Reduction of Peripartum Racial and Ethnic Disparities

Abstract

Racial and ethnic disparities exist in both perinatal outcomes and health care quality. For example, black women are three to four times more likely to die from pregnancy-related causes and have more than a twofold greater risk of severe maternal morbidity than white women. In an effort to achieve health equity in maternal morbidity and mortality, a multidisciplinary workgroup of the National Partnership for Maternal Safety, within the Council on Patient Safety in Women's Health Care, developed a concept article for the bundle on reduction of peripartum disparities. We aimed to provide health care providers and health systems with insight into racial and ethnic disparities in maternal outcomes, the etiologies that are modifiable within a health care system, and resources that can be used to address these etiologies and achieve the desired end of safe and equitable health care for all childbearing women.

Ensuring Fairness in Machine Learning to Advance Health Equity

“…Data on patients in the protected group might be distributed differently from those in the nonprotected group because of biological or nonbiological variation (9, 27). For example, the data may not contain enough examples from a group to properly tailor the predictions to them (minority bias) (28), or the data set of the protected group may be less informative because features are missing not at random as a result of more fragmented care (29, 30).…”

The Potential for Health Information Technology Tools to Reduce Racial Disparities in Maternal Morbidity and Mortality

“…In addition, ACOG's efforts to precisely define essential terms related to the mode of birth, hypertension, labor, rupture of membranes, gestational age, and parity are intended to ensure incorporation of these definitions into clinical practice and serve as standards for EHRs, coding, clinical practice guidelines, and policy statements. 3,24,25 In addition to educating clinical care teams about racial/ ethnic disparities in MMM, AIM care bundles and other recommendations emphasize shared decision-making as a strategy for improving communication and enhancing quality of care to reduce disparities. 3,9,[23][24][25] Decision aid tools have been found useful for promoting shared decision-making and for assisting patients' understanding of their risks and treatment options.…”

“…3,24,25 In addition to educating clinical care teams about racial/ ethnic disparities in MMM, AIM care bundles and other recommendations emphasize shared decision-making as a strategy for improving communication and enhancing quality of care to reduce disparities. 3,9,[23][24][25] Decision aid tools have been found useful for promoting shared decision-making and for assisting patients' understanding of their risks and treatment options. 3,26 Research studies about high-quality, evidence-based online decision aids and culturally appropriate risk assessment tools that incorporate medical, obstetrical, and social factors that influence birth outcomes are needed to foster informed choice, 3 as well as an evaluation of their effect on racial disparities in MMM.…”

Protocol for a randomized controlled trial evaluating the impact of the Nurse-Family Partnership’s home visiting program in South Carolina on maternal and child health outcomes

“…Maternal mortality rates have doubled in the USA over the last two decades [35], and preterm birth rates have risen each year over the last 3 years [36]. Substantial racial disparities have been documented surrounding childbirth, including higher rates of maternal mortality and morbidity and a higher likelihood of babies born preterm and low birth weight for black women compared to non-Hispanic white women [37][38][39]. Geographic disparities have also been documented; women living in rural areas are more likely to experience preterm birth, infant mortality, or maternal mortality than those living in urban areas [40,41], and are more likely to face the closure of their nearest hospital [40].…”