Advancing Maternal & Child Health Equity in Diverse Populations
This issue brief provides an “overview of racial and ethnic disparities for selected measures of maternal and infant health, discusses the factors that drive these disparities, and provides an overview of recent efforts to address them.” Publicly available data was analyzed from the CDC WONDER online database, the National Center for Health Statistics (NCHS) National Vital Statistics Reports, and the CDC Pregnancy Mortality Surveillance System. Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them. The authors’ key findings include the following: 1) “Large racial disparities in maternal and infant health outcomes persist;” 2) “Maternal and infant health disparities reflect broader underlying social and economic inequities that are rooted in racism and discrimination;” and 3) “Increased attention to maternal and infant health has contributed to a rise in efforts and resources focused on improving health outcomes and reducing disparities in these areas.”
This article reviews milestones in the history of advancing maternal and reproductive health equity. Topics discussed include inequities affecting maternal health outcomes, social determinants of health, geographic variations, the impact of structural racism, additional marginalized populations, and the importance of screening for and addressing cardiovascular disease risk factors. Selected national and state efforts and evidence-based strategies to improve maternal health are described. The following seven recommendations are made: “1) Improving health literacy and public awareness on preconception care; 2) Achieving cultural competency and bias reduction; 3) Mitigating the impact of social and structural determinants of health; 4) Transforming payment and promoting value-based care; 5) Modernizing health care delivery infrastructure and expanding care coordination; 6) Improving public health infrastructure and digitally enabled health care; 7) Quality reporting of maternal outcomes and health metrics; and 8) Expanding postpartum care.”
This article reviews the published literature about the social and structural determinants of maternal health. The authors discuss root causes of inequities such as structural racism, as well as “social and political structures and policies in the United States … born out of racism, classism, and gender oppression.” To address inequities in maternal health outcomes, they recommend the following practice and policy solutions: 1) paid family leave; 2) health insurance coverage and scope; 3) respectful, culturally appropriate care; and 4) invest in communities.
This fact sheet provides information designed to help facilitate the provision of more effective care to pregnant people living with disabilities. Topics addressed include the following: 1) Key Facts: Maternal Mental Health Conditions; 2) Key Points: Disability, Pregnancy, and Maternal Mental Health; 3) Types of Disabilities (Sensory, Intellectual and Developmental, and Physical); 4) Factors Impacting Perinatal Health Care for Women with Disabilities; 5) Challenges Women with Disabilities Experience; and 6) Strategies for Improving Perinatal Healthcare for Women with Disabilities.
Maternal Mental Health Leadership Alliance – Military, Veteran Women, and Maternal Mental Health (2024)
This Fact Sheet provides education and resources about Military and Veteran women, maternal mental health, risks and barriers to care, and the impact of military culture, stigma, frequent moves, and other factors. Topics addressed include the following: 1) Key Facts: Maternal Mental Health (MMH) Conditions; 2) Key Facts: Military and Veteran Women; 3) Military Maternal Mental Health; 4) Examples of Programs Supporting Pregnant and Postpartum People in the Military and the Department of Defense; 5) Women Veterans: Maternal Mental Health; 6) Examples of Programs Supporting Women Veterans; 7) Military Culture; and 8) Resources to Support Military and Veteran Mothers.
Maternal Mental Health Leadership Alliance – Resources for LGBTQ+ Individuals and Healthcare Providers
This article examines the increased risk for poor maternal health outcomes experienced by some immigrant women in the United States. Critical delays in obtaining adequate health care related to cultural, linguistic, or socioeconomic barriers can be an important factor and need to be addressed. The authors call for “ensuring access to high-quality, culturally appropriate perinatal health care … to improve the health and well-being of immigrant mothers and their children.” Community engagement and involving community members in the design and delivery of culturally appropriate maternal health services are proposed. Strategies described include the following: “working with community health workers, encouraging telehealth through community health workers, providing breastfeeding and mental health support within cultural norms, and involving community-based doulas and midwives.”
This article examines how language and communication barriers can negatively impact the quality, experiences, and outcomes of obstetrical and gynecological care in various clinical settings (e.g., labor and delivery, perioperative care, outpatient clinics, inpatient services, and reproductive health). Two illustrative clinical cases are shared involving patients with limited English proficiency. The authors present a framework with actionable recommendations for addressing drivers of language-related inequities at the clinician level (assessing language needs, appropriate collaboration with interpreters, compliance with qualified bilingual staff certification), health system level (adhering to the National Standards for Culturally and Linguistically Appropriate Services, promoting language-concordant care and cultural brokering, prioritizing language-related outcome measures), and societal level (language access policies, funding, and reimbursement structures, xenophobia, discrimination, and racism, and disproportionate effects of negative social determinants of health).
Rural Health Information Hub – Rural Maternal Health
Significant geographic variations in maternal and child health equity exist across diverse urban, suburban, and rural settings in the United States. This website focuses on rural communities and information/resources are provided about 1) disparities related to rural maternal and infant health; 2) maternal health access and utilization (e.g., health insurance and access to obstetric services) in rural America; 3) workforce challenges in providing rural maternal health services, 4) additional barriers and issues (e.g., social determinants of health, transportation barriers, intimate partner violence, and substance use) affecting rural maternal health; and 5) policies, programs, or models that address challenges with affordability, accessibility, and quality of maternal health services in rural areas.
American Hospital Association – Best Practices for Equitable Maternal Care (2023)
This brief communication offers suggestions from health care leaders about ways organizations can foster equitable practices in maternal care at the individual and systemic levels. Three examples of hospital-based programs focusing on doula services and postpartum hypertension are described.
IRTH App – Birth Without Bias (B)
This “Yelp-like” platform provides “prenatal, birthing, postpartum and pediatric reviews of doctor and hospital care from Black and brown women.”