Evidence-Based Recommendations for Healthcare Providers to Reduce Black and African American Maternal Mortality in the U.S. Public
Obert, Sophie (Spring 2022)
Published
Abstract
Maternal mortality is a critical public health issue globally, especially in countries that are considered low-and middle- income. Despite the many resources available in the United States, maternal mortality is significantly high, especially for Black and African Americans. There has been considerable research, funding, and public outcry on improving this health outcome. However, despite efforts, interventions for medical professionals aimed at reducing maternal mortality in Black and African Americans have led to mixed results.
This review aims to delve into the background and significance of maternal mortality in this population. Next, there will be an overview of how U.S. medical institutions have been influenced by racism and bias in healthcare. Next, classification and common clinical causes for Black and African Americans will be reviewed. Finally, existing evidence-based interventions will be evaluated, and through these literature reviews, there will be both individual provider recommendations and an example curriculum.
Table of Contents
Table of Contents
Gratitudes 6
Table of Contents 7
List of Abbreviations 9
Chapter 1: Introduction 9
1. 1. Statement of the Problem 10
1. 2. Statement of Purpose 10
1. 3. Research Questions 10
Chapter 2: Racism, Biases, & Disparities 11
2. 1. Institutional Racism and Legacy of Chattel Slavery on Maternal Mortality 11
2. 1. 1. Experimentation on Black Enslaved Women: A brief overview 11
2. 1. 2. Intergenerational Trauma: Effects on Health 11
2. 1. 3. Lasting Misinformation 12
2. 2. Bias in Provider Care 12
2. 3. Disparities 13
2. 3. 1. Systemic Racism in Healthcare 13
2. 3. 2. Medicalization of Birth: Erasure of Midwifery 14
Chapter 3: Defining & Classifying of Maternal Mortality 14
3. 1. Defining Maternal Mortality 14
3. 2. Classification 15
3. 3. Surveillance 16
3. 3. 1. National Vital Statistic System (NVSS) 16
3. 3. 2. PMSS 16
3. 3. 3. Discrepancies 16
Chapter 4: Clinical Causes of Maternal Mortality 18
4. 1. Background 18
3. 5. 1. Cardiovascular Conditions 19
3. 5. 2. Renal Conditions 20
3. 5. 3. Preeclampsia & Eclampsia 20
3. 5. 4. Shock, Infection, and Sepsis 20
3. 5. 5. Hemorrhage 21
3. 5. 5. Death from Unsafe Abortion 21
3. 5. 6. “Non Medical” Causes of Maternal Mortality 22
3. 5. 7. Contributing Factors & the Role of Chronic Health Issues 22
Chapter 2: Methodology 23
2. 1. Literature Review 23
2. 2. Commitment to Inclusivity 24
2. 3. Limitations 25
Chapter 3: Results 25
3. 3. Existing Recommendations for Maternal Mortality Reduction 25
3. 3. 1. Addressing SDOHs 26
3. 3. 2. Maternal Safety Bundles 26
3. 3. 3. Implicit Bias Training 26
3. 3. 4. Community Engagement 26
Chapter 4: Discussion, Recommendations, Example Curriculum, & Conclusions 27
4. 1. Discussion 27
4. 2. Individual Provider Recommendations 27
Advocate for Establishment of State-based Maternal Mortality Review Committees 27
Improve Rates of Chronic Illness and Promote Chronic Care Maintenance 27
Advocated for and Provide Quality Prenatal Care 28
Identify Personal Biases and Aim to Reduce Them 28
Advocate for and Protect Abortion Access 28
Accept Medicaid Patients and Treat Them Equitably 28
4. 3. Example Curriculum 30
4. 4. Conclusions 31
References 32
About this Master's Thesis
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