User:Tikomkheidze/Black maternal mortality in the United States

Revision Checklist

 * Edit the introduction, make it more informative for readers who have no knowledge of the (specific) topic.
 * Rephrasing “Prevention” Section
 * Create a new sub-title for the section (ex: “Preventative Measures: Institutional and Medical)
 * Edit general punctuation and formatting (capitalization, etc.)
 * Incorporate any other WikiLinks that may be applicable to the topic (if Wiki article exists)

Introduction from "Black Maternal Mortality in the United States" [Original]
Black maternal mortality in the United States refers to the incidence of maternal mortality in the U.S. specifically for those identifying as Black or African American. Maternal death is described as the death of a woman either during pregnancy or within 42 days of the end of the pregnancy. This death can be due to how the pregnancy was handled or the pregnancy itself, but is not associated with unintentional or secondary causes. Between 1897 and 2016, the maternal mortality rates in the United States more than doubled, while the maternal mortality rates around the world had seen an overall decrease.

There have been significant differences between the maternal mortality of white women versus Black women throughout history. In the U.S., the CDC reported that Black women experience maternal mortality at a rate two to three times higher than that of white women. The estimated national maternal mortality rate in the United States is about 17 per 100,000 live births–but is about 43 per 100,000 live births for Black women. Furthermore, data from the CDC Pregnancy Surveillance Study that shows these higher rates of Black maternal mortality are due to higher fatality rates, not a higher number of cases. This indicates that the higher maternal mortality rates among Black women is not due to a larger number of high-risk cases, but because Black women are more likely to die during or after giving birth at a disproportionate rate. Since the usual causes of maternal mortality are conditions that occur or are exacerbated during pregnancy, most instances of maternal mortality are preventable deaths. There has been more notice of these statistics recently, as more emphasis is being placed on minimizing these racial/ethnic disparities seen in maternal mortality. Researchers have identified several reasons for the Black–white maternal mortality disparity in the U.S., including historical context, access to healthcare, socioeconomic status, incidence of preexisting conditions, medical racism, and abortion access, all of which are social determinants of health in the United States.

Introduction REVISION
Black Maternal Mortality in the United States refers to the death of women, specifically those who identify as Black or African American, during or after child delivery. In general, maternal death can be due to a myriad of factors, such as how the nature of the pregnancy or the delivery itself, but is not associated with unintentional or secondary causes. In the United States, around 700 women die from pregnancy-related illnesses or complications per year. This number does not include the approximately 50,000 women who experience life-threatening complications during childbirth, resulting in lifelong disabilities and complications. However, there are stark differences in maternal mortality rates for Black American women versus Indigenous American, Alaska Native, and White American women. Between 1897 and 2016, the maternal mortality rates in the United States more than doubled, while the maternal mortality rates worldwide had seen an overall decrease.

There have been significant differences between the maternal mortality of white women versus Black women throughout history. In the U.S., the CDC reported that Black women experience maternal mortality two to three times higher than that of white women. The estimated national maternal mortality rate in the United States is about 17 per 100,000 live births––but it is about 43 per 100,000 live births for Black women. Furthermore, data from the CDC Pregnancy Surveillance Study shows that these higher rates of Black maternal mortality are due to higher fatality rates, not a higher number of cases. Since the usual causes of maternal mortality are conditions that occur or are exacerbated during pregnancy, most instances of maternal mortality are preventable deaths.

Recently, these statistics have been receiving more recognition, as researchers place more emphasis on minimizing these racial/ethnic disparities seen in maternal mortality. Researchers have identified several reasons for the Black-white maternal mortality disparity in the U.S., including factors such as: racial history, access to healthcare, socioeconomic status, pre-existing conditions, medical racism, and abortion access––all of which are social determinants of health in the United States. Preventative measures have been taken at an institutional level and medical level, by the creation of healthcare initiatives as well as policies that are in place.

