Proposal Essay (1)

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Black Women Deserve Better: Maternal Mortality Starr-Aisa Hayes The University of Texas At El Paso WS 2300 CEL: Introduction to Women’s Studies Naomi Fertman April 27th, 2023

The problem my project addresses and contextualizes in my community is black women's maternal mortality rate and how it is significantly higher than any other race. Maternal mortality is “the death of a woman during pregnancy, at delivery or soon after delivery” (CDC 2022 ), which is a misfortune for her family and society overall because now the family must raise the child and that child will never know or truly be able to form a connection with their mother. If she had no family now, the child goes into foster care and is up for adoption, which may be a blessing to some but at the cost of a life that at most times \could have been saved. Maternal mortality affects black women the most, “currently, Indigenous and Black Women are dying at 2- 5 times the rate of White Women, Asian/Pacific Islander and Hispanic Women.” (Guttmacher Institute 2023) Maternal mortality goes against everything that the reproductive justice movement is fighting. Reproductive justice is a framework that includes not only a woman’s right not to have a child, but also the right to have children and to raise them with dignity in safe, healthy, and supportive environments” (Roberts, 2015). Black women aren’t getting the chance to raise their children due to maternal mortality, this is deadly to the black community and a bad look on the United States because “The United States has one of the highest rates of maternal mortality among high-income countries and wide disparities by race that have been documented since rates separated by race were first published in 1935.” (Guttmacher Institute 2023) I hope to raise awareness and shed light on racial disparities and racial discrimination that Black women face in an area that is supposed to be a safe place for them and to be cared for regardless of race. The "Black Maternal Health Week is recognized each year from April 11-17 to bring attention and action in improving Black maternal health. Everyone can play a role in working to prevent pregnancy-related deaths and improving maternal health outcomes.” (CDC

2023) These doctors took an oath that some don’t uphold because they’re racist; “Research on maternal and infant death disparities has increasingly pointed to structural racism in society at large as a stressor that harms African American women at both physiological and genetic levels.” (Owens & Fett 2019) It is important to get an understanding of what happens to Black women during and after their pregnancy at most of these hospitals in America which have been embedded since slavery; “Public health initiatives must acknowledge these historical legacies by addressing institutionalized racism and implicit bias in medicine while promoting programs that remedy socially embedded health disparities.” (Owens & Fett 2019) There is only one group that is majorly affected by Maternal Mortality and that is black women; as long as national data have been available, significant disparities in maternal mortality between White and Black mothers have been documented, the “Centers for Disease Control and Prevention figures from 2016 show that today non-Hispanic Black infant mortality is 2.3 times higher than mortality among non-Hispanic White babies; 11.4 deaths and 4.9 deaths, respectively” (Owens & Fett 2019) The black-white gap is exacerbated by the fact that black mothers are more likely than white mothers to give birth in standardized severe maternal morbidity hospitals with higher risk. The causes of maternal mortality are eclampsia, which are seizures that occur in pregnant women; preeclampsia, which is a serious condition that can develop after the 20th week of pregnancy or after the birth of a child; and postpartum cardiomyopathy, which is a rare form of heart failure. Black women also suffer from obstetric embolism, which is a rare but potentially fatal problem that arises when amniotic fluid enters the bloodstream of a pregnant woman just before, during, or immediately following childbirth. and obstetric hemorrhage, which refers to excessive bleeding in a parturient, “For non-Hispanic Black women, eclampsia, preeclampsia,

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and postpartum cardiomyopathy occurred at rates five times those for non-Hispanic white women. Non-Hispanic Black maternal mortality rates from obstetric embolism and obstetric hemorrhage were 2.3 to 2.6 times those of non-Hispanic White women. Together, these four causes accounted for 59% of the nonHispanic Black–non-Hispanic White maternal mortality disparity” (MacDorman, Thoma, Declcerq & Howell 2021). Advocacy is a public support or recommendation for a particular policy or cause. This project is a form of advocacy that creates social change because it identifies ways for people of color to strengthen the relationship between them and the hospital during birth. My project would be empowering to me, my classmates, the Black community, and the community at large because its shows you ways that maternal mortality affects people of color in the United State at a significantly higher rate than any other countries; “The United States has the highest maternal mortality rate among comparable countries in the developed world.1 While the overall rate of 17.4 per 100,000 live births is cause for alarm among all American women, Black women are dying more than any other racial or ethnic group” (Taylor 2020). I want to find a way to get a doctor who will care for you regardless of race and educate people on how racial discrimination happens in a place that should be neutral and safe. They have now put in place protocols for preventing postpartum hemorrhage, intracranial hemorrhage in women with a hypertensive crisis, and death from post-cesarean pulmonary embolism. Pneumatic compression devices were universally used in all affiliated hospitals for women who had a cesarean section. They introduced specific checklist-based protocols for the prompt recognition and treatment of hypertensive crises with either labetalol or hydralazine, and emphasized the significance of aggressive recognition and management of preeclampsia-related pulmonary edema. In cases of postpartum hemorrhage, they developed and implemented a

