What’s Up Docs? Article
Amna Khan, MD FAAP
Posted June 10, 2024
Despite recent information this week, the incidence of Black maternal mortality in the U.S. continues to be one of the most egregious modern day health inequities that requires our continued examination into its multifaceted causes, effects and repercussions. A maternal death is defined by the World Health Organization as, “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes”. According to the CDC, in 2021, the maternal mortality rate for non-Hispanic Black women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White women (26.6) Rates for non-Hispanic Black women were significantly higher than rates for non-Hispanic White and Hispanic women.
Source: California Department of Public Health
As pediatricians, it is our responsibility to prioritize learning about the roots of this longstanding, devastating public health issue and identify our collective role in improving peri pregnancy outcomes for Black mothers, infants and families. Pediatricians have a significant role to play in advocating for mothers and infants, especially our Black families, during multiple clinical encounters within minutes to days following birth since 50% of maternal morbidity and mortality occurs in the postpartum period.
Consider asking all mothers during newborn clinical encounters for symptoms such as headache, chest pain, nausea, severe abdominal pain, and excessive bleeding that leads to higher morbidity and mortality in this patient population. In Santa Clara County, where I practice Outpatient Pediatrics, we are partnering with our OB colleagues to standardize screening of all mothers for these concerning symptoms and develop the corresponding clinical workflow to access OB care quickly and effectively for further evaluation.
See below for important additional resources to learn more about the upstream causes of this health inequity and inspire your role in challenging it, wherever you practice clinical medicine.
For additional information about anything described in this health equity corner, please reach out to me at thepeoplespediatrician@gmail.com. For additional child-focused, health equity resources and the link to subscribe to my monthly health equity newsletter, visit www.thepeoplespediatrician.com
In solidarity,
Amna Khan, MD FAAP
EDI Champion, Chapter 1 AAP
Books:
“Weathering: The Extraordinary Stress of Ordinary Life in an Unjust Society”, by Arline T. Geronimus
Podcasts:
American Dissected, The Black Maternal Health Caucus with Rep. Lauren Underwood
KQED Forum, How California’s Black Doulas are Fighting the Maternal Mortality Crisis
Article:
“Black Mothers Keep Dying After Giving Birth. Shalon Irving’s Story Explains Why”
Movie Trailer:
“Black Motherhood through the Lens”
Documentary created by medical student at Brown University and filmmaker, Adeiyewunmi (Ade) Osinubi spotlighting black maternal health inequities.