African American Mothers in the Community

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 African American Mothers in the Community

The United States has high maternal mortality and morbidity rates despite laws that

ensure medical coverage for low-income households. Moreover, disparities in maternal

mortalities in the community warrant investigation to determine the factors perpetuating the

health crisis. While socioeconomic factors and limited access to care are major concerns,

research indicates that racial discrimination undermines African Americans’ maternal health

outcomes. A systematic approach to practitioner and patient education is critical to reinforce

strategies to promote behavioral adjustments within the community.

Demographics

The United States has an upward trend in maternal mortality, which is higher than other

developed nations. The nation has a mortality rate of 26.4/100,000, which is significantly higher

than Italy's rate of 4.2/100,000, Denmark's 4.2/100,000, and Finland’s at 3.2/100,000 (Lister et

al., 2019). Moreover, within the United States, African American maternal mortality rates are

four times higher than non-Hispanic Caucasian communities (Lister et al., 2019). The figures

indicate an alarming trend in underrepresentation in healthcare delivery that should be addressed

using a systematic review of medical practices and the stakeholders affected.

Socioeconomic Factors

Studies on socioeconomic factors affecting disparities in maternal health outcomes have

identified behavioral tendencies that should be considered. While early and adequate prenatal

care provides opportunities for screening risk factors, African American women in the

community have lower adoption tendencies than Hispanics and Caucasians. Fewer prenatal visits

translate to poor pregnancy outcomes such as preterm births, child mortality, and low birth

weight. Research on the timing and reception of prenatal care reveals Hispanic, Caucasian, and
Asian women had higher visit rates at 69%, 79%, and 68%, respectively (Howell, 2018). On the

other hand, African American women recorded visitation rates of 64%, exposing the vulnerable

population to pregnancy complications (Howell, 2018). The evidence suggests that strategies

centered on behavioral adjustments are instrumental in promoting early prenatal visitation.

Preconception behaviors impact maternal health outcomes. Empirical findings reveal that

African American women are more likely to have obesity as a preconception risk factor than

other races (Howell, 2018). Furthermore, unintended pregnancies affect pregnancy duration,

prompting discussions on equipping women with the resources to plan for conception and

prenatal care. Health disparities across social, economic, and education domains warrant

investigation, as African American women with college degrees recorded higher death rates than

Hispanic and Caucasian women without college degrees (Robeznieks, 2021). Therefore,

discussions on the risk factors should be led by practitioners.

Environmental Factors

Climate change disproportionately affects African American maternal health dynamics.

Research suggests that adverse effects are evident in the at-risk community compared to

Caucasian communities. A 2017 study identified that a 10% temperature increase in heat zones

such as California translates to 8.6% preterm births in the general population; however, African

American mothers recorded a higher prevalence of 15% (Isaac, 2021). Furthermore, African

Americans from low-income backgrounds were likely to reside near pollution zones in the

community context (Isaac, 2021). Consequently, air pollution and extreme heat cause premature

births, underweight infants, and stillbirths. African American maternal deaths are two to three

times higher due to environmental risk factors (Isaac, 2021). The data indicate the need for

policy reforms to reinforce equality in environmental protections.

 Access to Healthcare

An analysis of health insurance coverage indicates gaps that undermine maternal health

outcomes for African American women of reproductive age. Access to high-quality care is

crucial in mitigating risks in prenatal and postnatal periods; however, adults with low incomes

are excluded from health services in states without Medicaid expansions (Solomon, 2021).

Among 12 such states, African American women represent two-thirds of the uninsured

population, highlighting disparities in access to maternal services (Solomon, 2021). Policy

incentives should be applied to mitigate such disparities.

Risk Factors

The Centers for Disease Control and Prevention (CDC) investigated maternal mortality

rates, and the findings highlight several factors that contribute to the crisis. The 2011 to 2017

research indicates that heart disease and stroke are the leading risk factors for pregnancy-related

mortality (Robeznieks, 2021). Preeclampsia, eclampsia, and embolism were among the leading

causes of African American mortalities (Robeznieks, 2021). Furthermore, chronic stress and

trauma due to discrimination occurring as early as during the initial phase of pregnancy signify

the persistence of early death among adults (Robeznieks, 2021). Therefore, potential solutions

target mental and physical risk factors.

Racial disparities in maternal health outcomes are persistent challenges. While

socioeconomic factors and limited access to care expose the vulnerable population to health

risks, they do not fully explain the scope of disproportional health outcomes. An analysis of

perceptions among African American women indicated perceived bias as a critical factor

undermining engagement with health services. Furthermore, racial bias among providers
perpetuates the issue, highlighting the need for a comprehensive review of sustainable measures

to restore trust levels between care providers and the at-risk population.

