mortality in low-income women.
mortality in low-income women.
Reply Hollie
Case study:
Health disparities a 32-year-old African American woman may experience related to her pregnancy, such as the risk for preterm labor and the high rate of infant mortality in low-income women.
This is a timely topic as this year the CDC pointed out that the risk of black* women dying in pregnancy is three to four times that of white women (CDC, 2019). ACOG (2015) discusses the consistent and prevalent disparities in obstetrics and gynecology. Healthcare access is one of the documented issues. ACOG reminds us that the United States is the only country that has a market driven health care system rather than the view that healthcare is a right that every citizen should have (ACOG, 2015). In 2013, 59% of black women lived in areas where Medicaid was not going to be expanded (ACOG, 2015). Also documented is the biases and stereotyping from a provider point of view (ACOG, 2015). Demographic and social biases have been shown to influence clinican’s decisions regarding contraception and pre-natal care (ACOG, 2015). Could the mistrust of many black women with the healthcare system have anything to do with forced sterilization in the past? (ACOG, 2015).
These disparities are nothing new. In 2011, Cox, Zhang, Zotti, and Graham discussed racial disparities and unfavorable birth outcomes. The study referenced that fact that black women consistency received less than adequate pre-natal care from providers. In addition black women had a greater chance of premature babies, babies with low birth weight, and babies who die in childbirth (Cox, Zhang, Zotti, & Graham, 2011). We have the power, as Nurse Practitioners to encourage and provider early and consistent pre-natal care free of bias and judgment. With consistent care, we can assist with nutritional and psychosocial counseling as well as assisting with modifiable risk factors such as alcohol, drug use, or cigarette smoking in pregnancy (Cox, Zhang, Zotti, & Graham, 2011).
*I am African Canadian so prefer to use the word black rather than African American
References
American College of Obstetrics and Gynecology (ACOG). (2015). Women’s Health Care Physicians. Retrieved from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Racial-and-Ethnic-Disparities-in-Obstetrics-and-Gynecology
Centers for Disease Control (CDC). (2019). Pregnancy-Related Deaths | CDC. Retrieved from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htm
Cox, R. G., Zhang, L., Zotti, M. E., & Graham, J. (2011). Prenatal care utilization in mississippi: Racial disparities and implications for unfavorable birth outcomes.Maternal and Child Health Journal, 15(7), 931-42. doi:http://dx.doi.org/10.1007/s10995-009-0542-6
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