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CDC Addresses Health Inequities Among BIPOC Pregnant Women With ‘Hear Her’

Wanda Barfield, MD, MPH, RADM USPHS Director of the Division of Reproductive Health, Centers for Disease Control and Prevention | April 29, 2021

Every year, 50,000 women in the United States experience severe pregnancy-related complications and 700 women die. Tragically, most of these deaths could be prevented. There are considerable racial disparities when it comes to pregnancy-related deaths. American Indian/Alaska Native, and Black women are two to three times more likely to die of pregnancy-related causes than white women. The CDC launched the Hear Her campaign to raise awareness of the potentially life-threatening warning signs during and in the year after pregnancy.

A number of factors contribute to the maternal mortality rate among Black and American Indian/Alaska Native women. Structural racism and implicit bias can play a role in the disparity. For example, delayed prenatal care initiation is associated with personal experiences of bias and racism. Protective factors also do not seem to convey the same risk reduction for minority women. For example, we see persistent disparities in maternal mortality, regardless of educational attainment. In addition, access to quality care can be an issue.  For example, it has been found that hospitals that disproportionately cared for Black women at delivery had increased poor outcomes for both Black and white women in those hospitals.

Valencia, one of the women featured in the campaign, talked about her experience with a pregnancy-related complication. During her first pregnancy, Valencia struggled with headaches and dizziness. When she reported worsening symptoms, she felt like no one took her seriously. “I didn’t know who to talk to and wasn’t sure how to speak up for myself,” she recalled. It was her primary care provider who finally helped her get the care she needed.

Valencia is just one of the many women who face serious health complications during and after pregnancy. Women like Valencia may feel ignored or dismissed when sharing their concerns, which may make them hesitant to ask questions or speak up. Not fully listening to women may cause providers to miss warning signs that require urgent care. Hear Her encourages partners, friends, family, and healthcare providers to really listen when a woman tells you something doesn’t feel right. Acting quickly could save her life.

To address racial and ethnic disparities in maternal mortality, CDC supports the work of Maternal Mortality Review Committees around the country to get quality data about the circumstances surrounding a pregnancy-related death, including the documentation of bias, discrimination, and racism. These data are used by committees to make recommendations to prevent future pregnancy-related deaths and are also used by CDC to better understand maternal mortality across the nation.

A better understanding of pregnancy-related deaths can lead to identifying the initiatives that will have the most impact. Standardized quality care can ensure the right care in the right places at the right time for women.  And high-quality care doesn’t end at delivery. It should extend into the postpartum period up to a year after delivery, when about a third of pregnancy-related deaths occur.

It is so necessary to be an active participant in your healthcare, especially when you’re pregnant or postpartum, and the CDC has identified what to look for if you feel like something might be wrong. Pregnant and postpartum women up to a year after pregnancy need to seek medical care immediately if they experience any of the following signs or symptoms:

  • Severe headache that won’t go away or gets worse over time
  • Dizziness or fainting
  • Thoughts about harming yourself or your baby
  • Changes in your vision
  • Fever of 100.4º F or higher
  • Extreme swelling of your hands or face
  • Trouble breathing
  • Chest pain or fast-beating heart
  • Severe nausea and throwing up (not like morning sickness)
  • Severe belly pain that doesn’t go away
  • Baby’s movement stopping or slowing down during pregnancy
  • Vaginal bleeding or fluid leaking during pregnancy
  • Heavy vaginal bleeding or leaking fluid that smells bad after pregnancy
  • Swelling, redness, or pain of your leg
  • Overwhelming tiredness

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