Introduction
Black maternal health is an important societal issue that must be addressed immediately. Maternal health results for African American women within the United States are unimaginably sad. High mortality rates associated with pregnancy or delivery are among the results.
Black women have a disproportionate number of severe health consequences and maternal mortality as a result of health care systems and sociocultural factors. This consequence makes sense since black women are more likely to encounter racial discrimination for the majority of their lives and to encounter obstacles to obtaining high-quality healthcare. Salary gaps have been caused by sexism, racial discrimination, and other institutional barriers in the US.
Black women are more likely to be uninsured, have trouble receiving prenatal care, and experience significant financial barriers when seeking to acquire maternity healthcare as compared to white women. Enforcing safeguards for pregnant employees, addressing structural racism, expanding access to maternity services, and reforming comprehensive healthcare laws are all essential to addressing Black maternal health disparities and advancing a more equitable healthcare system for all women.
The Problem of Black Maternal Health
Black women are dying more frequently during pregnancy and delivery than is concerning. In the United States, black women face a higher likelihood of mortality during pregnancy or childbirth compared to women of other races (Black Maternal Health Caucus, n.d.). The risk of death for black women during pregnancy is three to four times greater than that for white women. They face an alarming risk of pregnancy-related mortality due to their income and educational levels.
Women of color are more likely than white women to experience health problems associated with pregnancy, like hypertension and fibroids. Hospitals treating Black patients provide less valuable maternity care compared to those servicing White patients. 75% of Black mothers give birth in hospitals with a strong bias against Black patients (Dayo et al., 2023). Pregnancy problems are more common in these hospitals than in other hospitals. Getting the reproductive health services they need might be difficult for a lot of black women. Because they receive less counseling and high-quality contraceptive care than women of different races, black women have higher rates of unintended births.
Literature Review
People of color who give birth are more inclined to encounter life-threatening illnesses and maternal complications. Dayo et al. (2023) claim that evidence indicates that the healthcare sector often treats black women poorly. When black women report discomfort to doctors, they are typically not taken seriously (Dayo et al., 2023). The claim is supported by prejudice and discrimination within the healthcare system.
In comparison to their white equivalents, Black Americans receive lower-quality healthcare for nearly all ailments, especially prenatal care, based on Institute of Medicine research. Not only do black moms run the danger of dying after childbirth, but their offspring also do. Black babies within the US are twice as likely as white babies to die before becoming one year old. Black moms who are middle-class and educated have a higher chance of losing their children than impoverished white mothers who do not even possess a high school education.
Postpartum depression is rarely adequately treated for Black women. Postpartum depression affects around 10 to 20 per cent of women and is on the rise. When they do, however, black moms are less likely to receive medical assistance. Compared to 4% of Black women, around 8% of White women got therapy for postpartum depression (Dehkordi et al., 2019).
According to the 2018 CDC data, pregnancy-related complications claimed the lives of 658 women (Owens & Fett, 2019). Also, 277 deaths occurred between forty-two days and twelve months following birth. The data revealed racial and ethnic differences, with Black women dying at a rate of 37.1 per 100,000 live births, compared to 11.8 among Hispanic women, as well as 14.7 among White women (Owens & Fett, 2019). It is crucial to understand that wealth and education do not decrease the incidence of maternal deaths among African American women.
Theories and Models of Black Maternal Health
Bias and racism are two essential models associated with the health of Black mothers. Racism against Black Americans has existed in the US for several hundred years. The healthcare system is one of the many vital organizations and systems within US society where racism has taken place (Owens & Fett, 2019). The primary cause of African Americans’ disproportionately high rates of newborn and maternal mortality is racism.
Additionally, the structural impediments have been driven by unconscious and explicit bias. When it comes to baby and maternal mortality, the socioeconomic determinants of health—socioeconomic position, education, and income level—do not apply to Black Americans since they are primarily relevant to White Americans (Owens & Fett, 2019). The social determinants of health include factors that affect a person’s quality of life, including the places where individuals live, work, play, and earn a living.
Being Black within the US is ingrained with racism, which has been connected to the well-being of Black American mothers and newborns. It is said that structural racism comprises a system in which state policies, business initiatives, and representations of culture all contribute to the maintenance of ethnic inequality. It has been made worse by the predominantly White power institutions that keep citizens of color’s power discrepancy alive.
Since the Affordable Care Act (ACA) was designed to lessen racial minority groups’ unequal access to healthcare, it has proved a crucial component of black maternal health within the US. That being said, even though the model’s primary goal is to lessen racial disparities, black women are more likely than white women to be without health insurance (Baumgartner et al., 2020).
Consequently, there is a greater likelihood of poor maternal health because of the barriers that Black women face while trying to receive treatment. One of the main instruments intended to cover the uninsured, the expansion of Medicaid, has been abandoned by the states with the highest rates of health disparities in the US. As a result, even though they receive tax benefits, low-income Americans living in these states face a coverage gap as they age and can no longer purchase private health insurance because they become eligible for Medicaid.
Black people are disproportionately impacted by the Affordable Care Act (ACA) since they live in poverty and have higher rates of maternal and newborn deaths. As of 2022, eligibility for ACA coverage among non-elderly uninsured individuals is influenced by race and ethnicity (Baumgartner et al., 2020). Given that a greater proportion of uninsured Black individuals reside in states without Medicaid expansion, they are at a higher risk of falling into the Medicaid “coverage gap” compared to their White counterparts.
