MATERNAL MORTALITY: Black Women Face Far Greater Risk
The mortality rate for black women is nearly four times greater than it is for white women, according to a first-ever study released today, and the difference cannot be completely explained by socioeconomic factors. Research from the CDC, published in this week's Morbidity and Mortality Weekly Report, indicates that between 1987 and 1996 black women's maternal mortality rate -- defined as a death during pregnancy or within 42 days after giving birth due to pregnancy-related causes -- was 19.6 deaths per 100,000 live births, versus 5.3 per 100,000 for white women. The ratio of black deaths to white deaths ranged from 2.6 in Iowa, Maryland and South Carolina to 6.3 in Michigan (MMWR, 6/18). Julia Scott, president of the National Black Women's Health Project, said, "The death rate for black mothers is a national scandal that should outrage every American. ... There should be four times as much research on causes of death among black mothers giving birth as is being done on maternal death in the general population" (NBWHP release, 6/17). The New York Times reports, however, that "little research is focused on preventing deaths among black pregnant women, in large part because most people think dying in childbirth is no longer an issue."
Why the Gap?
Researchers pointed to a variety of possible explanations to explain the racial disparity: "black women are less likely to have good prenatal care than whites; they are more prone to high blood pressure," which along with hemorrhage and embolism are the leading causes of death among pregnant women; and black women "are in poorer health in general." Still, experts say that health access issues do not completely account for the gap, as even "well-off black women appear to be at greater risk than whites" (Stolberg, 6/18). Ronald David, medical director of an agency that runs DC General Hospital in Washington, said many black women "suffer so much social alienation that they simply withdraw and refuse to trust health care. These are the women who never see a doctor until they go into labor" (Goldstein, Washington Post, 6/18).
New York had the highest death rate for pregnant black women, at 28.7 per 100,000, and also posted a higher-than-average death rate for white women, at 7.6 per 100,000. Massachusetts had the lowest rates for both black and white mothers: 8.7 and 2.7 per 100,000, respectively. Data from many states was excluded because they did not meet the statistically significant threshold of seven deaths. CDC Director of the Division of Reproductive Health Dr. Lynne Wilcox noted that previous studies have shown that "the maternal mortality rate is 1.3 to 3 times higher than is reported on death certificates," upon which the CDC study relied for its data. The study did not include other ethnic groups (New York Times, 6/18).