Why It Matters
Every two minutes a woman dies from complications in childbirth in the US. Black women are three to four times more likely to experience these complications than white women.
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Redesigning Maternal Care for Safety, Dignity, and Respect

By Hagar Tomer | Thursday, September 12, 2019

Redesigning Maternal Care for Safety, Dignity, and Respect

Every two minutes a woman dies from complications in childbirth in the United States. Black women are three to four times more likely to experience these complications than white women.

During a recent episode of WIHI, IHI’s free audio program, guests discussed ways health care can treat women with equity, dignity, and respect during their prenatal, labor, delivery, and post-partum experiences. Panelists included Joia Crear-Perry, MD, FACOG, Founder and President of the National Birth Equity Collaborative; Ebony Marcelle, CNM, MS, FACNM, Director of Midwifery, Community of Hope; Kiddada Green, MAT, Founding Executive Director, Black Mothers’ Breastfeeding Association; and IHI Project Director, Shannon Welch, MPH. The WIHI guests agreed that black women’s voices must be amplified to address structural racism and implicit bias and that all efforts to create a safer, more respectful maternal health experience for black women will benefit all women.

Important Steps

Dr. Crear-Perry outlined what health care must do to improve maternal health, including:

  • Build connections between birthing professionals and health care organizations — When going into a birthing process, it is important to treat the participants as a collaborative team to encourage open communication and create the best experience for everyone involved, especially the patient. By encouraging communication, we encourage all parties to feel more comfortable and respected.
  • Share learnings based on lived experience — Communicating this knowledge can help educate and enlighten people working in health care so they can provide better care. Additionally, sharing this information can benefit research organizations such as the National Birth Equity Collaborative that gather data to paint a clearer picture of the realities of maternal mortality.
  • Establish more Maternal Mortality Review Committees — Currently, only 36 states have a Maternal Mortality Review Committee (MMRC). Without MMRCs, states are deprived of valuable data and potential improvement opportunities. MMRCs help ensure that women are seen and heard.
  • Practice with a health equity framework — For example, develop measures to support health equity work. This includes collecting race, ethnicity, and language (REAL) data. Instructions on how to develop and maintain a health equity framework can be found in IHI’s Achieving Health Equity: A Guide for Health Care Organizations white paper.
  • Identify when families may need additional supportUse a coding mechanism to identify and collect data on patients who are experiencing homelessness, food insecurity, or other factors that influence health and well-being. Collecting this kind of data can help make the case for strengthening the public health infrastructure.

Thriving, Not Just Surviving

All the WIHI panelists agreed that addressing racial and social inequity will help create an overall maternal care experience that improves safety, dignity, respect, and access to better care. As Community of Hope’s Ebony Marcelle pointed out, “[Women] do not want to go somewhere where they fear they will be judged and disrespected.” Dr. Crear-Perry noted that one of the driving principles of the National Birth Equity Collaborative is that women should thrive during and after pregnancy instead of just being thankful they’ve survived.

Hagar Tomer is IHI's Multimedia Project Assistant.

You may also be interested in:

The Better Maternal Outcomes Rapid Improvement Network is a free initiative aimed at connecting hospitals and providers from across the country who are committed to delivering safe, equitable, and respectful care for women and their babies. Wave 2 of the Better Maternal Outcomes Rapid Improvement Network is starting soon.

Sign up here to be added to the Better Maternal Outcomes mailing list and receive notifications about upcoming public webinars.

WIHI: Black Women and Maternal Care: Redesigning for Safety, Dignity, and Respect

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