Developing Tools to Report Racism in Maternal Health for the CDC Maternal Mortality Review Information Application (MMRIA): Findings from the MMRIA Racism &amp; Discrimination Working Group

Kheyfets, Anna; Mantha, Allison Bryant; Cornell, Andria; Crear-Perry, Joia; Graves, Cornelia R.; Grobman, William A.; James-Conterelli, Sascha; Jones, Camara Phyllis; Lipscomb, Breana; Ortique, Carla; Stuebe, Alison M.; Welsh, Kaprice; Howell, Elizabeth A.

doi:10.1007/s10995-021-03284-3

Cited by 38 publications

(37 citation statements)

References 34 publications

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“…The disproportionally large mortality consequence we estimate they would suffer if no abortion occurs is jointly caused by these two factors. Modifying policies and practices, for example radically reforming pregnancy and birth care along antiracist lines (Crear-Perry et al 2021;Hardeman et al 2020Hardeman et al , 2022, could help avoid the future our estimates describe.…”

Section: Discussionmentioning

confidence: 99%

The maternal mortality consequences of losing abortion access

Stevenson¹,

Root²,

Menken³

2022

Preprint

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We update estimates of the maternal mortality impact of no abortions occurring in the U.S. following the recent release of new national and state abortion incidence data for 2020. This estimate quantifies the increase in maternal deaths that would occur after a total abortion ban solely due to the greater mortality risk of continuing pregnancy to term compared to having an abortion. We estimate the number of additional U.S. maternal deaths by race/ethnicity that would be caused if no abortion occurred, following previously published procedures and using published 2020 statistics on maternal mortality, births, and abortions. After the first year of no abortion occurring, we estimate increased exposure to the risks of pregnancy would cause an increase of 210 maternal deaths per year (24% increase), from 861 to 1071. The increase would be greatest among non-Hispanic Black people, for whom it would be 39%. We also estimate, by state, the number of additional maternal deaths caused by no abortion occurring in the 26 U.S. states that either have banned or the Guttmacher Institute estimates will soon ban abortion. We find that increases in some states would be as great as 29%, while in others, because of already extremely low abortion rates and numbers, less than 1 additional death would be expected. Banning abortion will likely change maternal mortality in ways beyond exposing more people to the existing risks of maternal death; any increase in maternal mortality due to these changes would be in addition to our estimates.

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Section: Discussionmentioning

confidence: 99%

The maternal mortality consequences of losing abortion access

Stevenson¹,

Root²,

Menken³

2022

Preprint

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“…Despite growing recognition of maternal health inequities due to racism [ 3 ], this study calls attention to the critical lens of language preference on birthing experiences and outcomes, through differences in patient understanding of common procedures during labor and delivery. Our study demonstrates that in a relatively educated group of pregnant Hispanic/Latinx patients, overall comprehension of the key information presented in a global obstetric consent form was low, with key differences in those with Spanish compared to English language preference.…”

Section: Discussionmentioning

confidence: 99%

“…In the United States, racial/ethnic disparities in obstetric care persist when controlling for social and medical factors, signaling the role of racism in driving disparities in maternal health [1][2][3]. Less is known regarding disparities for those whose racial or ethnic identity is compounded by limited English proficiency (LEP).…”

Section: Introductionmentioning

confidence: 99%

Disparities in Comprehension of the Obstetric Consent According to Language Preference Among Hispanic/Latinx Pregnant Patients

Molina¹,

Adams²,

Aguayo³

et al. 2022

Cureus

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Background: We assessed understanding of the obstetric consent form between patients with English and Spanish language preference. Methods: This observational study included pregnant patients who identified as Hispanic/Latinx with English or Spanish language preference (defined as what language the patient prefers to receive healthcare information) and prenatal care providers at a large academic medical center from 2018 to 2021. Patient demographics, language preference, literacy, numeracy, acculturation, comprehension of the obstetric consent, and provider explanations were collected.Results: We report descriptive statistics and thematic analysis with an inductive approach from 30 patients with English preference, 10 with Spanish preference, and 23 providers. The English group demonstrated 72% median correct responses about the consent form; the Spanish group demonstrated 61% median correct responses. Regardless of language, the participants demonstrated limited understanding of certain topics, such as risks of cesarean birth.Discussion: Overall comprehension of key information in an obstetric consent form was low, with differences in language groups, which highlights opportunities for improvements in communication across language barriers. Innovations in the communication of critical pregnancy information for patients with limited English proficiency need to be developed and tested.

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Section: Actionable Stepsmentioning

confidence: 99%

“…In the US, structural racism, interpersonal racism, and discrimination have all been added to the Maternal Mortality Review Information Application (MMRIA) to allow the systematic tracking of the contribution of racism to maternal mortality and allow a greater standardization of its identification. 13 Throughout, it is critical that we directly engage racial and ethnic groups and communities in addressing their key health concerns and in interpreting our findings, at minimum through public and patient involvement and engagement, as well as through formal qualitative methodologies.…”

Section: Studying Disparitiesmentioning

confidence: 99%