The United States takes the last rank among all high-income nations included in the Organization for Economic Cooperation and Development (OECD) in terms of maternal mortality. Black women, in particular, are three times more likely to die from a pregnancy-related cause when compared to white and Hispanic women, a new study from the University of Houston.
Black women in Texas are also twice as likely to suffer complications from pregnancies than white women, based on 2020 national data. Owing to racial and ethnic disparities, Black women experience the highest rates of severe maternal morbidity, defined as “unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health.”
The study also focuses on the impact of preexisting health conditions, which may develop early in life or during pregnancy, to explain the disparities in such cases of maternal mortality. These include the allocation of Black women to hospitals that do not provide adequate care to women and other factors within hospitals, such as Black women receiving worse care than white women at the same hospital.
What the data says
To gauge a woman’s health status, the study uses a comorbidity score from 2016 to 2022, including medical conditions such as chronic hypertension, asthma, mental health disorders, and obesity, among others. The data showed that comorbidities increased in Texas by 42% for the prevalence of two or more comorbidities and 48% for the comorbidity score.
The comorbidity for Black women (non-Hispanic) is approximately 45% more than white women, and this gap has remained “fairly stable.” Moreover, for every 10,000 delivery hospitalizations for white and Black women, Black women are nearly twice (98%) as likely to receive at least one diagnosis indicative of SMM during their delivery hospitalization compared to white women.
“Differences in the comorbidity score between non-Hispanic Black and non-Hispanic White women alone account for 78% of the Black-White SMM gap,” said Annamaria Milazzo, research assistant professor with UH’s Institute for Research on Women, Gender and Sexuality, and the author of the study. “These results underscore the critical need for a major focus on the health of women well before they are hospitalized for the delivery of their child. Considering the evidence indicating a rise in ill health among Texas women, there seems to be a clear need for expanded access to healthcare for women from an early stage in life.”
Texas has the largest population of women from ages 19 to 54 without health insurance and is one of the states that has not adopted the expansion of Medicaid eligibility to low-income adults. Milazzo’s research analyzed hospital discharge data from all delivery hospitalizations in Texas hospitals from 2016 to 2022.
