Disparities in Maternal Health
Why Black women face the highest maternal mortality, and how to navigate implicit bias in your obstetrical care.
Many women, particularly in the Black community, have a lasting distrust of the healthcare system rooted in a real history of discrimination. Implicit bias in maternal care is especially worrying. When a patient senses bias, she may not feel comfortable asking questions about a healthy pregnancy, the right follow-up visits, or complications she should know about.
Black women have the highest maternal mortality rates during pregnancy and within a year postpartum. They are more likely to experience preeclampsia and eclampsia, postpartum hemorrhage from fibroids, non-elective C-sections, and cardiomyopathy. Awareness and access to culturally competent care can meaningfully change outcomes.
How to navigate: educate yourself on preventable conditions like gestational diabetes and pregnancy-induced hypertension. Ask your insurer for a list of minority OB/GYNs, or research culturally competent providers online or through your hospital. From personal experience, my Black patients often light up when I walk in and introduce myself as 'Doctor,' because they know I understand.
Come prepared: write down questions about ultrasounds, weight gain, urinalysis, labs, and glucose testing. Ask about nutrition, folic acid, and any needed medications. Share your full sexual, social, family, and medical history, including prior C-sections or fibroids.
Address mental health openly. Journal your feelings. Ask about genetic testing, safe exercise, and warning signs like bleeding. If you feel unheard or the fit isn't right, seek another opinion. You deserve a provider who respects your beliefs and works with you on your birth plan.
Dr. Maggie Cadet, MD