Hospitals That Serve Communities Of Color Are Failing Pregnant Women
When it comes to pregnancy and childbirth, Black mothers face higher risks of complications and death than their white counterparts. Decades of research have linked these disproportionate rates to systemic racism, discrimination, and stigma among health care professionals and in society at large. But a recent ProPublica report exposed just how women of color are put at higher risk of harm — in particular, how hospital fail black mothers during and after labor.
The mortality rate among new mothers is depressing: About 700 to 900 women die each year from pregnancy or childbirth-related complications, according to the U.S. Centers for Disease Control and Prevention. Women of color, though, account for a disproportionate number of those deaths; as ProPublica pointed out, using CDC data, Black mothers are more than three times more likely to die during pregnancy and childbirth.
Researchers have linked this disparity to poor care in hospitals serving populations of color. But journalists at ProPublica decided to conduct an in-depth analysis of the issue, combing through two years of hospital inpatient discharge data from New York, Illinois, and Florida. And what they found is that mothers who hemorrhage at what are termed "black-serving" hospitals faced higher complication and mortality rates.
Here's one startling statistic from the ProPublica report: 90 percent of women who deliver at SUNY Downstate Medical Center in New York are black. SUNY Downstate also has the highest hemorrhage complication rates across the three states studied, according to ProPublica.
From the report:
On average, 34 percent of women who hemorrhage while giving birth at New York hospitals experience significant complications. At SUNY Downstate, it’s 62 percent.
ProPublica discovered similar rates at the other hospitals it analyzed, confirming pervasive patterns identified by previous studies. But what exactly is driving this racial disparity in complication and mortality? And why, particularly, at hospitals serving populations of color primarily?
A 2016 American Journal of Obstetrics and Gynecology study links the disparity, at least among New York City's hospitals, to hospital quality. In particular, the disproportionate rates may be driven by poor policy and failure to follow recommended protocols — the case, it seems, at SUNY Downstate — according to ProPublica.
Think about it this way: Researchers behind the study found that black mothers were twice as likely to be harmed during childbirth than their white counterparts. In a separate American Journal of Obstetrics and Gynecology study published last year, those same researchers estimated that, if black women gave birth at the same hospitals that primarily serve white women, their rate of harm would drop by nearly 50 percent.
Morgan Hook, a spokesperson for SUNY Downstate, told Romper that the hospital's obstetrics and gynecology department follows the American College of Obstetrics and Gynecology protocols for obstetric hemorrhage, severe hypertension, and venous thromboembolism. Hook added,
In response to the challenges of the underserved, high-risk population we serve, we have also implemented additional hemorrhage protocols that have been highly successful in preventing maternal death from hemorrhage at SUNY Downstate for the last 15 years.
Hook declined to comment on ProPublica's report, but did tell Romper,
We aspire to have a staff that is representative of the diverse ethnic populations we serve, and we value the racial and ethnic diversity of the community. We strive to achieve the cultural sensitivity and cultural competency essential to achieving our vision of an efficient, cost-effective, and patient-friendly institution.
Though shocking, ProPublica's report is not surprising. Both news investigations and piles of research have shown that black mothers are at higher risk of complications and death due to poor quality of care, discrimination, and inaccessible health care — even abortion care. For example, Texas has some of the toughest restrictions on abortion services and also the highest rates of maternal death per 100,000 births as of last year, The Guardian reported. Recent data released by the Texas Maternal Mortality and Morbidity Task Force found that Black pregnant people in the state "bear the greatest risk for maternal death," according to Rewire.
Women of color also face higher rates of miscarriage and infant death compared to white moms. A 2006 Columbia University Medical Center study found that, of the miscarriage and newborn deaths studied, Black mothers accounted for 42 pregnancy losses for every 1,000 pregnancies; it was 10 for every 1,000 for white women.
These rates of pregnancy and childbirth complications faced by black women should not exist. Black mothers should not have to fear whether or not they will experience complications or worse during a time that should be a celebration. What the ProPublica report affirmed is that hospitals need to do better by mothers, particularly Black mothers, instead of perpetuating racism in health care.