from the U.S. Centers for Disease Control and Prevention, for every 1,000 live births, 4.8 white infants die in the first year of life. For black babies, that number is 11.7.” The majority of those black infants that die are born premature, because Black mothers have a higher risk of going into early labor.

But what are the causes of this disparity? Poverty? Lack of education? Lack of insurance or prenatal care?  While there is no single reason or solution, there are several known factors that may account for at least part of the disparity.  Aside from underlying health conditions experts also point to an array of social factors, including vast inequities.  But even after accounting for socioeconomic factors, educated, middle-class Black women were found to be at even higher risk of having smaller, premature babies with a lower chance of survival.

A growing body of research is linking racism-related stress and chronic worry about racial discrimination with Black-White disparities.  The U.S. has a legacy of reproductive oppression which may cause some women to delay getting care.  And unconscious bias may also play an important role.

Following the birth of her beautiful baby daughter, Serena Williams expressed concern that she was experiencing symptoms of a blood clot (she has a history of pulmonary embolisms), but she had to “shout repeatedly at her doctors” before her concerns were taken seriously.  She ended up needing multiple surgical procedures to repair her ruptured C-section scar and correct internal bleeding. Thankfully, Williams pulled through and by all accounts mother and baby are both healthy and happy.  But her experience has elevated the issue of unconscious bias in health care delivery.

So what’s the solution?  It may be impossible to safeguard against all the risk, but reproductive life planning and pre-conception care services offered at PPPSW, early and consistent prenatal care, and interventions like those offered by our community partners at the Black Infant Health Program (BIH) can enhance the pregnancy experience and help lead to better birth outcomes for Black women.  In addition to addressing the “basics”-- nutrition, avoiding alcohol, drugs and smoking and attending regular checkups, BIH also uses Afro-centric strategies to address social factors including stress reduction and fostering social support.  And women of color-led organizations like SisterSong and the Black Mamas Matter Alliance are leading the charge to center “Black mamas to advocate, drive research, build power, and shift culture for Black maternal health, rights, and justice.”


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