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Racial disparity in maternal mortality rate

Washington — The number of women who die during or shortly after childbirth is higher in the U.S. than any other developed nation, particularly among women of color. Determining the cause of that racial disparity poses “essentially one of the biggest challenges of public health,” the head of a Harvard task force studying the issue said Sunday.

“We see that as a top of the iceberg of poor health in women and poor health in Black women,” Dr. Henning Tiemeier, the director of Harvard’s Maternal Health Task Force, said in an interview on “Face the Nation.” “And there are several reasons, there seems to [be], from poverty to discrimination to poor care for this group of women.”

Every year in the U.S., roughly 700 women die while in labor or within the first month of giving birth, Tiemeier said, noting that most of these deaths are “preventable.”

According to a 2020 report by the Centers for Disease Control and Prevention, the maternal mortality rate in the U.S. for non-Hispanic Black women was 55.3 deaths per 100,000 live births — roughly 2.9 times the rate among non-Hispanic White women. Tiemeier said the high disparity can be attributed to the overall health of women, poverty, poor care after delivery and discrimination, among other factors.

The issue of maternal mortality has taken on greater importance in the wake of the Supreme Court’s decision overturning Roe v. Wade, with many states implementing long-awaited bans of the procedure and cutting off access for millions of women. Black women have accounted for nearly 40% of all abortions performed in the U.S., and Tiemeier said he thinks limiting abortion access will have an as-yet-unknown impact.

“We know that abortion occurs and people of poverty and minorities much more often,” Tiemeier said. “We know that they have difficulties to access abortion outside the state, so we think it will impact their physical and mental health. How many deaths? Nobody knows. It is very hard.”

About 40% of births are covered by Medicaid, but in many states, coverage ends two months after birth. The federal government has encouraged more states to accept additional Medicaid funding and expand maternal care, and Tiemeier pointed to Texas and Mississippi as states where expanding coverage would help new mothers.

“They have not accepted the Affordable Care Act offer to expand health care to women in the first year, and I would actually say it should go further than that in the first year after delivery,” he said. 

Tiemeier also stressed the importance of expanding paid leave for new mothers, saying the issue is often “under-recognized.”

“So, giving them leave, paid leave is very important because having a child is a stress on the system,” Tiemeier said. “Imagine you have three children, you have a fourth one, then you need, you know, you’re making a minimum, though you will not manage to make your ends meet, you will not find the time to breastfeed.”


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