African American women in New York City are eight times more likely than White or Hispanic women to die from pregnancy-related causes, while in California Black women are four times more likely to experience maternal death, a recent study concluded.
The statistics surfaced from research by a panel of physicians and epidemiologists in California who linked high rates of obesity, high blood pressure and inadequate prenatal care to what some medical researchers say is an alarming rise in maternal deaths in the U.S.
The findings emerged from research that scrutinized the sharp rise in pregnancy-related deaths in the last decade. California researchers conducted a detailed study of medical records to find out what’s behind an increase in maternal death rates in the U.S. to levels that, in some regions, rival maternal mortality in some developing nations.
“African-American people generally have worse health outcomes than Caucasian people…but not this degree, not four-fold,” Conrad Chao, a clinical professor of obstetrics and gynecology at the University of California, San Francisco and contributor to the report told PBS News. “What surprised me when we got through the numbers was the magnitude of the disparity.”
Interest in the topic was triggered by Centers for Disease Control (CDC) figures that pregnancy-related deaths among Blacks rising from 21.5 per 100,000 live births in 1997 to 28.4 per 100,000 live births in 2007, compared to 8.0 for Hispanics and 5.2 for whites.
Following the CDC study, the panel that Dr. Chao was involved with looked more closely at deaths in California.
Of the 386 women who died in the state during childbirth in 2002 and 2003, it found 65 had undergone C-sections “and most were unplanned or emergency surgeries to try and save the life of the mother or the infant.” Additionally, more than one-third of the deaths “were determined to have had a good to strong chance of being prevented and some causes of death appeared to be more preventable than others.”
Complications from obesity and hypertension were among the main contributors of death for pregnant Blacks, the California panel found. High rates of obesity or excessive gestational weight gain were contributing factors in one of four deaths.
Additionally, experts point to a number of socioeconomic issues for the high death rates, including inadequate health care, low education levels and low income.
The rise in Caesarian deliveries was also cited by researchers as a factor in the rise of maternal death. While the procedure was used for 20 percent of all child births in the U.S. one decade ago, it now accounts for one-third of deliveries.
Dr. Kerry M. Lewis, chairman of the Department of Obstetrics and Gynecology at Howard University’s College of Medicine and chief of the Division of Maternal Fetal-Medicine told America’s Wire that C-sections can lead to hemorrhage, infections, pulmonary embolisms, or blood clots in the lungs.
“Women who have C-sections have higher rates of complications and maternal mortality than with vaginal deliveries,” Lewis told America's Wire.
Lewis, who specializes in high-risk pregnancies, says the mortality rate reflects lack of access to specialized health care that integrates comprehensive skills and technology. Too often, he says, patients are treated by family practitioners, nurse midwives, general obstetricians and gynecologists instead of specialists trained in high-risk pregnancies and medical problems that can cause complications during birth.
Chao said no single factor can be labeled the primary cause for the rise in deaths, noting that although the Hispanic population has seen a marked rise in obesity, it has not yet seen a spike in maternal deaths.