checklist-based protocol for prompt fluid, blood, and component replacement. If you are a pregnant woman or family member, reducing maternal mortality is to be aware, and if anything does not feel right or is worrying you, see a doctor. Know and look for surefire care if encountering any of the earnest maternal admonition signs, including serious cerebral pain, outrageous enlarging of hands or face, inconvenience breathing, weighty vaginal draining or release, and overpowering sleepiness. There are side effects that could demonstrate a potentially dangerous entanglement so you should bring your most recent pregnancy history with you to every appointment for up to one year after birth or getting in touch with social and medical support networks prior to, during, and after pregnancy.

References Centers for Disease Control and Prevention. (2022, September 16). Maternal mortality . Centers for Disease Control and Prevention. Retrieved April 15, 2023, from https://www.cdc.gov/reproductivehealth/maternal-mortality/index.html Clark, S. L., Christmas, J. T., Frye, D. R., Meyers, J. A., & Perlin, J. B. (2015). Maternal mortality in the United States. Obstetric Anesthesia Digest , 35 (3), 121–122. https://doi.org/10.1097/01.aoa.0000469455.21336.4b Committee on Oversight and Reform, Birthing while black: Examining America's Black Maternal Health Crisis: Hearing before the Committee on Oversight and Reform, House of Representatives, One Hundred Seventeenth congress, first session, May 6, 2021 (n.d.). Dayo, E., Christy, K., & Habte, R. (2022). Health in colour: Black women, racism, and maternal health. The Lancet Regional Health - Americas , 17 , 100408. https://doi.org/10.1016/j.lana.2022.100408 Holdt Somer, S. J., Sinkey, R. G., & Bryant, A. S. (2017). Epidemiology of racial/ethnic disparities in severe maternal morbidity and mortality. Seminars in Perinatology , 41 (5), 258–265. https://doi.org/10.1053/j.semperi.2017.04.001 Howell, E. A., Egorova, N. N., Balbierz, A., Zeitlin, J., & Hebert, P. L. (2016). Site of delivery contribution to black-white severe maternal morbidity disparity. American Journal of Obstetrics and Gynecology , 215 (2), 143–152. https://doi.org/10.1016/j.ajog.2016.05.007

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James-Conterelli, S., Dunkley, D., McIntosh, J. T., Julien, T., Nelson, M. D., & Richard- Eaglin, A. (2023). The impact of systemic racism on health outcomes among Black Women. The Nurse Practitioner , 48 (2), 23–32. https://doi.org/10.1097/01.npr.0000000000000001 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 mortality review committees . Guttmacher Institute. (2023, April 5). Retrieved April 15, 2023, from https://www.guttmacher.org/state-policy/explore/maternal-mortality- review-committees?gclid=CjwKCAjw0N6hBhAUEiwAXab-Tago- XFwZC6rOpuGZ5dXTMrpXvSMTuw2tJjnocp3w2myu-shQUmV-xoC_WIQAvD_BwE Owens, D. C., & Fett, S. M. (2019). Black maternal and infant health: Historical legacies of slavery. American Journal of Public Health , 109 (10), 1342–1345. https://doi.org/10.2105/ajph.2019.305243 Roberts, D. (2015). Reproductive Justice, not just rights. Dissent , 62 (4), 79–82. https://doi.org/10.1353/dss.2015.0073 Taylor, J. K. (2020). Structural racism and maternal health among Black Women. Journal of Law, Medicine & Ethics , 48 (3), 506–517. https://doi.org/10.1177/1073110520958875

Proposal Essay (1)

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