Addressing inequities in maternal health outcomes

Every year in the U.S., nearly four million women give birth. The vast majority happen uneventfully. However, per the Centers for Disease Control and Prevention (CDC), about 50,000 each year, or more than 135 expectant and new mothers every day, have serious and sometimes life-threatening complications. The rates of maternal mortality and morbidity have been rising in the U.S. despite our continuing advancements in medical care overall. Compared to peer nations, we have a two to three times higher rate of maternal mortality.

Within these numbers exist stark racial disparities in maternal health outcomes. For Black and AIAN women, pregnancy-related mortality rates are three and two times higher, respectively, compared to the rate for white women. These disparities increase with maternal age and persist across education levels.

To top it off, recent CDC data has found that more than eight out of 10 (84 percent) pregnancy-related deaths are preventable.

So, what can we do to improve maternal health outcomes and tackle racial inequities? In this episode of Inside Angle, I sat down with Dr. Steve Calvin, a board-certified OB-GYN and maternal-fetal medicine physician. He has more than 40 years of experience in caring for moms and babies throughout the entire range of pregnancy concerns. As founder and medical director for the Minnesota Birth Center, he believes that health care reform should start where we all did, with pregnancy and birth, and that all mothers deserve comprehensive team-based care for a single package price.

We discuss the structural causes, including racism and segregation, that have given rise to racial inequities in pregnancy outcomes. We also discuss solutions, everything from the role of value-based payments and AI, to addressing social determinants of health and racial bias. Throughout, Dr. Calvin offers his perspective not only as a practicing OB-GYN, but also as a current member of the U.S. Health and Human Services Secretary's Advisory Committee on Infant and Maternal Mortality. I invite you to listen to our conversation to learn more about this solvable issue of maternal morbidity and mortality.

Melissa E. Clarke, MD, CMQ, is the chief population health officer, health care transformation and health equity at 3M Health Information Systems.