Let’s break down the numbers.
To be clear, absolute rates of maternal mortality have fallen for women of all ethnic groups over the past 100 years. However, relative rates of disparities in maternal mortality between Black and white women have persisted and widened.
Here are the stats:
- The US has experienced a 26.6% increase in maternal mortality from 2000 to 2014 (source)
- Black women have an almost four-fold increased risk of pregnancy-related death (source). Even between women of the same education and income level!
- In women over 30, the MMR (maternal mortality ratio) is 5 times higher for Black women than for white women (source)
- The PRMR (pregnancy-related mortality ratio) for Black women with a college degree was 5.2 times that of their white counterparts(source)
- Of the 5 major pregnancy complications, case fatalities rates for all 5 conditions are significantly higher for Black women, even though prevalence rates are similar (source)
- Case fatality rate= number of people who die from a particular disease divided by number of people diagnosed with the disease for that particular time period.
- Prevalence rate= proportion of persons in a population who have a particular disease over a specified period of time.
- SO, Black and white women experience pregnancy complications at similar rates, but Black women are significantly more likely to die from them
- Black women have the highest rates for 22 of 25 severe morbidity indicators used by the Center for Disease Control and Prevention (source). Severe maternal morbidity is unexpected health consequences that arise from labor and delivery.
- Black women receive less intensive care, are less likely to receive the correct treatment for cardiac-related issues, and are less likely to receive correct routine care, even when compared at similar access and socioeconomic levels (source). This hurts the preconception health of Black women before they ever become pregnant, which in turn damages their maternal health.
- Hospitals which primarily serve Black populations perform worse than white-serving hospitals on 12 out of 15 obstetric-related metrics (source).
These statistics provide just a snapshot of disparities that are pervasive in our healthcare system. We know that in general, education and income are inversely related with maternal mortality, but these gaps persist even among college-educated and Black women with high socioeconomic status. In order to understand these differences, and be able to solve them, we need to dive deeper into the drivers of the disparities.