When it’s time to deliver a baby, moms can be filled with excitement, anxiety and love.
But now more than ever, new mothers aren’t surviving long enough for their child’s first birthday.
“Across the board, women today having a baby are 50 percent or more at risk of death than their mother was a generation before them,” said Dr. Donna Patno, director of patient care services for the Women’s Health and Family Maternity Center at Sentara Williamsburg Regional Medical Center. “We have to start looking at [maternal] health care differently, because when we’re talking about the mom we are talking about the whole family.”
Patno said the issue is even worse for black women. On average nationally, black women are four times more likely than white women to die from causes related to childbirth.
The issue has hit national headlines as the United States remains the only developed nation with rising maternal mortality rates. In Virginia, it has become a large enough concern that Gov. Ralph Northam announced a new initiative on June 6 to lower the racial disparity in mortality rates.
In Williamsburg, James City County and York County, the maternal mortality rates are 13.8 for white women and 56.4 for black women per 100,000 live births between 2004 and 2013, according to data from the Virginia Department of Health.
The maternal mortality rate is calculated by dividing the number of pregnancy-associated deaths occurring within 42 days of the end of a pregnancy by the number of live births in that same time period and multiplying by 100,000, according to the VDH.
There are a number of hypothesized reasons for the rising rate in maternal mortality, Patno said. Specifically for black women, she said experts are starting to believe it has to do with epogenetic social stress changes, which is the study of how outside influences impact the way genes show themselves.
Exposure to chronic racism might increase the risk of chronic illness.
“The stress associated with the experiences of racism does modify genes and creates an impact across three generations,” she said.
Another reason is for a lot of black women, having a baby is their first entry into the health care system. When they come in to deliver their child, they might not know of any pre-existing conditions that could cause complications during and after childbirth, she said.
“The fact of the matter is everyone is not the same,” Patno said. “The woman standing next to me—her experience in the world is probably very different than mine. Some of the stressors of things we’ve been exposed to impact us greater than others.”
She said one factor could start to change the issue: listening.
Patno said one of the things the teams at Sentara are working to do even better is listening to women more when they describe any issues. A lot of deaths and complications can come days or months after childbirth, but sometimes larger issues can slip through the cracks because mothers’ doctors aren’t listening well enough.
The leading cause of maternal deaths within the first year outside of the hospital are heart disorders either diagnosed or not. She said one of the reasons the early signs of these issues are missed is because doctors tend to relate symptoms, such as shortness of breath, to simply being part of the recovery process postpartum.
“One of the biggest messages we’ve learned across the board is that we don’t listen, and if you’re a black woman we listen to you even less,” she said. “It’s taking her concerns very seriously, it’s stepping back and relearning those basic skills of listening to women.”
Sentara has also recently appointed its first system director of health care equity, said Dale Gauding, spokesman for Sentara.
Sentara also have five hospitals participating in a pilot program with the Virginia Hospital and Healthcare Association.
“We are utilizing data to help us better understand the needs of our community and determine how we collaborate with our community partners to implement initiatives upstream to produce better outcomes for our moms and babies,” Iris Lundy, director of health equity, wrote in an email.
According to Northam’s website, a majority of pregnancy-associated deaths occur more than 43 days after pregnancy but the current program only provides Medicaid coverage for women during pregnancy and 60-days after giving birth.
“While 13 white women die for every 100,000 live births, the rate for Hispanic women is 11.4. The figure for African-American women is 42.8 for every 100,000 live births, and for Native American/Alaska Native women, it’s 32.5,” Lundy said. “We have much work to be done.”
Editor’s Note: This story was originally published in 2019 and has been updated.
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