30 January

Glenn Ellis: Childbirth is killing Black mothers

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Tennis superstar Serena Williams revealed she needed an emergency C-section and had multiple surgeries after giving birth to her daughter Alexis.

The day after the operation, she got terribly sick, and doctors found several small clots in her lungs.

Then she suffered another terrifying scare when her C-section scar popped open and medics found a large hematoma had flooded her abdomen. The sports star has a history of blood clots, so she was the one who raised the alarm after she found herself feeling short of breath 24 hours after becoming a mother. Serena was found to have a pulmonary embolism, and the coughing it caused meant her C-section wound popped open.

Because she had been taking blood thinners to dispel the clots, the medication caused bleeding at the site of the incision doctors had made for the baby.

Williams has lots of influence, fame and power. Regrettably, she doesn’t represent the majority of Black women in this country who have babies. Even though maternal deaths are high for all women in America, Black women seem to get the “short straw.”

Women in the United States are more likely to die from childbirth- or pregnancy-related causes than other women in the developed world, and half of those deaths may be preventable.

The United States has one of, if not the worst, maternal mortality rate in the developed world. In fact, while global maternal death rates have dropped by more than a third from 2000 to 2015, the rate in the United States has more than doubled since 1987. According to the Centers for Disease Control and Prevention (CDC), about 700 women in the United States die each year as a result of complications related to pregnancy or childbirth. But buried in state and national data related to maternal mortality rates is an even more worrisome trend: Black women bear the greatest risk of maternal death.

The tragedy of maternal death affects Black women disproportionately in the United States as they are nearly four times more likely to die from pregnancy-related causes than white women.

But why is there such a big racial disparity in the first place? Why are Black women more likely to die from pregnancy-related causes than any other racial group? Like many health-related issues, the answer isn’t simple and there’s no one single contributing factor at fault.

Some experts argue that higher rates of obesity, women having children at older ages, and other social changes and trends in public health could drive an apparent increase.

According to research from the CDC, the most common causes of maternal death in all women are cardiac events, drug overdoses, hypertension, eclampsia and hemorrhaging.

Others point to differences in socioeconomic status, access to health care, education, insurance coverage, housing, levels of stress and community health among Black and white women, including even implicit bias and variations in the ways in which health care is delivered to Black versus white women.

Another factor for consideration is tied to unplanned pregnancies. Black women are three times as likely as white women to experience an unintended pregnancy.

The CDC points to the fact that 50 percent of pregnancies are unplanned. These pregnancies are associated with increased mortality for the mother and infant. Lifestyle factors (e.g., smoking, drinking alcohol, unsafe sex practices and poor nutrition) and inadequate intake of foods containing folic acid pose serious health hazards to the mother and fetus and are more common among women with unintended pregnancies. The CDC estimates that half of the women that experience an unintended pregnancy do not seek prenatal care during the first trimester.

Historically, Black women in low-income communities haven’t had the same access to quality care as white women in high-income communities.

Those same factors shed light on disparities not only in maternal mortality but in obesity, hypertension, heart disease and overall health.

This is not a state-by-state solution to solving the problem of disparities. This is a national problem, and we all know it. It’s always the elephant in the room in the United States that things are different for Black women.

In an ideal world, a woman would have the opportunity to have a visit with a physician before she becomes pregnant to identify any potential risk factors before she gets pregnant. Then a woman would enter prenatal care in her first trimester. Unfortunately, African-American women are the least likely to have that first trimester of prenatal care.

The U.S. spends more per capita on health care than any other developed nation — has one of the most sophisticated, technologically advanced health care systems in the world — but we still have inequities. Black women are still suffering from preventable maternal deaths. A human rights framework provides a road map to solutions.

Just being a Black woman in America comes with its own level of stress.

Remember, I’m not a doctor. I just sound like one.

Take good care of yourself and live the best life possible!


-- http://www.phillytrib.com/ --

Read 276 times Last modified on Wednesday, 31 January 2018 06:38
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Pusat Kebijakan dan Manajemen Kesehatan (PKMK)
Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FKKMK)
Universitas Gadjah Mada

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