Health & Wellness July 2020 Newsletter

Addressing the Impact of Systemic Racism on Maternal Morbidity & Mortality

Cornelia Graves, MD, FACOG

An esteemed speaker for Symposia Medicus, Dr. Cornelia Graves is extensively published and nationally recognized for her expertise in maternal disease states. Currently the Medical Director of Tennessee Maternal Fetal Medicine, she holds professorships at the University of Tennessee, Vanderbilt University, and Meharry Medical College.

Living in Nashville, Tennessee, Dr. Graves addresses the troubling trend she and other healthcare professionals have seen first-hand of maternal health disparities among different ethnicities during the COVID-19 pandemic.

The COVID-19 pandemic has called attention to the significant racial and ethnic differences in health outcomes. Data suggests that people of color have been disproportionately affected by COVID-19 and have a worse clinical course. In Nashville, 1 in 3 COVID-19 cases are Hispanic. These disparities are no surprise to those of us who work in women’s health.

The United States has the highest maternal mortality rate of any developed country in the world. In 2015, the World Health Organization noted a rate of 26.4 per 100,000. The next closest developed country was the United Kingdom with a rate of 9.2 per 100,000.

Women of color experience worse birth outcomes in the United States, with African Americans having the worst outcomes out of all racial and ethnic groups. Data suggests that African American women are 3-5 times more likely to die during childbirth than their white counterparts. In addition, Black infants and American Indian/Alaska Native infants are more likely to die in their first year of life. There are a number of factors that contribute to these outcomes including pre-existing illnesses such as diabetes, hypertension, and obesity. Other factors include socioeconomic issues, transportation, food deserts, education, housing, and safe neighborhoods. But these factors do not tell the entire story.

In 2020, the Society of Maternal Fetal Medicine and ACOG released statements regarding the impact of systemic racism on maternal morbidity and mortality. Hopefully, guidance from the CDC regarding how to apply the lens of racism to maternal mortality reviews will help us to better understand and learn from this impact.

As providers of women’s health, we must all be committed to delivering the best care to all of our patients. Together, we can change this trend and make birth safe for every mother in the United States.