Racial Differences and Pregnancy Care

By Jane Farrell

The National Institutes of Health (NIH) announced that it will fund new research examining racial and ethnic disparities in pregnancy-related complications and deaths.

According to the Centers for Disease Control and Prevention (CDC), approximately 700 women die each year in the United States from pregnancy-related complications. The grants to six institutions are expected to total over $21 million over five years, pending the availability of funds. The project is supported by the National Institute on Minority Health and Health Disparities (NIMHD), the National Heart, Lung, and Blood Institute (NHLBI), and the NIH Office of Research on Women’s Health.

In a news release, the NIH said the research will include original, innovative, and multidisciplinary efforts to advance the understanding, prevention, and reduction of pregnancy-related complications and deaths among disproportionately affected women. This includes women from racial and ethnic minority groups, women with underprivileged socioeconomic status, and those living in underserved rural settings.

The racial disparities in pregnancy-related mortality are stark: respectively, African American and American Indian/Alaska Native women are 3.2 and 2.3 times more likely to die from pregnancy-related causes than are white women. In the case of African American women, the disparity increases with age. Black women under 20 are 1.5 times more likely to die from pregnancy-related causes than are white women in the same age group, but black women ages 30-34 are 4.3 times more likely to die from pregnancy-related causes than are white women ages 30-34. Approximately two thirds of pregnancy-related deaths are preventable, the NIH said, underscoring the need for more research to improve the maternal health outcomes for women before, during, and after delivery.

In addition to maternal deaths, over 25,000 women each year experience severe maternal morbidity (SMM), requiring unexpected short- or long-term life-saving healthcare interventions. Like maternal mortality, SMM has a high rate of preventability. All racial and ethnic minority populations have higher rates of SMM than do white women.

“This initiative is a significant undertaking to reduce preventable causes of maternal deaths,” said NIMHD Director Eliseo J. Pérez-Stable, M.D.  “We need to take a closer look at underlying factors beyond the individual, such as healthcare access, health care settings providing care, community resources, and racial bias and examine how these factors may impact the maternal health outcomes of racial and ethnic minority women.”

In addition to examining factors influencing maternal health disparities, researchers will be among the first to evaluate the effectiveness of a multilevel intervention—at the individual, health care setting, community, and societal levels—to reduce maternal deaths and complications.