Health

Systemic racism plays a role in much higher maternal mortality rates among Black women


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Black women have a 53% increased risk of dying in hospital during childbirth, regardless of income level, insurance type or social determinants of their health, showing systemic racism severe effects on maternal health, according to an 11-year analysis of more than 9 million births in US hospitals presented at the Anesthesiology 2022 annual meeting.

“This study is the most extensive and up-to-date study — factoring across multiple states, insurance types, hospital types, and income levels — to determine that maternal mortality rates are much higher among women. Black people often can’t due to health differences, says Robert White, MD, MS, lead author of the study and an assistant professor of anesthesiology at Weill Cornell Medicine, New York. “Clearly there is a need for it. legislation to improve access to health care during pregnancy and to improve funding among safety net hospitals. But it is essential that hospitals train their staff to provide culturally appropriate care, provide translation services, and perform implicit bias association checks.”

Causes of maternal death include development of blood clots, heart failure, postpartum hemorrhage (excessive blood loss), and preeclampsia (extremely high blood pressure). The United States’ maternal mortality rate of 17.3 deaths per 100,000 births is higher than any other developed country, with a huge gap between black and white mothers. The Centers for Disease Control and Prevention defines maternal death as death during pregnancy, childbirth, or within one year of the end of a pregnancy. This study focused on maternal deaths during hospital delivery.

Researchers analyzed 9.5 million deliveries that took place in hospitals between 2007 and 2018, based on the State Inpatient Database from California, Florida, Kentucky, Maryland, New York, and New York. York and Washington. Of these, 49,472 mothers (0.5%) died in hospital or suffered heart, eye, kidney, brain or other organ injuries, including 0.8% black women, 0.5% women Hispanic and 0.4% white women. The researchers determined that compared with white women, black women had a 53 percent increased risk of dying in hospital, even after adjusting for insurance type, hospital type, income, and social factors. other association. Hispanic women and white women have the same risk of death in hospital.

“Resuscitative anesthesiologists are leaders in quality, safety and perioperative medicine and are working very hard to help reduce racial disparities through the science and implementation of protocols for treat everyone equally – focus on the worse off to achieve health equity,” he said. Dr. White. “We not only provide pain management during childbirth, but also training in the urgent care help us proactively handle complications, prevent death, and ensure safety for mother and baby”.

Anesthesiologists are working to standardize practices, helping to reduce disparities. For example, the Society for Obstetrics and Gynecology (SOAP) has developed an enhanced recovery procedure after a cesarean section, focusing on pain relief, mobility, mother-infant bonding, and reduced use of labor. opioid use and shorter length of stay. Anesthesiologists have also played an important role in the Alliance for Maternal Health Innovation (AIM), a national data-driven quality improvement effort. This includes developing patient safety packages — a set of best practices, informed by evidence, to be implemented in all care settings, for all patients, in each session — to improve outcomes.

In addition, anesthesiologists participated in state maternal mortality review committees to identify trends and systemic issues that could be improved, helping to coordinate care for maternal morbidity at risk. high muscle mass and placental implantation disorders, and organized and guided simulations for obstetric hemorrhage (OB). This is of particular importance because maternal mortality from OB hemorrhage is higher in black women. Anesthesiologists have invented algorithms using point-of-care ultrasound (POCUS) that are particularly useful in the case of maternal bleeding and can be quickly used when women do not have a pulse to identify them. see if there is activity in the heart.


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Provided by American Society of Anesthesiologists

Quote: Systematic racism plays a role in much higher maternal mortality rates among Black women (2022, October 23) accessed October 23, 2022 from https://medicalxpress.com /news/2022-10-racism-role-higher-maternal-mortality.html

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