Empirical studies reveal that the challenges affecting the vulnerable population extend

beyond socioeconomic factors. Research involving 10,755 women from similar socioeconomic

backgrounds suggests that there were different maternal health outcomes depending on racial

characteristics (Lister et al., 2019). The women had Medicaid coverage; however, Hispanics had

lower risks of pre-term birth than Caucasians. African American women had higher risks of pre-

term birth and preeclampsia (Lister et al., 2019). In another study centering on maternal deaths

between 1998 and 2005, Caucasians recorded the lowest rates of maternal mortalities, while

African American women had higher risks out of the 4,693 cases considered (Lister et al., 2019).

The findings indicate that the disparities in health outcomes occur even if the at-risk population

receives early prenatal care. Therefore, the research should expound on factors extending beyond

the outlined demographic elements.

The empirical results reveal a positive correlation between site of care and

disproportional maternal health outcomes. Approximately 75% of the African American patients

received care in facilities with 25% minority staff representation (Lister et al., 2019).

Furthermore, most of the African American patients received care from teaching facilities and

hospitals based in urban areas (Lister et al., 2019). Considering that the vulnerable population is

more likely to have comorbidities, such as asthma, obesity, and hypertensive and placental

disorders, healthcare leaders should apply strategic responses to improve the quality of care at

their facilities (Lister et al., 2019). A multi-tiered approach, including policy frameworks,

healthcare professionals, and the underserved patients, can address racial disparities in maternal
health outcomes. Sustainable solutions include revisions of healthcare services to address racial

bias and perceived causes of prejudice.

Health Promotion Activities

Potential solutions include requisite education and referral channels to transfer high-risk

patients to tertiary care facilities. African American patients mistrust health practitioners and

perceive that they are less valued than Caucasian clients (Lister et al., 2019). Obstetricians are

mainly involved in reproductive health cases affecting the targeted population; hence they are

strategically positioned to serve as intermediaries between patients and care specialists (Lister et

al., 2019). Through social media networks, obstetric care providers can elaborate on the stress-

test context of pregnancy as the period indicates potential future health risks. Effective patient-

provider communication is instrumental in improving patient engagement with health services.

Training health practitioners on skills necessary in reinforcing compassion and respect in

handling African American patients is crucial in sustaining engagement with health services.

Community-based outreach programs are effective resources for raising awareness of the

importance of early prenatal care. The initiative includes an interprofessional collaboration

involving community representatives, health practitioners, social workers, and locals in regions

predominantly occupied by African American women. Free screening features are crucial in

conveying the need for prenatal services. Public service announcements are effective

communication resources that can be leveraged to equip African American women with the

knowledge to prepare for pregnancies. The communication design entails educational packages

centered on preconception risk factors affecting the population and behaviors that undermine

maternal health outcomes. As a result, women receive guidance on nutrition, physical exercise,
contraceptives, and planning for pregnancies. Consequently, they receive information on relevant

behavioral adjustments needed and support systems available.

Health professionals should advocate for Medicaid expansions to address maternal health

risks. Lobbying for change through interdisciplinary channels is an effective approach to health

promotion that ensures that medical systems cater to the risks discussed. Educating women on

such issues enables them to make informed voting choices. Moreover, public pressure is vital in

enforcing the Equal Protection Clause of the 14th Amendment. Therefore, voter education and

advocacy should be prioritized.

The African American maternal crisis extends beyond socioeconomic factors and

coverage gaps. Racial discrimination in healthcare delivery may manifest due to unintended bias

leading to mistrust which undermines engagement with maternal care resources. Appropriate

health promotional interventions should be administered through collaborative efforts to

influence change at the systems level through policy reform. Furthermore, health professionals

should receive training on compassion and respectful care approaches as a resource to promote

engagement among African American Communities. The promotional activities discussed center

on education and awareness campaigns to influence desirable behavioral adjustments.

 References

Howell, A. E. (2018). Reducing disparities in severe maternal morbidity and mortality. Clinical

Obstetrics and Gynecology, 61(2), 387–399.

https://doi.org/10.1097/GRF.0000000000000349

Isaac, F. (2021). Climate change is hurting expectant Black mothers. American Bar Association.

https://www.americanbar.org/groups/environment_energy_resources/publications/

natural_resources_environment/2020-21/winter/climate-change-hurting-expectant-black-

mothers/

Lister, L. R., Drake, W., Scott. H. B., & Graves, C. (2019). Black maternal mortality-The

elephant in the room. World Journal of Gynecology & Women's Health, 3(1).

https://doi.org/10.33552/wjgwh.2019.03.000555

Robeznieks, A. (2021). Examining the Black United States maternal mortality rate and how to

cut it. American Medical Association.

https://www.ama-assn.org/delivering-care/population-care/examining-black-us-maternal-

mortality-rate-and-how-cut-it

Solomon, J. (2021). Closing the coverage gap would improve Black maternal health. Center on

Budget and Policy Priorities. https://www.cbpp.org/research/health/closing-the-

coverage-gap-would-improve-black-maternal-health