This article was featured in the Summer 2024 issue of Trauma Matters, a quarterly publication by The Connecticut Women’s Consortium. The full edition can be downloaded here.
Maternal health serves as a key indicator of a nation’s overall health, reflecting the effectiveness of its health care system and highlighting existing disparities and weaknesses. The United States has the highest level of maternal mortality in the developed world. The rate is especially high for Black women.
Black women are three times more likely to die from a pregnancy-related cause than white women in the U.S., according to the Centers for Disease Control and Prevention (CDC.) Black women are also twice as likely as white women to be affected by potentially life-threatening conditions or complications, known as severe maternal morbidity.
Connecticut, despite its reputation as one of the healthiest states, has significant maternal health disparities. The state’s Maternal Mortality Review Committee looked at data from 2015 to 2019 and found 62 deaths occurring during a pregnancy or the first year after birth. While Black people made up only 13% of live births, they made up 27% of all pregnancy-associated deaths. Babies born to Black women in Connecticut are twice as likely to be born with low birthweight than babies born to white women (12.5% vs. 6.3%). Infants born to Black women are four times more likely than those born to white women to die before their first birthday.
Health disparities are found at every step of the journey to parenthood. Nationally, Black women are nearly twice as likely than white women to have a birth with late or no prenatal care (9% vs. 5%). Women of color are at a higher risk of being uninsured before their pregnancy. Black women are also more likely to experience reproductive health disorders such as fibroids and are at higher risk of pregnancy-related complications such as preeclampsia. Across all racial groups, more than half of pregnancy-related deaths happen up to one year after delivery, underscoring the need for comprehensive postpartum care.
While socioeconomic differences are contributing factors in some instances of maternal mortality, they do not fully explain racial differences in maternal and infant health. A study found that Black women with a college degree or higher were 1.6 times more likely to die from pregnancy-related causes than white women without a high school diploma. Among those with a college education or higher, Black women were 5.2 times more likely to die from pregnancy-related causes than white women.
These inequities are deeply rooted in racism and discrimination. Research indicates that racism and chronic stress adversely affect maternal and infant health outcomes. A recent survey revealed that many U.S. mothers reported experiencing mistreatment and discrimination during pregnancy and childbirth. About 20% of mothers overall reported mistreatment, with the rate climbing to nearly 30% for Black, Hispanic, and multiracial mothers. This mistreatment included being ignored by healthcare providers and having requests for help refused. Among Black mothers, 40.1% reported experiencing discrimination related to factors such as language barriers, lack of health insurance, and involvement with the justice system.
Healthy Connecticut 2025: A State Health Assessment identifies focus areas to improve these outcomes. It involves preconception health, which includes improving the health of people who could become pregnant and preventing chronic disease, prenatal health to improve outcomes, and medical care improvement including hospital protocol and care.
This year, the Connecticut Health Foundation will be commissioning a blueprint for maternal health equity for people of color in Connecticut, informed by those with lived experience, decision makers, and those who work in the field. We are eager to join those working on these critical issues and to share the findings of this process in 2025.