Assignment 5.1- Introduction and Search History

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Maryville University *

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Feb 20, 2024

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INTRODUCTION AND SEARCH HISTORY 1 Assignment 5.1: Introduction and Search History Dezene Thompson-Powell Maryville University

INTRODUCTION AND SEARCH HISTORY 2 Assignment 5.1: Introduction and Search History Black pregnant women are dying from pregnancy complications during and after childbirth. However, when compared to their white counterparts, the black mortality rate is significantly higher and is almost four times higher in black pregnant women (Adegoke et al., 2021). Black women are treated differently, and face disparities and this contributes to the elevated mortality rate. Some of the factors affecting black maternal mortality rate are social support, socio-economic background, chronic health conditions, mother-provider communication, implicit bias, systemic bias, mental health, and systemic factors. Among these, mother-provider communication was the main factor contributing to the maternal experience. It was discovered that it was primarily influenced by the provider's discriminatory behaviors and attitudes toward black mothers and maternal health literacy (Alio et al., 2022 & MacDorman et al., 2021). This topic is important to nursing because not only are black mothers dying, but black infants are dying, too. This is a serious problem, but it is also preventable. According to the Centers for Disease Control and Prevention (2023), more than 80% of maternal mortality in the US is preventable. As nurses, we are all responsible for providing timely treatment and assessment, delivering respectful, quality care, and recognizing urgent maternal warning signs. All these can prevent most pregnancy-related mortality. It was these findings that led to the PICO(T) question. In pregnant black women (P), how does cultural humility (I), versus usual care (C), impact outcomes, that is, the maternal mortality morbidity rate in black women (O), over 6 months to one year?

INTRODUCTION AND SEARCH HISTORY 3 Practice Problem According to Hoyert (2023), the World Health Organization (WHO) defined maternal death 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”. Maternal mortality rate refers to the number of maternal deaths per 100,000 live births (Hoyert, 2023). Maternal mortality is steadily on the rise, with the most increase in black women. In 2021, 1,205 women died of maternal issues in the United States; when compared to 2020, there was a 344 increase in maternal deaths and a 451 increase from 2019. The maternal mortality rate for 2021 increased by 9.1 from 23.8 in 2020 to 32.9 deaths per 100,000 live births and from 20.1 in 2019. “In 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6). Rates for Black women were significantly higher than rates for White and Hispanic women” (Hoyert, 2023). Providers don’t spend much time listening to their black patients. If they spend more time listening to them, disparities in maternal mortality can be reduced significantly. We must break systemic racism and implicit bias before we can reduce maternal mortality rate in the US. Providers must ask the appropriate questions to get to know their black patients and the things that are affecting their lives. Stop blaming the patients for their situations; instead, help them to understand urgent maternal warning signs (Centers for Disease Control and Prevention [CDC], 2023). This is a personal example from when I was pregnant with my second child. I was so

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INTRODUCTION AND SEARCH HISTORY 4 scared. I knew the statistics and hoped I wasn’t among that percentage. I made sure to select a black doctor, hoping she would listen to me and respect my wishes. Search History During my search history, Google Scholar and Maryville online library were utilized with the following databases: CINAHL, PubMed, and Medline. The parameters utilized to locate the articles were full text, case study, PDF full text, and other primary research articles with dates ranging from 2018 to 2023 with the intention of staying within five years. Keywords used to locate articles include black mortality rate, disparities in black pregnancy, structural racism, and implicit bias in black pregnancy. Many articles were found, but only thirteen were chosen for the literature review. Some articles were excluded due to limited data on the topic and credibility. Only journals with five years or less of primary research data were selected. Statistics were primarily retrieved from CDC or WHO websites.

INTRODUCTION AND SEARCH HISTORY 5 References Adegoke, T. M., Pinder, L. F., Ndiwane, N., Parker, S. E., Vragovic, O., & Yarrington, C. D. (2021). Inequities in adverse maternal and perinatal outcomes: The effect of maternal race and nativity. Maternal and Child Health Journal , 26 (4), 823–833. https://doi.org/10.1007/s10995-021-03225-0 Alio, A. P., Dillion, T., Hartman, S., Johnson, T., Turner, S., Bullock, S., & Dozier, A. (2022). A community collaborative for the exploration of local factors affecting black mothers’ experiences with perinatal care. Maternal and Child Health Journal , 26 (4), 751–760. https://doi.org/10.1007/s10995-022-03422-5 Centers for Disease Control and Prevention. (2023, April 28). Working together to reduce black maternal mortality . Retrieved November 15, 2023, from https://www.cdc.gov/healthequity/features/maternal-mortality/index.html Hoyert, D. L. (2023, March 16). Maternal mortality rates in the united states, 2021 . Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/hestat/maternal- mortality/2021/maternal-mortality-rates-2021.htm MacDorman, M. F., Thoma, M., Declcerq, E., & Howell, E. A. (2021). Racial and ethnic disparities in maternal mortality in the united states using enhanced vital records, 2016‒ 2017. American Journal of Public Health , 111 (9), 1673–1681. https://doi.org/10.2105/ajph.2021.306375 Maternal deaths . (n.d.). World Health Organization. https://www.who.int/data/gho/indicator- metadata-registry/imr-details/4622

Assignment 5.1- Introduction and Search History

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