Current data on disparities in maternal outcomes

This article is on based on information presented at the Society for Maternal-Fetal Medicine’s 2021 Virtual Annual Meeting, which will be held from Jan. 25 to Jan. 30.

For more information and registration details, visit SMFM.org.

On Tuesday, Jan. 26, Sarahn Wheeler, MD, and Aviva Lee-Parritz, MD, led the postgraduate course titled, “Inequalities in Maternal Outcomes from Recognition to Reduction: A Practical Skills Approach.” The curriculum focused on providing MFM practitioners with the tools to recognize racism at the individual, institutional and system levels that ultimately lead to inequities in maternal outcomes, and practical skills to enact real change.

During the course, Kacey Eichelberger, MD, presented recent data on the disparities in maternal outcomes of non-Hispanic Black women.

Kacey Eichelberger, MD

When compared to non-Hispanic white women, non-Hispanic Black women in the U.S. are 50% more likely to experience unintended pregnancies and twice as likely to have a preterm birth. They are also, according to Eichelberger, 3 times as likely to die during or around childbirth. They are 35% less likely to be using any contraception and 38% less likely to be using the most effective contraception.

“There are two massive dangers in how we in health care report our data on disparities,” says Eichelberger. The first, she says, is the danger of the detached observer.

“We are analyzing and observing, which is space that is comfortable for most of us. These injustices are so great, that one cannot, should not, analyze and observe without naming the immoral reality to which they are bearing witness. Say it and name it.”

Equally as dangerous, says Eichelberger, is the bystander effect. “This is where we report contemporary outcomes in the here and now without any regard to the historical context of how we got here. We observe and report differences without any seeming ability to connect them to our own history.

“It is my firmest belief that the disproportionate, immoral excess of adverse health outcomes lived by Black women is linearly connected to [that] history,” she said.

“For me, justice begins in the space between describing the problem and actually changing who you are in the world—how you practice your life and your craft. Make it personal,” concluded Eichelberger.

Eichelberger practices maternal-fetal medicine and serves as the site Principal Investigator for the NICHD’s Maternal-Fetal Medicine Unit Network at Prisma Health.