Each year in the United States, an estimated 700 to 900 women die from pregnancy or childbirth-related causes, while another 65,000 nearly die, according to the Centers for Disease Control and Prevention. It's the highest rate of maternal mortality in the industrialized world.
Within the U.S., there are drastic racial disparities — black mothers die at three to four times the rate of white mothers. As NPR previously reported:
A black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, but 300 percent more likely to die from pregnancy- or childbirth-related causes. In a national study of five medical complications that are common causes of maternal death and injury, black women were two to three times more likely to die than white women who had the same condition."
And then, there are the babies. In Minnesota, African-American and American Indian infants are more than twice as likely as white babies to die in their first year.
Many social scientists and medical researchers agree that the disparities in maternal mortality is due to racism, not race. And there's a growing consensus that racial discrimination experienced by black mothers during their lifetime makes them less likely to carry their babies to full term.
"Structural racism will restrict access for black women or people of color in general to health-promoting factors like wealth, income, safe housing, quality of education and health care, and the result is a disadvantage," said Rachel Hardeman, an assistant professor at the University of Minnesota who researches health equity. "There have been studies throughout the years that have actually looked at how that accumulated process can really impact the health and well-being of African-American or black women."
And that's before they even get to the hospital or the delivery room.
Unconscious or implicit bias can also play a role in the quality of care or a woman's relationship with her physician. Some women have reported feeling disrespected by their health care providers, while others say they're even made to feel apologetic for being pregnant, said Clara Sharp, a doula at Ahavah Birthworks.
That's where culturally centered care can step in, when expectant and new moms can develop a relationship with someone who looks like them and can relate to them. That can lead to mothers seeking more care during and after pregnancy.
"We're a safe person to talk to. These moms are not going to tell everything to their providers. They're not going to talk about all their struggles. They're not going to talk about what stresses them every day," Sharp said. "But that sister doula — that's what we call ourselves — she'll talk to her about that."
To hear more from this conversation, click on the audio player above.