For years researchers who study maternal morbidity and mortality have been stumped as to why rates continue to rise and why women of color are adversely affected despite education, health care, and socio-economic factors.
A new report and the first of its kind released in May, New York City 2008 – 2012: Severe Maternal Morbidity, shows the myriad reasons why women of color, especially low-income, Black non-Latina, women fare the worse with severe maternal morbidity (SMM). While most studies in the past across the country focus on maternal mortality, this report focused on maternal morbidity, the causes of maternal mortality.
Women who had more than two babies, had a history of diabetes, hypertension, and weight issues where at greatest risk of developing SMM symptoms. According to the report, the rate of SMM in New York City increased 28.2% from 2008 to 2012 (197.2 per 10,000 deliveries in 2008 to 252.9 per 10,000 deliveries in 2012). Additionally, while the maternal mortality rate has increases in the United States from 12.0 to 17.8 deaths per 100,000 live births the SMM rate has likewise increased from from 73.8 to 129.1 per 10,000 live births from 1998 to 2009.
The report found that poverty causes much of the SMM in Black non-Latina women. Immigrants who have lived in the United States for less than a year also had high rates of SMM particularly those who hail from Mexico, the Dominican Republic as well as from Jamaica. Women across the board with the least education bore the greatest brunt of SMM. Although it is also important to note that Black non-Latina women who were college graduates and had even higher education had a greater prevalence of SMM that their peers from other ethnic groups.
“This report underscores the need to do all that we can to ensure a woman has the opportunity to live a healthy life before, during and after pregnancy,” said Health Commissioner Dr. Mary T. Bassett. “We will continue to focus our efforts in neighborhoods most affected by severe maternal morbidity, which far too often are communities of color. I encourage health care providers and community-based organizations to join us in this effort.”
The report listed recommendations to combat the growing increase in severe maternal morbidity and mortality including greater access to prenatal services and education why these services are important to the health and life of mothers and their babies. Additionally, since the report looked at NYC as a whole as well as segmented SMM data based on boroughs, a key recommendation is to hone in on the NYC areas that has the highest SMM rates. Family planning services and education must also be increased for women who wish not to become pregnant.
New York City, with its diverse population, provides an ideal data set to research why poor, ethnic women experience the vast majority of SMM and mortality. Armed with this new data, researchers, health providers, and health care workers should be able to decrease the numbers of women who experience less than ideal pregnancies and who may even die.
To read more about the report, visit the New York City Department of Health and Human Hygiene.