DiversityNursing Blog

Maternal health disparities are a significant problem in the United States. Women in America are dying at a higher rate from pregnancy-related causes than in any other developed nation. Black women are three times more likely to die from pregnancy-related causes than white women.

According to the Center for Health Care Strategies, Black infants are more than twice as likely to die within the first year of life as white infants. Native Americans/Alaska Natives, Asian Pacific Islanders, and subgroups of Latina women and children also fare worse than white families when it comes to maternal and child health outcomes.

Reducing racial disparities in maternal health requires a multilayered approach that addresses the underlying social causes of health and institutional racism.

Here are some strategies that could help erase racial disparities in maternal health:

Increase Access to High-Quality Prenatal Care

Black women are less likely to receive early and regular prenatal care than white women, which can lead to higher rates of complications during pregnancy and childbirth. Improving access to high-quality prenatal care can help reduce these disparities.

Address Structural Racism in Healthcare

Structural racism in healthcare, including implicit bias among healthcare providers, contributes to maternal health disparities. This racism means African American women often receive poorer quality care than white women. It means the denial of care when African American women seek help when enduring pain or that health care and social service providers fail to treat them with dignity and respect. This issue requires training healthcare providers to recognize and address their own biases and implementing policies that promote equity, culturally competent care and justice.

Increase Awareness and Education

Raising awareness of these disparities and educating the public, healthcare providers, and policy makers can help reduce disparities. This includes addressing the impact of systemic racism and the social determinants of health that contribute to poor maternal health outcomes.

Address Social Determinants of Health

Social determinants of health, such as poverty, lack of access to healthy food and safe housing, and limited access to transportation, can all impact maternal health outcomes. Improving these underlying issues can positively impact maternal health outcomes for all women.

Invest in Maternal Health Research

Investing in research on maternal health disparities can help identify effective approaches and programs. This includes studying the impact of implicit bias, the effectiveness of community-based interventions, and the impact of policies that address social determinants of health.

In conclusion, racial disparities in maternal health is complex and cannot be resolved overnight. This requires a comprehensive approach that addresses underlying social determinants of health and institutional racism. By implementing these strategies, we can work towards improving maternal health outcomes for all women, regardless of race.

Aside from skin cancer, breast cancer is the most common form of cancer affecting women in the U.S. The chance for a female to be diagnosed with breast cancer during her lifetime has increased from 1 in 11 women in 1975 to 1 in 8 women.

Increased emphasis on early detection and more effective treatments have decreased mortality rates in the white population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic populations have continued to grow.

Research has shown that Black women are more likely to die from breast cancer than any other ethnic group. Black women:

• are more likely to be diagnosed with triple-negative breast cancer, which means the cancer has no receptors for the hormones estrogen and progesterone, as well as no receptors for the HER2 protein; this limits the medicines that can be used to treat the cancer
• are more likely to be diagnosed with later-stage disease than other women
• have the lowest survival rates in each stage of diagnosis

There are many factors that play a role in the disparities. Black women are more likely to have diabetes, heart disease, and obesity, and are less likely to breastfeed after childbirth, which are all risk factors for breast cancer. They are also more likely than white women to have inadequate health insurance or access to health care facilities, which may affect access to screening, follow-up care, and completion of therapy.

In order to close the breast cancer mortality gap, prevention programs must increase and policies need to improve.

Increasing screening rates, providing timely access to diagnostic testing, and improving access to comprehensive, quality healthcare coverage and cancer treatment care are all imperative.

That also includes increasing outreach to Black women so they're aware about their breast cancer risks and can seek preventive care.

Molecular geneticist and Associate Professor of cell and developmental biology research in surgery, Dr. Melissa Davis points out that part of the problem in addressing these disparities and, in turn, finding more effective medications to improve outcomes, is that minorities haven’t traditionally been included in adequate numbers in research studies or clinical trials. “A lot of breast cancer investigations that have resulted in advances in treatment have overwhelmingly involved white women,” she says. “So the treatments work better in those populations than in others. We’re trying to change that.”

The Center for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides uninsured and underinsured women access to no-cost screening, diagnostic, navigation, and education/outreach services, as well as a pathway to cancer treatment care.

All women regardless of age, ethnicity, economic status, or other health conditions deserve the best breast cancer care and the best prognosis possible.

National Midwifery Week is the first week of October, and Frontier Nursing University (FNU) is celebrating by hosting a virtual event from Oct. 5-8, called Empower 2020: Year of the Nurse and the Midwife. 

The event features four free sessions, including two continuing education opportunities, presented by FNU faculty, students, and alumni on the latest practices and topics influencing nurse-midwifery care:

• It’s the Year of the Nurse and the Midwife: Get the 411 on Becoming a Nurse-Midwife, presented by Dr. Jeneen Lomax and Dr. Tonya Nicholson - Oct. 5 at 5 p.m. ET
• Midwifery Pearls of Telehealth, a Free CE Session presented by Dr. Tanya Belcheff, Dr. Cassie Belzer, Dr. Judith Butler, Martha Harvey, Dr. Audrey Perry and Heidi Loomis - Oct. 6 at 5 p.m. ET
• Hot Topics in the Management of Perimenopause & Menopause: A Conventional & Integrative Approach, a Free CE Session presented by Dr. Ruth Ellen Elsasser and Dr. Ana Verzone - Oct. 7 at 5 p.m. ET
• Racial Disparities in Maternity Care: Where Do We Go From Here?, presented by Dr. Heather Clarke and Dr. Susan Stone - Oct. 8 at 5 p.m. ET

It’s the Year of the Nurse and the Midwife: Get the 411 on Becoming a Nurse-Midwife is for midwifery students or anyone who is considering becoming a nurse-midwife. Participants will hear from current midwifery students about their experiences and have the opportunity to ask questions during this live session.

Midwifery Pearls of Telehealth will provide an overview of telehealth from a midwifery perspective with special emphasis on the areas of patient engagement, group care, provider satisfaction and best practices for meeting compliance requirements.

Hot Topics in the Management of Perimenopause & Menopause: A Conventional & Integrative Approach will provide a review of the most common conventional and evidence-based integrative medicine interventions used during perimenopause and menopause.

Maternal and infant mortality affects black and indigenous women at a much higher rate than other races. In Racial Disparities in Maternity Care: Where Do We Go From Here?, FNU Assistant Professor Dr. Heather Clarke and FNU President Dr. Susan Stone will review the issues related to health care disparities and discuss how midwives can engage in meaningful strategies for change.

The World Health Organization (WHO) designated 2020 as the “Year of the Nurse and the Midwife” in honor of the 200th anniversary of Florence Nightingale’s birth. The designation brings awareness to the importance of nurses and midwives in the health and care of populations across the globe. According to the WHO, the world needs nine million more nurses and midwives to achieve universal health coverage by 2030.

Southern Cross Insurance Solutions is sponsoring the 2020 virtual event. National Midwifery Week was created by the American College of Nurse-Midwives (ACNM) to celebrate and recognize midwives and midwife-led care. ACNM and its 7,000+ midwife members, physicians and women’s health organizations observe National Midwifery Week each year. Dr. Cathy Collins-Fulea, FNU course faculty member and DNP graduate, is currently serving as president of the ACNM Board of Directors.

Frontier Nursing University is the birthplace of nurse-midwifery in the United States and has 80 years of experience in delivering graduate nursing and midwifery programs. This is the sixth consecutive year FNU has hosted a virtual event in support of National Midwifery Week.

Register for the Empower 2020: Year of the Nurse and the Midwife virtual event and learn more at Frontier.edu/MidwiferyWeek.