Despite aspirations and efforts in the U. S. to eliminate or minimize inequalities in healthcare by 2010, disadvantaged societies endure facing large differences in morbidity, access to treatment, mortality, and risk factors. There are significant racial or ethnic inequalities in birth outcomes in the United States. In 2002, the mortality rates of Black (13.5/1,000 live births) infants were about three times higher as compared to that of whites (5.7/1,000), Asians (4.7/1,000), and Hispanics (5.4/1,000) (Jain et al., 2018). Black newborns were nearly twice as probable to be born with LBW (low birth weight) of approximately 13 percent than whites with approximately 6 percent or Hispanics with about 7 percent. Black infants (18 percent) were more expected to be born preterm than Whites or Hispanics. (Declercq & Zephyrin, 2020). Preterm delivery and LBW have both been linked to an increased risk of infant death and developmental problems like cerebral palsy or mental retardation. In the US health facilities, there still exist health disparities, however, the great improvement in the US health sector. This paper, therefore, is based on examining the morbidity and mortality rate among vulnerable women, their infants, and children.
Bleeding-related deaths are one of the causes of frequent causes of mortality rates in women. This factor is frequent during birth and when the women are still expectant, whereas deaths from mental related disorders, heart disease, suicide, and substance abuse are most frequent in the postpartum period. The top causes of mortality rates during the neonatal period and the initial five days of life include diarrhea, pneumonia, malaria, and birth defects. In the U. S. in 2018, the maternal death rate was 18 per 100,000 conceptions, resulting in roughly 650 maternal deaths (Declercq & Zephyrin, 2020). Black women had a maternal mortality rate of approximately 36 per 100,000 pregnancies, 3 times that of white women,15 percent, and 3 times that of Hispanic women, who are at 11.8 percent (Jain et al., 2018). In the world’s industrialised countries, this nation is considered last, due to the increased infant mortality rate.
Cardiovascular diseases (CVD) are also another factor that is responsible for the high mortality rate among vulnerable expectant women within the US. Despite improvements in overall CVD mortality rates, racial and gender inequities continue to exist. Black women had elevated rates of Mortality than White women, which has been linked to poorer cardiovascular (CV) health as well as a larger load of clinical complications and modifiable risk factors (Hauspurg et al., 2018). Moreover, as contrasted to other ethnic groups, racial, Black women accumulate more clinical and behavioral CV potential risks and develop CVD at an earlier age. Whereas there are well-documented variations in CVD incidence, morbidity, prevalence, and mortality by sex and ethnicity or race, research on the role of genetic variables is sparse. In genetic studies, people of African heritage have been neglected. Moreover, assessments of sex chromosomes and the interplay of genetic features and sex hormones are rarely included in genomic research. As a result, there are substantial worries regarding the potential for precision medicine initiatives, like polygenic risk scores, to increase CVD health inequities when precision medicine research depends on genetic studies with insufficient involvement from African-American communities.
Lastly, chronic discrimination-related stress has been discovered to be a strong predictor of poor delivery outcomes. It has been confirmed that Black women who are not of Hispanic origin are greatly affected – likely to give birth to low-weight babies as compared to non-Hispanic white women. Black women (the non-Hispanic) are at a disadvantage when it comes to the protective factor of early prenatal care beginning, with just 67 percent engaging in the first trimester, compared to 77 percent of non-Hispanic White women and 81 percent of Asian women (Fryer, 2021). This is troubling, considering perinatal mental health treatments are crucial, especially for Latina women and non-Hispanic Black, who have higher rates of anxiety and depression during pregnancy and are more likely to have a poor outcome of the pregnancy. According to statistics, up to 28 percent of non-Hispanic Black women suffer from prenatal depression (Hauspurg et al., 2018). Perinatal depression has been linked with an advanced menace of gestational diabetes, low birth weight, preeclampsia, and preterm birth in mothers and babies.
Infant and maternal mortality can be reduced in various ways, measures involved are that applied before conception, during pregnancy, and during the postpartum period. Before conception, women should be screened for several health risks and chronic pre-existing conditions such as hypertension, diabetes, and sexually transmitted diseases. Women should also be advised to avoid drug and substance abuse, causes of LBW. According to Ahn et al., (2020) during pregnancies expectant women should be provided with access to high-quality care, this is to maintain both the health of the baby and the maternal parent. In the postpartum period, the health of the newborns should be monitored in several ways such as vaccination of the newborns at the appropriate ages. Above all, community health workers should play vital roles in ensuring they fight every form of health disparity in the health sector. Through the imposing of laws that protect and treat the maternal parents equally regardless of race or origin.
In conclusion, understanding the findings on maternal deaths and their cause is a crucial step in developing federal and state healthcare provision and policy solutions. Pregnant women, infants, and children are vulnerable as they are prone to several harsh conditions that, when not properly monitored, are likely to lead to death. Health sectors should protect the rights of their patients; maternal women and their infants regardless of the place of origin. With the absence of health disparity, there will be low instances of maternal and infant mortality rates among the US population.
References
Ahn, R., Gonzalez, G. P., Anderson, B., Vladutiu, C. J., Fowler, E. R., & Manning, L. (2020). Initiatives to reduce maternal mortality and severe maternal morbidity in the United States: A narrative review. Annals of Internal Medicine, 173(11_Supplement).
Declercq, E., & Zephyrin, L. (2020). Maternal mortality in the United States: a primer. Commonwealth Fund.
Fryer, K., Munoz, M. C., Rahangdale, L., & Stuebe, A. M. (2021). Multiparous black and latinx women face more barriers to prenatal care than white women. Journal of Racial and Ethnic Health Disparities, 8(1).
Hauspurg, A., Ying, W., Hubel, C. A., Michos, E. D., & Ouyang, P. (2018). Adverse pregnancy outcomes and future maternal cardiovascular disease. Clinical Cardiology, 41(2),
Jain, J. A., Temming, L. A., D’Alton, M. E., Gyamfi-Bannerman, C., Tuuli, M., Louis, J. M.,… & Riley, L. E. (2018). SMFM Special Report: Putting the “M” back in MFM: Reducing racial and ethnic disparities in maternal morbidity and mortality: A call to action. American Journal of Obstetrics and Gynecology, 218(2).