Black Lives Matter: Claiming a Space for Evidence-Based Outrage in Obstetrics and Gynecology

Eichelberger, Kacey Y.; Doll, Kemi M.; Ekpo, G.; Zerden, Matthew L.

doi:10.2105/ajph.2016.303313

Cited by 90 publications

(78 citation statements)

References 3 publications

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“…Social ecological models have increasingly been applied in health promotion and intervention contexts over the past 40 years . A variety of factors have led to this trend, including increased attention to social determinants of health and health inequities; recognition of the limitations of focusing only on linear causality via proximal individual‐level risk factors; and frustration with individual behavior change interventions that do not account for contextual influences . Social ecological approaches have been applied most often in public health interventions to change behaviors such as nutrition intake, physical activity, and smoking .…”

Section: Resultsmentioning

confidence: 99%

“…55 A variety of factors have led to this trend, including increased attention to social determinants of health and health inequities; recognition of the limitations of focusing only on linear causality via proximal individual-level risk factors; and frustration with individual behavior change interventions that do not account for contextual influences. [55][56][57][58] Social ecological approaches have been applied most often in public health interventions to change behaviors such as nutrition intake, physical activity, and smoking. 59 For example, a behaviorally focused ecologic approach to improve nutrition and physical activity within a population might include education for individuals; modifying home cooking practices for families; engaging schools and workplaces to support access to fresh, healthy food options; fostering healthy norms and ensuring access to healthy foods in the community; and taxing unhealthy foods and funding the creation of public exercise spaces.…”

Section: Development Of the Plus Conceptual Frameworkmentioning

confidence: 99%

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The Prevention of Lower Urinary Tract Symptoms (PLUS) in girls and women: Developing a conceptual framework for a prevention research agenda

Brady

Bavendam

Berry

et al. 2018

Neurourology and Urodynamics

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PLUS Consortium work is premised on the notion that programs, practices, and policies designed to promote health will have optimal impact if the conceptual foundation upon which efforts are based is comprehensive and informed by multiple disciplines. The PLUS conceptual framework is broadly applicable to domains of health that have historically focused on the treatment of illness and symptoms rather than the promotion of health. It is also applicable to domains of health that have been examined from a predominantly biological or social ecological perspective, without integration of both perspectives.

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Section: Resultsmentioning

confidence: 99%

Section: Development Of the Plus Conceptual Frameworkmentioning

confidence: 99%

The Prevention of Lower Urinary Tract Symptoms (PLUS) in girls and women: Developing a conceptual framework for a prevention research agenda

Brady

Bavendam

Berry

et al. 2018

Neurourology and Urodynamics

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“…61 Researchers in obstetrics have documented racial/ethnic disparities in maternal morbidity and mortality and it is now time for action. We have reviewed the evidence that demonstrates that hospital quality is related to maternal mortality and morbidity, how disparities can be generated by between and within-hospital differences, and the evidence base for potential levers to reduce disparities and improve quality.…”

Section: Resultsmentioning

confidence: 99%

“…61 Research tells us that nearly one-half of maternal mortality and severe events are preventable and hospital quality is a significant lever to improve outcomes, while minority women have been found in numerous studies to be more vulnerable to receiving poor quality care. The Council on Patient Safety in Women’s Health Care and the Alliance for Innovation in Maternal Health (AIM Program) are interdisciplinary groups that include the American Congress (college) of Obstetricians and Gynecologists the Society for Maternal Fetal Medicine, American Academy of Family Physicians, American College of Nurse-Midwives, and the Association of Women’s Health, Obstetrics, and Neonatal Nurses as well as others.…”

Section: Introductionmentioning

confidence: 99%

Improving hospital quality to reduce disparities in severe maternal morbidity and mortality

Howell

Zeitlin

2017

Seminars in Perinatology

101

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Significant racial/ethnic disparities in maternal morbidity and mortality exist in the United States. Black women are three to four times more likely to die a pregnancy-related death as compared with white women. Growing research suggests that hospital quality may be a critical lever for improving outcomes and narrowing disparities. This overview reviews the evidence demonstrating that hospital quality is related to maternal mortality and morbidity, discusses the pathways through which these associations between quality and severe maternal morbidity generate disparities, and concludes with a discussion of possible levers for action to reduce disparities by improving hospital quality.

