Call for posts: Inequities in Maternal Mortality in the U.S.

Posted on November 2, 2015

To highlight the rising and disparate rate of maternal deaths in the U.S., the Maternal Health Task Force is launching a blog series to explore strategies to mitigate these deaths and inequities and build a repository of information and resources for stakeholders across the U.S. and globe. We invite you to participate in the blog series by contributing a post and following the series.

Maternal mortality has decreased 45% worldwide since 1990. However, this progress has not extended to the U.S. where the maternal mortality ratio (MMR)—or number of women who die in pregnancy or within 42 days of termination of pregnancy per 100,000 live births—has been rising since the 1980s. The United States fares worse than most developed nations, ranking 65th in the world with an MMR of 28 in 2013. Despite the U.S. commitment to Millennium Development Goal 5—to decrease the MMR by three quarters from 1990 to 2015—the MMR in the U.S. has more than doubled in that time.

Equally disturbing are the deep inequities in maternal mortality in the U.S. The most notable inequity is race: When MMR is stratified by race, black women die at three to four times the rate of white women.

Approaches to mitigate inequities in maternal health and death in the U.S. are needed at multiple levels of the system, from clinical care at the individual level to interventions aimed at the underlying social and economic determinants at a societal level. Integration of these multi-level efforts and capacity building of community-based efforts are needed.

Now that the U.S. has adopted the Sustainable Development Goals (SDGs), it has committed to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. The strategy to end preventable maternal mortality, which operationalizes SDG goal 3.1, states that countries, like the U.S., who have an MMR less than 420[*], should seek to reduce it by two thirds by 2030. What do we need to do to get to 9 deaths per 100,000 live births by 2030?

Potential topics for blog submissions, all with an equity lens:

1. Situating the U.S. maternal health crisis within the global context: Often the U.S. is used as a benchmark for other countries. However, maternal health in the U.S. is rife with problems. How do we change the dialogue about maternal health and the U.S. in order to describe an accurate picture and create awareness for the need of improvement?
2. Addressing rising Cesarean section rates: What are some of the underlying reasons why African Americans experience higher rates of C-sections? What does this say about the experience of pregnancy, birth and the post-partum period among minority women? How do women describe their experience with the healthcare system when it comes to choosing birthing options?
3. Addressing chronic disease as a driver of maternal mortality: Why do these health conditions disproportionately affect women in the U.S.? How do chronic diseases impact maternal health in the U.S.? How does overall health impact pregnancy outcomes among women of color? What is being done to address some of these issues?
4. Improving measurement and reporting requirements: There are only six states that require the measurement of maternal mortality, resulting in systematic undercounting of maternal deaths as well as lack of information regarding the background and causes of maternal deaths. What impact does this lack of effective measurement have on efforts to address maternal health and mortality? Does this disproportionately affect racial minorities and those with low socioeconomic status? How does lack of measurement affect accountability?
5. Opportunities for collaboration between the public health, medical, policy, and advocacy communities: Too often organizations and people working on maternal health in the U.S. are siloed. How can we combine efforts and work collaboratively to address inequities in maternal health care? How can we merge policy and public health efforts in reducing inequities in maternal mortality?

You may also feel free to suggest your own topic to our editors.

General guidelines for blog posts:

• Please include the author name, title, and photo.
• Goal: Guest posts should raise questions, discuss lessons learned, analyze programs, describe research, offer recommendations, share resources, or offer critical insight.
• Audience: The audience for this series is health and development professionals working in maternal and newborn health around the world, primarily in resource-constrained settings.
• Tone: Conversational. Doesn’t need to meet peer-reviewed publication standards.
• Feel free to choose your own style or approach. Q/A as well as lists (eg. top ten lessons) can often be effective ways of organizing blog posts.
• Length: 600-800 words.
• No institutional promotion.
• Please include links to sources such as websites and/or publications.
• May also include photos and videos, please include a caption and a credit for the photo.

To contribute a post to this series, please contact Vanessa Brizuela at vbrizuela@mail.harvard.edu or Katie Millar at kmillar@hsph.harvard.edu.

Submissions to this series will be reviewed and accepted on a rolling basis, but preference will be given to posts received by November 16, 2015.

Posts in this series will be shared on the MHTF blog and may be cross-posted on other leading global health and development blogs.

Photo: “United States of America” ©2011 Mr. Lugan, used under a Creative Commons Attribution-NoDerivs 2.0 Generic license.

Categories: Inequities in Maternal Mortality in the U.S.

Topics: Health Systems Inequities & Inequalities Maternal Morbidity Maternal Mortality Quality of Care Reproductive Health Respectful Maternity Care Social Determinants

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