Practice Skills and Strategies Related to the Problem
Maintain and Expand Access to Health Coverage
Given the large percentage of uninsured Black individuals and the rise in coverage gaps, health policy needs to promote access to care and coverage. Throughout their lives, women will need constant access to preventive care. The care may involve birth control to preserve their health and pick the right moment to have children (Owens & Fett, 2019).
To have healthy pregnancies and infants, women must also receive appropriate maternity and prenatal services. Therefore, the extension of Medicaid coverage can help to alleviate the gap or absence of health insurance and improve the maternity outcomes for Black women. The plan works because it reduces financial volatility and improves black women’s access to healthcare.
Tackling the Issue of Social Determinants of Health
Social factors affect health differently across racial and ethnic groups. These are the settings where individuals are created, developed, live, work, and ultimately age. These include language, education, immigrant status, financial position, physical and local environment, place of employment, social assistance systems, and access to medical facilities (Owens & Fett, 2019).
Black women who are marginalized by systemic inequalities and prejudice face ongoing stress from racism and poverty, which has been shown to affect their medical conditions negatively and be linked to their ongoing health disparities. Health-related social factors must be addressed through policies that increase wealth and revenue, enhance the standard of education, provide accessible, secure, and clean housing, increase the availability of reasonably priced and healthful food, and give priority to inexpensive and reliable public transportation for healthcare visits to further enhance the maternal health results for Black women.
Expand Protections for Pregnant Employees
Increasing safeguards for expectant workers is a critical first step in tackling the widespread problem of pregnancy discrimination, which disproportionately affects Black women. To do this, thorough state and federal legislation that improves the rights and allowances offered to expectant workers should be developed and implemented (Owens & Fett, 2019). These legal actions might include, among other essential elements, a precise definition of pregnancy discrimination that covers all work areas, including employment, advancement, dismissal, and benefits. Ensure that all pregnant employees are covered by the benefits, regardless of race, ethnicity, or other demographic factors.
Examine and revise the PDA to account for the requirements and challenges pregnant workers now face. Extend and define the PDA’s definition of conditions associated with pregnancy and allowances (Owens & Fett, 2019). By giving appropriate state and federal departments the authority to look into and punish companies that are found to have discriminated against pregnant workers, mechanisms to enforce this will be strengthened. A more equitable and open working environment for all persons, regardless of their pregnancy status, may be fostered by society by improving and increasing safeguards for pregnant staff members, especially in response to the obstacles experienced by Black women.
Best Strategies for Tackling Black Maternal Health
Advocacy and social change techniques are the most effective approaches for addressing challenges in black maternal health. Advocates are working to diversify the medical staff, challenge racism head-on, and provide Black moms with treatment that is sensitive to their cultural needs to reverse the effects of these practices (Owens & Fett, 2019). To help Black moms, this involves making midwives and doulas more widely available.
Consequently, a systematic change is required to successfully enhance the health of Black mothers, starting with modifying the healthcare system through applying pertinent laws and regulations. It will result in improved access to care, better lives, and employment opportunities for Black women, as well as a more equitable and responsive response to their needs. Social improvements, such as better and safer housing, better education, and greater access to affordable, healthy food, will support these efforts. The maternal and newborn mortality of the black population will be significantly reduced with this all-encompassing strategy.
Conclusion
Maternal health among Black women in the United States is a complex and widespread concern that demands urgent attention and comprehensive solutions. The discrepancies in maternal death rates between Black and White women point to structural problems in the healthcare system. Socioeconomic issues, prejudice, and discrimination all play a part in the poor health outcomes Black women endure throughout pregnancy and delivery. The assessment of the research emphasizes how widespread racism and prejudice are in healthcare environments, which exacerbates the abuse of Black women.
Targeted interventions are necessary since the socioeconomic determinants of health, such as income and education, do not appear to reduce the risk of maternal mortality among Black women. Theoretical models, such as the effects of racism and the Affordable Care Act, illuminate the underlying reasons for these differences. The persistence of unequal access to high-quality healthcare is primarily due to structural racism and bias, which hurts the results for mothers and babies.
The Affordable Care Act was designed to reduce healthcare inequities, yet there are still implementation issues and coverage gaps that disproportionately affect Black women. The most effective tactics ultimately combine social transformation with advocacy. Racial prejudices should be eradicated, and the healthcare workforce should be more diverse by promoting changes to health systems and educational programs. Social reforms that improve housing, education, and access to healthy food can foster a more supportive climate for Black moms.
References
Baumgartner, J., Collins, S., Radley, D., & Hayes, S. (2020). How the Affordable Care Act (ACA) has narrowed racial and ethnic disparities in insurance coverage and access to health care, 2013‐18. Health Services Research, 55, 56-57.
Black Maternal Health Caucus. (n.d.). Black maternal health Momnibus.
Dayo, E., Christy, K., & Habte, R. (2023). Health in colour: Black women, racism, and maternal health. The Lancet Regional Health–Americas, 17.
Dehkordi, Z. R., Hosseini-Baharanchi, F. S., Kazemian, A., Madiseh, M. R., Reisi, M., & Motaghi, B. (2019). The effects of infant massage on maternal postpartum depression: A randomized controlled trial. Nursing and Midwifery Studies, 8(1), 28-33.
Owens, D. C., & Fett, S. M. (2019). Black maternal and infant health: Historical legacies of slavery. American Journal of Public Health, 109(10), 1342–1345.