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“…17,18 As reasons for the cesarean delivery disparity among minority women remain poorly characterized, we evaluated whether evidence regarding the safe promotion of vaginal delivery was applied differently based on maternal race and ethnicity. Our objectives were to examine whether racial and ethnic differences exist in the frequency of and indications for cesarean delivery, and determine whether these differences may be explained by disparities in the application of labor management strategies intended to reduce the frequency of cesarean deliveries.…”

Section: Introductionmentioning

confidence: 99%

Racial and Ethnic Differences in Utilization of Labor Management Strategies Intended to Reduce Cesarean Delivery Rates

Yee¹,

Costantine²,

Rice³

et al. 2017

Obstetrics &Amp; Gynecology

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Objective To examine whether racial and ethnic differences exist in the frequency of and indications for cesarean delivery and to assess whether application of labor management strategies intended to reduce cesarean delivery rates is associated with patient’s race and ethnicity. Methods This is a secondary analysis of a multicenter observational obstetric cohort. Trained research personnel abstracted maternal and neonatal records of >115,000 pregnant women from 25 hospitals (2008–2011). Term women with singleton, nonanomalous, vertex, liveborn neonates were included in two cohorts: 1) nulliparous women (n=35,529) and 2) multiparous women with prior vaginal deliveries only (n=39,871). Women were grouped as non-Hispanic black, non-Hispanic white, Hispanic, and Asian. Multivariable logistic regression was used to evaluate the following outcomes: overall cesarean delivery frequency, indications for cesarean delivery, and utilization of labor management strategies intended to safely reduce cesarean delivery. Results A total of 75,400 women were eligible for inclusion, of whom 47% (N=35,529) were in the nulliparous cohort and 53% (N=39,871) in the multiparous cohort. The frequencies of cesarean delivery were 25.8% among nulliparous women and 6.0% among multiparous women. For nulliparous women, the unadjusted cesarean frequencies were 25.0%, 28.3%, 28.7%, and 24.0% for non-Hispanic white, non-Hispanic black, Asian, and Hispanic women, respectively. Among nulliparous women, the adjusted odds of cesarean were higher in all racial and ethnic groups compared with non-Hispanic white women (non-Hispanic black aOR 1.47, 95% CI 1.36–1.59; Asian aOR 1.26, 95% CI 1.14–1.40; Hispanic aOR 1.17, 95% CI 1.07–1.27), due to greater odds of cesarean delivery both for nonreassuring fetal status and labor dystocia. Nonapplication of labor management strategies regarding failed induction, arrest of dilation, arrest of descent, or cervical ripening did not contribute to increased odds of cesarean delivery for non-Hispanic black and Hispanic women. Compared with non-Hispanic white, Hispanic women were actually less likely to experience elective cesarean (aOR 0.60, 95% CI 0.42–0.87) or cesarean for arrest of dilation prior to 4 hours (aOR 0.67, 95% CI 0.49–0.92). Additionally, compared with non-Hispanic white, Asian women were more likely to experience cesarean for nonreassuring fetal status (aOR 1.29, 95% CI 1.09–1.53) and to have had that cesarean be performed in the setting of a 1-minute Apgar score ≥7 (aOR 1.79, 95% CI 1.07–3.00). A similar trend was seen among multiparous women with prior vaginal deliveries. Conclusions Although racial and ethnic disparities exist in the frequency of cesarean delivery, differential use of labor management strategies intended to reduce the cesarean delivery rate does not appear to be associated with these racial–ethnic disparities.

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Black Lives Matter: Claiming a Space for Evidence-Based Outrage in Obstetrics and Gynecology

Cited by 90 publications

References 3 publications

The Prevention of Lower Urinary Tract Symptoms (PLUS) in girls and women: Developing a conceptual framework for a prevention research agenda

The Prevention of Lower Urinary Tract Symptoms (PLUS) in girls and women: Developing a conceptual framework for a prevention research agenda

Improving hospital quality to reduce disparities in severe maternal morbidity and mortality

Racial and Ethnic Differences in Utilization of Labor Management Strategies Intended to Reduce Cesarean Delivery Rates

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