HealthMay 14, 2024

Six ways physicians can turn the tide of Black maternal health

Physicians who understand these six foundational factors can positively influence the future of Black maternal health.

Despite news that maternal mortality in the United States might be lower than previously reported, Black pregnant patients still die at a rate three times higher than White pregnant patients, according to a study in American Journal of Obstetrics and Gynecology.

Most of these deaths (80% according to the Centers for Disease Control) are preventable and rooted in factors that physicians can influence. This means that physicians have a growing opportunity to turn the tide of these trends, especially with the assistance of technology built for these challenges.

1. Individual and cultural preferences shape the patient’s experience

Many Black patients are highly aware of the disparities in their health outcomes and the history of systemic discrimination in healthcare. Physicians working with Black maternity patients should understand how a patient’s desire for improved outcomes may influence individual care decisions. One such example is the inclusion of doulas and/or midwives in the patient’s care team.

Doulas and midwives provide physical and emotional support, education, and advocacy during pregnancy and childbirth. They can amplify the patient’s voice within the medical system and provide information to the patient in a culturally sensitive manner. Benefits include improved communication and strengthening of the patient-provider relationship. Healthcare systems that understand the unique needs of their populations and provide access to enhanced care teams to meet those needs will be poised to improve outcomes and reduce care disparities.

2. Institutions are stepping in to offer support

Some of medicine’s oldest organizations are working to increase awareness through innovative learning opportunities.

The American Hospital Association hosted the 2023 Institute for Diversity and Health Equity. Included in the event Understanding Bias in Black Maternal Health was a screening of the educational short film, Toxic: A Black Woman’s Story.

Events such as this provide physicians the opportunity to expand their understanding of complex issues and gain insights that contribute to professional success. Health care organizations and physician groups that prioritize such learning will be better prepared to meet the evolving needs of their patients and community. 

3. Black maternal health is a population health emergency

Stories like those of Krystal Lakeshia Anderson, software engineer, patent holder for software to assess the risk of postpartum hemorrhage, and former Kansas City Chiefs cheerleader, highlight the importance of Black Maternal Health Week. Despite her professional accomplishments and insight regarding maternal health issues, Krystal died from sepsis shortly after the stillbirth of her daughter. Her story reinforces the urgent need for improved care for Black birthing patients.

“Racism as a social construct has been identified as a persistent population health emergency and a fundamental cause of disease both in the United States and globally.” This quote is from a 2023 study on the pregnancy outcomes of Black women in the U.S. It explores the community, organizational, societal, interpersonal, and individual factors that contribute to the poor maternal health results that Black women experience.

Physicians who invest some time in understanding Black maternal health from a public health perspective will be better prepared to improve outcomes for their own patients.

4. Communication is a key area of opportunity for physicians

Physician communication is foundational to the outcomes of Black pregnancy patients. A 2022 study of pregnancy and birth experiences and factors that contribute to disparities found that mother-provider communication was “the most salient factor affecting the maternal experience.” The primary influences behind this factor were maternal health literacy and discriminatory attitudes and behaviors of providers in perinatal care.

With training and tools, physicians can improve their communication skills and bridge the gap in maternal health literacy. Patient engagement solutions that provide content tailored to individual and cultural needs are critical part of the physician toolbox.

5. Each region has its own opportunities

While Black maternal health is a worldwide concern, physicians should leverage local and state resources and partnerships to support their patients.

California’s Abundant Birth Project works to address racial disparities in birth outcomes through efforts like providing cash supplements to Black (as well as Pacific Islander) mothers. It provides $1,000 per month to pregnant and postpartum people who live in San Francisco. In Pennsylvania, the bipartisan Black Maternal Health Caucus focuses on financial investment, legislation, and policies to address the state’s challenges in Black maternal health.

6. Black maternal health is an international issue

Physicians might also benefit from understanding Black maternal health from an international perspective. In the United Kingdom, overall maternal death rates have reached their highest in almost 20 years. Black women are now three times more likely to die compared to their White counterparts.

Physicians who provide personalized and inclusive care will create a professional standard that transcends the location of the patient and community.

Technology can help close the gap

The explosion of technologic innovation provides exciting opportunities to improve patient care and reduce harm. Addressing disparities in Black maternal health requires us to evaluate these new technologies through a lens of equitable care. We must ensure that new systems do not perpetuate harmful biases and errors of the past.

An integrated content system that is tailored to the needs of individual Black maternity patients will be crucial in navigating complex care challenges. Enlisting patients as healthcare partners when developing these systems is one opportunity to improve the technology and drive better health outcomes. Individuals who have experienced inequity and poor communication in the healthcare setting have valuable insights as to where the prior systems failed and where new technologies may fill gaps.

Look for patient education solutions that consider social determinants of health materials that best address diverse populations in providing effective maternity services.

Learn more about UpToDate Patient Engagement for Black Maternal Health

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Kristen Eckler professional headshot
Director, Clinical Content – Editorial Marketing and Deputy Editor — Obstetrics, Gynecology and Women's Health, Wolters Kluwer Health
Dr. Eckler is a board-certified clinical specialist in Obstetrics and Gynecology with a focus on Female Pelvic Medicine and Reconstructive Surgery, Menopause, and Female Sexual Dysfunction.

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