Does race figure in maternal and infant death?

On February 20, 2003, the Centers for Disease Control and Prevention issued a press release stating that black women are four times more likely to die from pregnancy or childbirth than white women. During the nine-year study period, the pregnancy-related mortality ratio for black women was 30.0 deaths per 100,000 live births, compared to 8.1 for white women. Pregnancy-related mortality has the largest racial disparity of any maternal and child health indicators, persisting for more than 60 years.

The pregnancy-related mortality ratio for all women was 11.8 deaths per 100,000 live births, which is well above the nation's Healthy People 2010 goal of no more than 3.3 maternal deaths per 100,000 live births. In terms of maternal mortality, the United States ranks fourteenth among "civilized nations," with only Spain and Belgium having a higher death rate.

The Centers for Disease Control (CDC) determined that women who had no prenatal care were three to four times more likely to die than those who received care and the rate was higher for black women. Interestingly, birth defects are the leading cause of infant mortality on a national level, but for black infants the leading cause of death is low birth weight and other prematurity complications.

In the fall of 2003, a symposium, titled Autumn in New York, focused on the disparities between racial and ethnic groups in terms of perinatal and women's health. Dr. Karla Damus of the Albert Einstein College of Medicine and the March of Dimes pointed out that despite the decline of infant mortality in the past two decades, the rate has fallen faster for white infants than black infants. Black infants are 2.5 times more likely to die than white infants. In 2001, the infant mortality rate for black infants was 13.3 per 1,000 live births, far exceeding the Healthy People goal of 4.5 per 1,000 for the year 2010.

Dr. Haywood Brown of Duke University's School of Medicine also attended the symposium and showed that some of these racial disparities are correlated with geography. In the District of Columbia, Mississippi, Oregon, Iowa, and Texas there were higher rates of low birth weight babies among black women. Dr. Brown theorized that these higher rates could have something to do with higher stress levels.

Dr. Brown believes that these growing disparities in health outcomes for black women point to failures in our healthcare system. He feels the solution is not only to improve access to existing services, but also to tailor them to better fit the needs of black women and their families.

--Obstetrics & Gynecology, February, 2003