User:Sdekk13/sandbox

This sandbox includes drafts of additions to make to Wikipedia page, Maternal Health. We propose adding a section on good maternal health practices and add two sub sections to "Factors Influencing Maternal Health Care". These sub sections would explain the relationship between race and maternal health, and religion and maternal health.

Sub Section: Race, Ethnicity, and Maternal Health
The pregnancy related mortality ratio (PRMR) represents the number of deaths per 100,000 live births resulting from pregnancy or pregnancy related causes. Analysis of the Pregnancy Mortality Surveillance System, conducted by the Center for Disease Control and Prevention (CDC), indicates significant racial and ethnic disparities in pregnancy related deaths. Specifically, A 2019 report from the CDC shows that the PRMRs of Black women and American Indian women in the United States are 3-4 times higher than that of White women. For White women during 2019, there were an approximate 13 maternal deaths per 100,000 live births. For Black and American Indian women, there were 41 and 30 maternal deaths per 100,000 live births respectively. The majority of these deaths were due to preventable diseases associated with pregnancy related mortality, such as hypertension. While the fatality rate of these diseases was higher among Black and American Indian women, the initial prevalence was generally the same across all races. Although lower than that of Black and American Indian women, the PRMR for Asian and Pacific Islander women was found to be higher than that of White women (with a disparity ratio of 1.1). The PRMR for Hispanic women has shown a decline in recent years. However, state specific reports show that Hispanic women face high rates of maternal morbidity.

The CDC cites multiple possible causes for the racial gap in maternal mortality. They say that most pregnancy related deaths are the combined result of 3-4 contributing factors. For Black and American Indian women, this can include issues of implicit racial bias held by healthcare providers, which affects the quality of care given to treat or prevent a fatal disease. These factors can also be more structural (e.g. the gap in access to primary and preventative care in minority communities). In the CDC report, economic status is not cited as a leading cause of maternal mortality. While economic status and education level is a possible contributing factors to maternal mortality, the racial gap is shown to persist across all economic and education levels.

Draft of Article Section - Recommended Maternal Health Practices
Maternal health care and care of the fetus starts with prenatal health. The World Health Organization suggests that the first step towards health is a balanced diet which includes a mix of vegetables, meat, fish, nuts, whole grains, fruits and beans. Additionally, Iron supplements and folic acid are recommended to be taken by pregnant women daily. These supplements are recommended by the National Surgeon General to help prevent birth complications for mothers and babies such as low birth weight, anemia, hypertension and pre-term birth. Folic acid can aid neural tube formation in a fetus, which happens early in gestation and therefore should be recommended as soon as possible. Calcium and Vitamin A supplements are also recommended when those compounds are not available or only available in low doses in the natural diet but other supplements such as Vitamins D, E, C, and B6 are not recommended. The WHO also suggests that low impact exercise and reduction of caffeine intake to less than 330 mg/day can help to reduce the likelihood of neonatal morbidity. Light exercise should be continued for pregnant mothers as it has been recommended to combat negative heath outcomes, side effects and birth complications related to obesity. Should possible side effects of a pregnancy occur, such as nausea, vomiting, heartburn, leg cramps, lower back pain, and constipation can be anticipated to occur and low intensity exercise, balanced diet, or natural herb supplements are recommended by the WHO to mitigate the side effects. the National Surgeon General recommends abstaining from consuming alcohol or nicotine in any form throughout the duration of one's pregnancy, and to avoid using it as a way to mitigate some of the side effects mentioned earlier.

During a pregnancy, women should receive continuous care from a physician to monitor the growth and status of the fetus. Maternal health organization suggest that at a minimum pregnant women should receive one ultrasound at week 24 to help predict any possible growth anomalies and prevent future gestational concerns. It is also stated that pregnant women should also fulfill any missing vaccinations as soon as possible including the tetanus vaccine and influenza vaccine. For pregnant women who are at an increased risk for preeclampsia, one could take a dietary supplement of low dose aspirin before 20 weeks gestation.

In the case of a healthy vaginal birth, mothers and babies typically are recommended to stay at the hospital for 24 hours before departing. This is suggested to allow time to assess the mother and child for any possible complications such as bleeding or additional contractions. The WHO recommends that babies should have checkups with a physician on day 3, day 7-14 and 6 weeks after birth. At these follow up appointments the emotional well-being of the mother should also be considered. Special attention to the possibility of postpartum depression, which affects 10-15% of mothers in 40 countries is also recommended. At these check ins mothers also have the opportunity to seek consultation from a physician about starting the breastfeeding process.

Sub Section: Religion and Maternal Health
There are many factors that influence maternal health and the utilization of resources that women have access to. One of these factors that recent studies have highlighted is religion. A study that took place in St John’s, Canada researched how immigrant Muslims living in the area were treated and given maternal care. Due to the insensitivity and lack of knowledge that the doctors showed these Muslim women, their health information and treatment suffered. The information did not contain anything based on their religious or cultural practices and did little to provide cultural adjustments and emotional support. The maternity health care and practices did nothing to meet the needs of the Muslim women who put their lives into the hands of these doctors. In order to provide a safer and more comfortable environment for Muslim women, it was proven that they needed more support that would connect with the immigrant community and health-related information. Discrimination based on religion is definitely a factor that effects the maternal health and health care of women from different backgrounds. It is evident that there needs to be proactive steps to adjust some of the mainstream practices to improve all maternal health. There is not a lot of discussion regarding the studies that reflect the hardships that women go through based on maternal care in terms of religion. Instead, there is a lot of stigma and norms regarding all religion that in turn place women at risk when receiving health-care.

While misunderstanding religion in healthcare can lead to a dangerous health environment, some religious practices have been shown to influence maternal health in a negative way. Apostolic sect members in Zimbabwe have been associated with higher maternal mortality. Results of a study showed the dangerous associations that some religions may have on maternal health. The study in Zimbabwe shows that Apostolicism promotes high fertility, early marriage, non-use of contraceptives and low or non-use of hospital care. There are delays in recognizing danger signs, deciding to seek care and receiving appropriate health care. The practices and beliefs inherent to the religion increases the risk of maternal death.