Healthcare Disparities in Prenatal and Childbirth Care

The United States has one of the most advanced healthcare systems in the world. Despite this fact, a significant portion of our population is under-served. Research consistently shows that healthcare disparities result in black women not receiving the same level of care as white women during pregnancy and childbirth.

Healthcare disparities exist in obstetrical, prenatal and childbirth care at alarming levels. Each year, there are approximately 83,000 preventable deaths due to racial and ethnic disparities in healthcare. In terms of pregnancy outcomes, maternal outcomes and obstetrical care, black patients are at a higher risk for the following:

• Congenital abnormalities
• Fetal demise
• Preterm birth
• Fetal growth restriction
• Hypertensive disorders
• Diabetes
• Obesity
• Cesarean delivery

The Reality of Healthcare Disparities among Women and Infants

• At least 22% of black women do not have health insurance, as compared to 12.7% of white women.
• 7.5% of black women are diagnosed with gestational diabetes, as compared to 3.3% of white women.
• Black women are over three times more likely to die from pregnancy-related causes than white women.
• Infants born to black mothers are more likely to be preterm. 18% of preterm births are among black women, as opposed to 11.7% among white women
• Infants born to black mothers are twice as likely to suffer from low birth weight.
• Research shows that black infants are twice as likely to die within the first year of life compared to other races.
• Only 54% of black infants ever receive breast milk, compared to 74% of white infants.
• Researchers consistently report a higher fetal death rate among black infants.
  • In 2010, the infant mortality rate among black infants was 11.61%. The infant mortality rate among white infants was 5.19%.
  • In 2009, the gap was even wider. The infant mortality rate in 2009 among black infants was 12.64%, compared to 5.30% among white infants.
• The death rate among white mothers was 11.7 per 100,000 live births in 2005. The rate among black mothers was 39.2 per 100,000 live births.
• Among high-risk pregnancies, black women are 5.6 times more likely to die than white women.
• Black women with preeclampsia and eclampsia are 9.9 times more likely to die than white women who have the same disorders.

Disparities in Healthcare Services

The Agency for Healthcare Research and Quality measures disparities across a variety of measures. Their National Healthcare Quality and Disparities Reports shows that black women are far less likely to receive quality obstetrical care than their peers:

• Research shows that 69% of pregnancies among black women are unintended, compared to only 40% of pregnancies among white women. Researchers believe that inadequate access to family planning services is the primary factor.
• Almost 50% of black women suffer from discontinuous insurance coverage between preconception and childbirth. Only one-fourth of white women experience the same discontinuous coverage.
• Black mothers tend to suffer from inadequate prenatal care. Around 79% of white women are provided with prenatal care that is at least adequate. Only 69% of black women receive at least adequate care. 
• Only 79% of black women get prenatal care during the first trimester of pregnancy, as opposed to 89% of white women.
• 32% of black women do not receive the recommended number of prenatal visits. This is compared to 25% of women of other races.
• A study of maternal deaths finds that 46% of maternal deaths among black women are preventable, compared to 33% of maternal deaths among white women. The study found that quality care (or lack thereof) was a factor in preventable deaths.

Literature

Written By Sam Uribe

Sam Uribe is a researcher and writer. She lends her expertise to the team at Birth Injury Guide to provide up-to-date and relevant content that clients can count on.