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Racial Discrimination and Economic Obstacles Contribute to Dramatically Elevated Maternal Death Rates for Women of Color in the United States, Says a New Amnesty International Report
African-American women are four times more likely than white women to die from childbirth-related complications.
WASHINGTON - March 15 - A new report from Amnesty International reveals that African-American women are nearly four times more likely to die of pregnancy-related complications than white women. In high-risk pregnancies, the disparities are even greater; African-American women are five and a half times more likely to die than white women.
The report, Deadly Delivery: the Maternal Health Care Crisis in the USA, faults discrimination, a lack of nationally enforced standards and barriers to adequate maternal care as contributing to the high death rate among women of color giving birth. Women living in poverty and those who speak little or no English face additional barriers to quality maternal care, resulting in missed opportunities to save women's lives and reduce complications.
Inamarie Stith-Rouse, 33, who was African-American, died in a Boston hospital after delivering a healthy baby girl following an emergency c-section. Her husband Andre said he tried telling staff that his wife was in distress and struggling to breathe after surgery, but he said he was told it was "no big deal" and the couple was "too emotional." Hours went by before appropriate tests showed she was hemorrhaging. It was too late. Inamarie went into a coma and died four days later. Andre Rouse felt race played a part in the hospital staff's immediate lack of response.
Two to three women die every day in the United States from pregnancy-related complications, according to the Centers for Disease Control, and half of these deaths are preventable. More than 34,000 women nearly die each year due to flaws and shocking disparities in maternal health care. These severe pregnancy-related complications that nearly cause death have increased by 25 percent since 1998. Authorities concede that haphazard reporting means maternal death statistics could be twice as high as officially reported.
"This country's extraordinary record of medical advancement makes its haphazard approach to maternal care all the more scandalous and disgraceful," said Larry Cox, executive director of Amnesty International USA. "Women should not die in the richest country on earth from preventable complications and emergencies."
Maternity care advocates and practitioners confirm the findings in AI's report. "In the 20 years I've been in this country, the racial disparity has not improved. I cannot comprehend how such a stark racial disparity could even exist in a country like this," said Jennie Joseph, a U.K.-trained midwife who founded the Easy Access Prenatal Care Clinic, an outreach maternity clinic in West Orlando, FL; the outreach clinic clientele is 50 to 60% African American.
The report includes these key findings:
- l Women of color account for 32 percent of all women in the United States but more than half (51 percent) of uninsured women; this means they are more likely to go into pregnancy with less than optimum health or untreated medical problems. (State data available.)
- l Women who do not receive any prenatal care are three to four times more likely to die than women who do. African-American and Latina women are two and a half times and Native American women are three and a half times more likely than white women to receive late or no prenatal care. (State data available.)
- Burdensome bureaucratic procedures in Medicaid enrollment delay access to prenatal care. Twenty-one states do not currently allow pregnant women to temporarily access medical care while their permanent application for Medicaid is pending.
- l In rural areas and inner cities there is a critical shortage of health care professionals. In 2008, 64 million people were living in "shortage areas" for primary care, but federally-supported community health centers-a critical safety net-were available in only 20 percent of these areas. (State data available.)
- Caesarian sections make up nearly one-third of all deliveries in the United States-twice as high as recommended by the World Health Organization. African American women have the highest c-section rate of any group. The risk of death following c-sections is more than three times higher than for vaginal births.
Comprehensive, Consistent Approach Needed to Maternal Care
The Amnesty International report calls for a coordinated, comprehensive and consistent approach to maternal care, from family planning to post-partum care, to fix a system that is failing so many women.
Because there is no systematic, robust government response to this critical problem, Amnesty International is urging the government to establish a single office within the Department of Health and Human Services responsible for ensuring that all women receive quality maternal care.
Other recommendations include:
- l An increase in support for federally qualified health centers by 2011 to expand the number of women who can access affordable maternal health care
- l Vigorous enforcement of federal non-discrimination laws
- l Ensure access to timely prenatal care for all women
- l Encouraging home care visits during the first weeks following birth
- l Protocols to prevent and respond to the leading complications that cause pregnancy-related death
Respect for human rights requires the recognition that everyone has the right to live in dignity, and the right to food, shelter, water, basic health care and education. For more information about Amnesty International's "Demand Dignity" campaign, please visit: http://www.amnestyusa.org/demand-dignity/
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