"Prevention" Section from "Black Maternal Mortality in the United States" [Original]
A large proportion of maternal deaths are thought to be preventable, and thus research has been conducted to identify methods to decrease maternal mortality and reduce these health disparities. (not supported by article??)

Some researchers looking at hospital quality believe that improving the quality of care can help address the maternal mortality disparity in the United States. (again, not supported) The authors of one article from the Seminars in Perinatology journal suggest that higher quality hospitals have administrative and physician advocates, collect and use feedback, and have substantial goals they want to achieve. In addition, the capacity for hospitals to offer maternal health-related services, such as an intensive care unit, 24-hour anesthesia, and OB/GYN specialists contributes to maternal mortality rates by hospital. Prioritizing standardizing care in times of crisis and early risk factors may also directly address issues that lead to maternal mortality in Black women, such as hypertension, hemorrhage, and eclampsia. Notably, a 2018 initiative in New York City attempting to address the strikingly high levels of Black maternal mortality had healthcare workers undergo implicit bias training, and included a public health component through community-based organizations.  ( how is this relevant? too random to be thrown in at the end-- does not flow with themes of next paragraph)

It is also important to recognize that only 87% of Black women have health insurance and most have gaps in coverage at some point in their lives. To improve the health of Black women, then policies need to be implemented that focus on the expansion and maintenance of the care and coverage.

A 2018 Lancet study employed a health technology system called “Gabby” to assess health risks and pre-existing conditions in Black women before conception. The study found that the use of this system to target preconception health risks increased the number of risks that received the necessary attention and treatment. (what exactly does this mean? must put into layman terms) Addressing conditions prior to conception and prenatal care could be an important part of reducing Black maternal mortality, as Black women are more likely to have unaddressed pre-existing conditions that endanger their health or their child’s health. These conditions can impact the health of the parent or child even before conception occurs, so the use of this kind of system could be beneficial in reducing adverse outcomes. (make more neutral)

In addition, experts in medicine, sociology, and law have said that deliberately addressing racism, both within and outside of the medical field, is necessary. (maybe add some quotations, of both sides-- while remaining neutral) Some have argued against the conventional classification of race as a risk factor in health, instead calling for the recognition of racism and poverty as the underlying factors contributing to Black maternal mortality and other poor health outcomes for Black people.

Medical Measures
In order to prevent maternal deaths from occurring, methods have been identified which decrease maternal mortality overall along with the accompanying health disparities. Researchers believe that by improving the quality of care within hospitals, maternal mortality would be properly addressed and accounted for. It has been suggested that higher quality hospitals, that have multiple layers of care such as administrative and patient advocates, are consistent with their collection of feedback from patients which allows for further improvement in regards to addressing maternal mortality. Additionally, maternal health-related services, such as an intensive care unit, 24-hour anesthesia, and OB/GYN specialists, contribute to the decrease of maternal mortality rate. With the prioritization of standardized care and early risk factors, issues that may lead to maternal mortality in Black women, such as hypertension, hemorrhaging, and eclampsia, would be directly addressed. It is also important to recognize that only 87% of Black women have health insurance and most have gaps in coverage at some point in their lives. To improve the health of Black women, policies need to be implemented that focus on the expansion and maintenance of the care and coverage.

Institutional Measures
Some have argued against the conventional classification of race as a risk factor in health, instead calling for the recognition of racism and poverty as the underlying factors contributing to Black maternal mortality and other poor health outcomes for Black individuals. To address the medical racism that exists within healthcare, which ultimately leads to maternal mortality, many states and cities have taken initiative by creating programs to address the high levels of Black maternal mortality. Most notably, in 2018, an initiative was created in New York City in which healthcare workers had to undergo implicit bias training. In addition, experts in multiple sectors, such as medicine, sociology, and law, have said that deliberately addressing racism, both within and outside of the medical field, is necessary to decrease the rate of Black maternal mortality.